Dangerous by design The People Most At Risk A people-focused approach to traffic safety identifies and prioritizes the safety of those who are most exposed to danger, those who are most vulnerable to danger, and those who bear disproportionate risk of injury or death—namely people outside of vehicles, older adults, people with disabilities, people of color, and people walking in lower-income areas. Prioritizing Vulnerable Road Users Income Rates of death increase as the income of an area decreases. The per-capita pedestrian fatality rate systematically gets more deadly as a census tract’s median incomes go down. Despite only accounting for 17 percent of the population, 30 percent of all pedestrian deaths happen in census tracts with yearly incomes below $50,000. The fatality rate in census tracts with incomes between $15,000 and $25,000 is more than four times higher than in areas with a median income over $100,000 (4.90 vs 1.07). Race The data show that people of color, particularly American Indian and Alaska Native populations, are more likely to die while walking than people from any other race or ethnic group. This group, plus Black Americans, combined to account for nearly 22 percent of all pedestrian deaths in metro areas despite accounting for just under 13 percent of the population. Black people are killed at more than twice the rate of white people; Native people are killed at over four times the rate of white people. These disparities are also felt with injuries The rate of emergency department visits for pedestrian injuries was significantly higher for all people of color compared to that for non-Hispanic white people. 45 out of every 100,000 emergency department visits were for a walking-related injury, but that proportion dipped to just 32 out of 100,000 visits for white people. The proportion was nearly double for Black people (62 out of 100,000). Age People between the ages of 50 and 65, and people over 75, are more likely to be struck and killed while walking. Crashes that may result in only injuries for younger people are more likely to become severe injuries or deaths for older people. When the mobility of older people is reduced—whether that’s because of the lack of safe infrastructure for walking, the higher risk to their lives, or they stop driving—their social isolation and disconnection increases, which leads to negative health outcomes.
The out-sized impacts (despite underreporting) on Native Americans Though accounting for less than 3 percent of the landmass of the US, in 2022 alone, Indigenous reservations were the site of at least 44 pedestrian deaths (a fatality rate of 2.9 per year per 100,000). Between 2018 and 2022, at least 254 pedestrians traveling on Indigenous reservations have been involved in traffic violence incidents. Across the US during this same time frame, the pedestrian death rate was 2.06 percent; the death rate on reservations was 3.39 percent. These numbers are striking since nearly 5 percent of Indigenous people living on tribal lands weren’t counted in the 2020 Census. Reservations are oftentimes underinvested in by federal programs and must find ways to improve safety on roads often owned by counties, states, or the interstate highway system. Even for those communities committed to making changes, they face an uphill climb in seeing them funded or installed. 0 The Centers for Disease Control and Prevention provided support for data analysis and synthesis used in the report under cooperative agreement OT18-1802 supporting the Active People, Healthy NationSM Initiative, a national initiative led by the CDC to help 27 million Americans become more physically active by 2027. Learn more: https://www.cdc.gov/physicalactivity/activepeoplehealthynation/index.html. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.