Motor vehicle deaths in children: Geographic variations

doi:10.1016/0001-4575(91)90031-Y

Accident Analysis & Prevention

Volume 23, Issue 1, February 1991, Pages 19-28

https://doi.org/10.1016/0001-4575(91)90031-Y Get rights and content

Abstract

Motor vehicle-related injury is the leading cause of death in children ages 0–14 years in the United States. Using data from the National Center for Health Statistics and the Fatal Accident Reporting System, specific types of motor vehicle injury death in children were examined for the years 1980–1985 (using NCHS data) and 1985–1986 (using FARS data). Death rates were calculated for each specific category of motor vehicle injury for each state and were then mapped to determine patterns of geographic variation. In general, nontraffic pedestrian death rates and death rates for crashes involving light trucks and/or rollovers were higher in the West, and rates of pedestrian deaths in traffic were highest in the South. Some of the likely contributing factors and possible interventions are discussed.

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Are we failing our rural communities? Motor vehicle injury in British Columbia, Canada, 2001-2007
2012, Injury
Citation Excerpt :
Despite these substantial improvements, it remains unknown whether these changes are equally distributed across all populations and amongst all geographic regions. In the US, rural crashes have been shown to account for the majority of motor vehicle collisions and deaths.3–6 However, albeit with few exceptions,7 stratification by geographic area in Canadian injury prevention literature remains rare, and is largely void from provincial and national reporting efforts.
In Canada, stratification by geographic area or socio-economic status remains relatively rare in national and provincial reporting and surveillance for injury prevention and trauma care. As injuries are known to affect some populations more than others, a more nuanced understanding of injury risk may in turn inform more effective prevention policy. In this study we assessed rates of hospitalization and death from motor vehicle collisions (MVC) in British Columbia (BC) by socio-economic status (SES) and by rural and urban status between 2001 and 2007. Excess risk in injury morbidity and mortality between different SES groups were assessed using a population attributable fraction (PAF). Over a six-year period rural populations in BC experienced a three-fold increase in relative risk of death and an average of 50% increase in relative risk of hospitalization due to injury. When assessed against SES, relative risk of MVC mortality increased from 2.36 (2.05–2.72) to 4.07 (3.35–4.95) in reference to the least deprived areas, with an estimated 40% of all MVC-related mortality attributable to the relative differences across SES classes. Results from this study challenge current provincial and national reporting practises and emphasize the utility of employing the PAF for assessing variations in injury morbidity and mortality.
Is it safe to walk in the Sunbelt? Geographic variation among pedestrian fatalities in the United States, 1999-2003
2006, Journal of Safety Research
Previous work using data from the 1980s showed higher rates of pedestrian mortality in the southern United States.
This study was a descriptive analysis of state-specific mortality information from the National Center for Health Statistics for 1999–2002 and the National Highway Traffic Safety Administration for 2003.
Highest rates were in the southern rim (“Sunbelt”) states for the U.S. population and for the non-Hispanic white population. Rural rates in the highest quartile were 2.1 (95% CI 1.8 to 2.6) times those in the lowest quartile. Urban rates in the highest quartile were 2.2 (95% CI 1.9 to 2.5) times those in the lowest quartile. Posted speed limits at crash sites were 2.6 (95% CI 2.0 to 3.4) times more likely to be ≥ 35 mph (48.3 km/h) in the highest quartile than in the lowest quartile. Pedestrians killed in the highest quartile were 1.9 (95% CI 1.2 to 3.1) times more likely to have blood alcohol concentrations ≥ 0.25 g/dL than pedestrians in the lowest quartile.
The highest pedestrian fatality rates concentrate in Sunbelt states experiencing rapid population growth in the past 50 years. This pattern may result from at least three features of these states: (a) a high percentage of urban vehicle miles traveled; (b) urban sprawl; and (c) a high prevalence of alcohol use — especially heavy use — among Sunbelt pedestrians.
Understanding spatial concentrations of road accidents using frequent item sets
2005, Accident Analysis and Prevention
Citation Excerpt :
This probably indicates that “black” zones often correspond to road segments close to schools, playgrounds or other activities characterizing densely built areas. This confirms former papers showing that pedestrian injury collisions often occur when and where large numbers of pedestrians travel within complex roadway systems with high traffic flows (see e.g. Baker et al., 1991; Braddock et al., 1994; LaScala et al., 2000 or Julien and Carré, 2002). Educational as well as environmental prevention efforts should hence focus on the harmonization of the road function and aspects such as traffic flow and local neighborhood as well as raising community awareness about the risks associated with them.
This paper aims at understanding why road accidents tend to cluster in specific road segments. More particularly, it aims at analyzing which are the characteristics of the accidents occurring in “black” zones compared to those scattered all over the road. A technique of frequent item sets (data mining) is applied for automatically identifying accident circumstances that frequently occur together, for accidents located in and outside “black” zones. A Belgian periurban region is used as case study. Results show that accidents occurring in “black” zones are characterized by left-turns at signalized intersections, collisions with pedestrians, loss control of the vehicle (run-off-roadway) and rainy weather conditions. Accidents occurring outside “black” zones (scattered in space) are characterized by left turns on intersections with traffic signs, head-on collisions and drunken road user(s). Furthermore, parallel collisions and accidents on highways or roads with separated lanes, occurring at night or during the weekend are frequently occurring accident patterns for all accident locations. These exploratory results show the potentiality of the frequent item set method in addition to more classical statistical techniques, but also suggest that there is no unique countermeasure for reducing the number of accidents.
