The discrepancy between encouraging young people to walk to benefit their health and keeping them safe on the roads is explored. Child pedestrian death rates have declined in the USA but this is related more to reduced exposure than to a safer environment or better pedestrian skills. Boys are more likely to be injured than girls, largely because of greater exposure to traffic. Toddlers sustain the highest overall number of pedestrian injuries. They are particularly vulnerable to reversing in driveways. Mid-block accidents are commonest at 3-9 years of age, particularly where children attempt to cross between parked cars. Adolescents are more likely to be injured on busier roads, further from home. Parents of 5- to 9-year-olds often overestimate their road crossing skills. High traffic volume, low parental income and younger age are most strongly related to child pedestrian injury. Surveillance systems linked to child pedestrian injury are considered inadequate and the opportunity to improve roads is lost. Sociological, individual, engineering and educational factors linked with child pedestrian accidents are explored and the combination of improved highway design with practical rather than classroom-based training in crossing the road is suggested as the way forward.
Abstract