Local Infrastructure and Economy Predicts Traffic Related Fatalities in Children | 2017-2021 | Cross-sectional ecological study | Inclusion criteria: | Counties with >100,000 children | ≥1 pediatric traffic fatality | Significant predictors of pediatric motor vehicle collision (MVC) related mortality: | walkability | social vulnerability index | food area deprivation | population density | public school density | Most walkable counties = 50% pediatric MVC deaths vs least walkable counties | Conclusion: | Urban planning policies should improve community walkability, which reduces the rates of pediatric traffic deaths. | https://doi.org/10.1016/j.jpedsurg.2024.162109 | Hellmann ZJ et al. | Division of Pediatric Surgery, Yale New Haven Children's Hospital, United States | Journal of Pediatric Surgery | @LizzyPAC8 | @globalcastmd | @StayCurrentMD | Cincinnati Children's
Local Infrastructure and Economy Predicts Traffic Related Fatalities in Children
Infographic · Aug 2025 · 1 min read
In brief
In brief
County-level analysis of 158 US counties found that poor walkability infrastructure independently predicts higher pediatric traffic fatality rates, with each decile increase in walkability associated with 7% decreased mortality. The findings suggest that improving local infrastructure and walkability may be an effective policy intervention to reduce child traffic deaths.
- Counties with poor walkability infrastructure have significantly higher pediatric traffic fatality rates independent of socioeconomic factors.
- Each 10% improvement in National Walk Index correlates with 7% reduction in child MVC mortality (IRR 0.93, 95% CI 0.91-0.96).
- Population density and social vulnerability alone don't fully explain pediatric traffic deaths—local infrastructure design matters.
- 158 high-population US counties analyzed 2017-2021 show walkability is modifiable risk factor for child traffic safety.
- Policy interventions improving pedestrian infrastructure could directly reduce pediatric traffic fatalities at county level.
Written by the GCMD Library team from the infographic.
A multi-panel infographic with turquoise header, light gray middle section, and yellow footer. Left panels show icons of researchers and data visualization. Center panel displays two figures carrying a map with inclusion criteria listed. Bottom section features colorful illustrated cars stacked vertically with a child pedestrian figure. Color-coded bullet points (purple, green, red, gray, teal) highlight key predictors.
Zane J. Hellmanna, Elena Graetzb , Shahyan Rehmana, Miranda Mooreb, Eric B. Schneiderb, Emily R. Christison-Lagaya, Daniel G. Solomon
Purpose
Previous research on pediatric motor vehicle collisions (MVC) and fatalities has primarily focused on patient demographics and crash specific information. This study evaluates whether various measures of local infrastructure, including the National Walk Index (NWI), population density, and public school density, or macroeconomic forces, encapsulated in Social Vulnerability Index (SVI) and food area deprivation (PFA) can predict which counties are most at risk for pediatric traffic fatalities.
Methods
Counties with more than 100,000 children in the most recent US census and ≥1 pediatric traffic fatality as identified in the Fatality Analysis Reporting System (FARS) between 2017 and 2021 were included in the study. Poisson regression modeling was used to identify county level infrastructure and macroeconomic forces that predicted increasing MVC related average annual mortality rate per 100,000 children.
Results
There were 158 counties that met inclusion criteria. Univariate Poisson regression demonstrated that NWI, SVI, PFA, population density, and school density each individually correlated with MVC related mortality rate (p < 0.001 for all predictors). When controlling for SVI and population density, multivariable Poisson regression demonstrated that each decile increase in walkability was associated with a 7 % decrease in MVC related mortality rate (IRR 0.93, 95 % CI 0.91–0.96).
Conclusion
Areas with poor walkability predict the likelihood of pediatric traffic fatality. These findings highlight tangible local and state policy changes that could be implemented to decrease the likelihood of traffic-related child fatality rates in specific counties.