Is it safe to walk in the Sunbelt? Geographic variation among pedestrian fatalities in the United States, 1999

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Is it safe to walk in the Sunbelt? Geographic variation among pedestrian fatalities in the United States, 1999–2003

Paulozzi, Leonard J.

AbstractIntroductionPrevious work using data from the 1980s showed higher rates of pedestrian mortality in the southern United States.MethodsThis 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.ResultsHighest 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.ConclusionsThe 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.