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Trends in school-age pedestrian and pedalcyclist crashes in the USA: 26 states, 2000–2014
  1. Katherine C Wheeler-Martin1,2,
  2. Allison E Curry3,4,
  3. Kristina B Metzger3,
  4. Charles J DiMaggio1,2
  1. 1 Surgery, NYU Langone Medical Center, New York City, New York, USA
  2. 2 Population Health, NYU Langone Medical Center, New York City, New York, USA
  3. 3 Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
  4. 4 Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
  1. Correspondence to Katherine C Wheeler-Martin, Surgery, NYU Langone Medical Center, New York, NY 10016, USA; katherine.wheeler-martin{at}


Background Despite substantial progress, motor vehicle crashes remain a leading killer of US children. Previously, we documented significant positive impacts of Safe Routes to School interventions on school-age pedestrian and pedalcyclist crashes.

Objective To expand our analysis of US trends in motor vehicle crashes involving school-age pedestrians and pedalcyclists, exploring heterogeneity by age and geography.

Methods We obtained recent police-reported crash data from 26 states, calculating population rates of pedestrian and pedalcyclist crashes, crash fatality rates and pedestrian commuter-adjusted crash rates (‘pedestrian danger index’) for school-age children as compared with other age groups. We estimated national and statewide trends by age, injury status, day and travel hour using hierarchical linear modeling.

Results School-age children accounted for nearly one in three pedestrians and one in two pedalcyclists struck in motor vehicle crashes from 2000 to 2014. Yet, the rates of these crashes declined 40% and 53%, respectively, over that time, on average, even as adult rates rose. Average crash rates varied geographically from 24.4 to 100.8 pedestrians and 15.6 to 56.7 pedalcyclists struck per 100 000 youth. Crash rates and fatality rates were inversely correlated.

Conclusions Despite recent increases in adult pedestrian crashes, school-age and younger pedestrians experienced ongoing declines in motor vehicle crashes through 2014 across the USA. There was no evidence of displacement in crash severity; declines were observed in all outcomes. The growing body of state crash data resources can present analytic challenges but also provides unique insights into national and local pedestrian crash trends for all crash outcomes.

  • pedestrian
  • bicycle
  • adolescent
  • child

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  • Contributors KCW-M acquired, maintained and processed all study data, co-developed the analytic plan, analysed the complete data set, and drafted and revised the paper. AEC contributed to study conceptualisation, review and revision, and supervised data acquisition and processing (CHOP Traffic Safety Data Warehouse). KBM contributed to data analyses (CHOP data), advised on the analytic plan and visualisation, and reviewed the paper. CJDM conceptualised the original study design and methodology, supervised data acquisition and analyses, and reviewed and revised the paper.

  • Funding This work was supported by the National Institute of Child Health and Human Development of the US National Institutes of Health, grants number R01-HD087460 (CJDM, PI) and R21-HD092850 (AEC, PI).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data may be obtained from a third party and are not publicly available.