Article Text

Download PDFPDF

13 The epidemiology of police-reported pedestrian injuries treated in North Carolina emergency departments: a focus on health disparities and serious injuries
  1. Katherine Harmon1,
  2. Katherine Peticolas2,
  3. Amy Ising3,
  4. Anne Walleranna3
  1. 1University of North Carolina Highway Safety Research Center
  2. 2North Carolina Department of Health and Human Services
  3. 3Carolina Center of Health Informatics, Department of Emergency Medicine, University of North Carolina at Chapel Hill


Statement of Purpose Older adults, people of color, and residents of lower-income communities are disproportionately represented in pedestrian fatalities. Fatalities, however, represent a small proportion of all pedestrian traffic-related injuries. We linked crash, emergency department (ED) visit, and American Community Survey (ACS) data to examine the socio-demographic and crash characteristics of pedestrian injuries and their association with serious injuries in North Carolina (NC).

Methods/Approach We linked information for pedestrians from 2017 NC police-reported crashes to population-based ED visit and ACS data using hierarchical deterministic linkage methods. We used descriptive epidemiologic methods to calculate injury incidence rates and to examine the relationships among patient, socio-demographic, and crash characteristics and serious injuries, defined using an adapted definition of ‘serious injury’ developed by the National Transportation Safety Board.

Results We linked 45% percent of police-reported pedestrian injuries to NC ED visit data (N=1,398). The 2017 rate of police-reported pedestrian injuries treated in NC EDs was 13.6 visits per 100,000 person-years. Rates per 100,000 person-years (in parentheses) were highest among adults 20–29 years of age (19.2), higher among men (15.5) than women (10.6), and higher among blacks (22.7) than whites (8.2). Patient and socio-demographic characteristics associated with serious injuries included age, sex, race/Hispanic ethnicity, expected source of payment, and county poverty level. Crash characteristics associated with serious injuries included posted speed limit, ambient light, number of lanes, and striking vehicle type.

Conclusion Pedestrian injuries are not distributed evenly across the NC population. Communities of color and counties with high levels of poverty are disproportionately impacted. Key crash characteristics are associated with rates of serious injury.

Significance/Contribution to Injury and Violence Prevention Science Policies, interventions, and other countermeasures designed to prevent pedestrian injuries should recognize and address social disparities and promote health equity.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.