Demographic and environmental correlates of pedestrian injury collisions: A spatial analysis
2000, Accident Analysis and Prevention
Citation Excerpt :
Child pedestrian research has found several environmental factors to be associated with pedestrian injury, including traffic flow, traffic speed, the presence of curbside parking and the presence of pedestrian footpaths (Roberts et al., 1995; Stevenson et al., 1995). Other child pedestrian studies have examined geographic variations such as differences in child pedestrian death rates at the state-level (Baker et al., 1991) and identified characteristics of high frequency collision sites using a geographic information system (Braddock et al., 1994). Another recent study of adult pedestrians estimated the effects of reduced travel speeds on pedestrian fatalities (Anderson et al., 1997).
Pedestrian injury collisions often occur when and where large numbers of pedestrians travel within complex roadway systems with high traffic flow. The pedestrian injury literature suggests a number of individual and environmental correlates of injury risks, however studies in this area have primarily focused upon demographic differences (e.g. related to age) and a few global characteristics of the roadway system (e.g. aspects of pedestrian traffic). Studies in which the geography of communities has been considered are primarily descriptive, identifying pedestrian injury ‘hot spots’. The current study more extensively explores some geographic correlates of pedestrian injury collisions through a spatial analysis of data from the city of San Francisco, CA. A spatial autocorrelation corrected regression model was used to determine factors associated with pedestrian traffic injury in 1990. The study used a geographic information system to map locations of pedestrian injuries, and environmental and demographic characteristics of the city across census tract units. In addition to a number of demographic factors (gender, age, marital status, education, income and unemployment), it was proposed that several environmental features of the city would be related to injury rates (high traffic flow, complex roadway systems, greater population densities and alcohol availability). Results of the study showed that pedestrian injury rates were related to traffic flow, population density, age composition of the local population, unemployment, gender and education. Availability of alcohol through bars was directly related to pedestrian injury collisions in which the pedestrian had been drinking alcohol.
Analysis of circumstances and injuries in 217 pedestrian traffic fatalities
1998, Accident Analysis and Prevention
We performed a retrospective analysis of 217 pedestrian traffic fatalities in Seattle, WA, U.S.A. that occurred over a six-year period using medical examiner records with essentially all of the deaths examined by autopsy. The annual pedestrian fatality rate for the county averaged 2.0/100,000 for all ages and both sexes, and the age-specific rate varied from 1.0/100,000 for the 22–34 year age group to 1.5/100,000 for children under seven years and 7.0/100,000 for ages 70 years and older. Males had a 50% higher rate than females. Fatal accidents were most common during December and January and during the evening hours. Wednesday had the greatest number of accidents leading to death, 79% higher than the Saturday weekend rate. Of those tested, 24% had ethanol in their blood. 66% of the fatal injuries occurred on city or residential streets, and 29% occurred on major thoroughfares. A single urban highway accounted for 12% of pedestrian fatalities and represented a particularly hazardous traffic environment. Fatal head injuries and severe chest injuries were present in 73% of cases; injuries involving multiple sites were present in 60%. There were few significant differences in the extent of injuries with respect to vehicle speed or type of vehicle. Head injuries were much less common in the oldest age group, probably because elderly pedestrians were more vulnerable to death from less severe trunk and extremity injuries. Severe chest injury was the most important predictor of death occurring at the scene.
Paediatric slow-speed non-traffic fatalities: Victoria, Australia, 1985-1995
1997, Accident Analysis and Prevention
An important group of fatal incidents are slow-speed pedestrian non-traffic incidents to children, which account for 14% of accidental deaths from all causes in Victorian children under 5 years of age between 1985 and 1995, and 12% of pedestrian deaths of all ages. In Victoria, Australia, the database of the state Consultative Council on Obstetric and Paediatric Morbidity and Mortality was utilised to identify paediatric slow-speed pedestrian non-traffic-accident deaths in the local population. Additional data relating to the car and its driver, the child, and the circumstances of the incident were abstracted from records kept by the State Coroner and the Victorian compulsory third party traffic injury insurance organisation. Twenty eight Victorian children were identified who had died in one of three types of incident (driverless cars, child interacting with the vehicle and driver, and drivers who were unaware of the child's proximity). These incidents were more common in rural areas compared with urban, usually occurring at the child's home. The child was with or near an adult on all occasions. The vehicle was usually being driven by a relative, and was reversing in a higher proportion of ‘unaware’ incidents compared with the ‘interactive’ type. The association of ‘off-road’ family vehicles and trucks with these incidents appears to be increasing, especially in recent years. These findings suggest some countermeasures, including the separation of vehicle driveways from children's play areas, and object vicinity ultrasonic warning devices for vehicles.

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Motor vehicle deaths in children: Geographic variations

Abstract

Accid. Anal. Prev.

The Injury Fact Book

Childhood Injury Mortality: State-by-State Mortality Facts

Geographic variations in mortality from motor vehicle crashes

N. Eng. J. Med.

County mapping of injury mortality

J. Trauma

Fatal pedestrian injuries to young children: A different pattern of injury

Am. J. Public Health

Study of fatal rollover crashes in the Navajo area