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Wang H, Su X, Fan M, Schwebel DC. The more peers are present, the more adventurous? How peer presence influences adolescent pedestrian safety. TRANSPORTATION RESEARCH. PART F, TRAFFIC PSYCHOLOGY AND BEHAVIOUR 2024; 102:155-163. [PMID: 38559498 PMCID: PMC10977920 DOI: 10.1016/j.trf.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Objective Adolescence is a high-risk period for traffic injury. One factor that may impact adolescent safety in traffic is the presence of peers. We conducted a quasi-experimental research study to examine the impact of peer presence, peer familiarity, and peer group size on adolescent pedestrian risk-taking intentions in both sidewalk and street-crossing settings. Methods 607 students aged 12-18 years from Nantong city, China, completed a questionnaire that presented 20 traffic scenarios. The scenarios varied based on a 3 (peer group size: no peer vs. one peer vs. multiple peers) x 2 (peer familiarity: familiar vs. unfamiliar) x 2 (traffic setting: crossing the street vs. walking on the roadside) experimental design. Adolescents' responses indicated safer vs riskier intentions in each situation. Results Results found that: (1) Adolescents were safer when walking on the sidewalk than when crossing the street; (2) Whether crossing the street or walking on the sidewalk, adolescents' behavioral intentions were safer when there were peers present than when there were no peers present; (3) Adolescents' safety tended to be higher overall with unfamiliar peers than with familiar peers; (4) Adolescents were less safe when crossing the street with familiar peer(s) than with unfamiliar peer(s), but no differences emerged when walking on the sidewalk. Conclusions Adolescents report safer behavior when walking with a peer or peers compared with walking alone. Familiar peers reduce adolescents' safety of behavior intentions in traffic, especially when crossing the street.
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Affiliation(s)
- Huarong Wang
- Department of Traffic Psychology, Institute of Special Environmental Medicine, Nantong University, 9 Seyuan Road, Nantong, Jiangsu Province 226019, China
| | - Xueyang Su
- Department of Traffic Psychology, Institute of Special Environmental Medicine, Nantong University, 9 Seyuan Road, Nantong, Jiangsu Province 226019, China
| | - Mengmeng Fan
- Department of Traffic Psychology, Institute of Special Environmental Medicine, Nantong University, 9 Seyuan Road, Nantong, Jiangsu Province 226019, China
| | - David C Schwebel
- Department of Psychology, University of Alabama at Birmingham, 1300 University Blvd, CH 415, Birmingham, AL 35294, USA
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Saberi RA, Stoler J, Gilna GP, Turpin AG, Huerta CT, Ramsey WA, O'Neil CF, Meizoso JP, Brady AC, Hogan AR, Ford HR, Perez EA, Sola JE, Thorson CM. Pediatric Pedestrian Injuries: Striking Too Close to Home. J Pediatr Surg 2023; 58:1809-1815. [PMID: 37121883 DOI: 10.1016/j.jpedsurg.2023.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 03/01/2023] [Accepted: 03/27/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND Pediatric pedestrian injuries (PPI) are a major public health concern. This study utilized geospatial analysis to characterize the risk and injury severity of PPI. METHODS A retrospective chart review of PPI patients (age < 18) from a level 1 trauma center was performed (2013-2020). A geographic information system geocoded injury location to home and other public landmarks. Incidents were aggregated to zip codes and the Local Indicators of Spatial Association statistic tested for spatial clustering of injury rates per 10,000 children. Predictors for increased injury severity were assessed by logistic regression. RESULTS PPI encompassed 6% (n = 188) of pediatric traumas. Most patients were black (54%), male (58%), >13 years (56%), and with Medicaid insurance (68%). Nine zip codes comprised a statistically significant cluster of PPI. Nearly half (40%) occurred within a quarter mile of home; 7% occurred at home. Most (65%) PPI occurred within 1 mile of a school, and 45% occurred within a quarter mile of a park. Nearly all (99%) PPI occurred within a quarter mile of a major intersection and/or roadway. Using admission to ICU as a marker for injury severity, farther distance from home (OR 1.060, 95% CI 1.001-1.121, p = 0.045) and age <13 years (3.662, 95% CI 1.854-7.231, p < 0.001) were independent predictors of injury severity. CONCLUSIONS There are significant sociodemographic disparities in PPI. Most injuries occur near patients' homes and other public landmarks. Multidisciplinary injury prevention collaboration can help inform policymakers, direct local safety programs, and provide a model for PPI prevention at the national level. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Rebecca A Saberi
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA; Ryder Trauma Center at Jackson Memorial Hospital, Miami, FL, USA.
| | - Justin Stoler
- Department of Public Health Sciences, Department of Geography and Sustainable Development, University of Miami, Coral Gables, FL, USA
| | - Gareth P Gilna
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA; Ryder Trauma Center at Jackson Memorial Hospital, Miami, FL, USA
| | - Alexa G Turpin
- Department of Surgery, New York-Presbyterian Weill Cornell Medical Center, New York, NY, USA
| | - Carlos T Huerta
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Walter A Ramsey
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA; Ryder Trauma Center at Jackson Memorial Hospital, Miami, FL, USA
| | - Christopher F O'Neil
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA; Ryder Trauma Center at Jackson Memorial Hospital, Miami, FL, USA
| | - Jonathan P Meizoso
- Ryder Trauma Center at Jackson Memorial Hospital, Miami, FL, USA; DeWitt Daughtry Family Department of Surgery, Division of Trauma and Surgical Critical Care, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ann-Christina Brady
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Anthony R Hogan
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Henri R Ford
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Eduardo A Perez
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Juan E Sola
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Chad M Thorson
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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Rothman L, Schwartz N, Cloutier MS, Winters M, Macarthur C, Hagel BE, Macpherson AK, El Amiri N, Fuselli P, Howard AW. Child pedestrian and cyclist injuries, and the built and social environment across Canadian cities: the Child Active Transportation Safety and the Environment Study (CHASE). Inj Prev 2022; 28:311-317. [PMID: 35058306 PMCID: PMC9340017 DOI: 10.1136/injuryprev-2021-044459] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 12/31/2021] [Indexed: 12/02/2022]
Abstract
Introduction Traffic injury is a leading and preventable cause of child death and disability, with child pedestrians and cyclists particularly vulnerable. Examining built environment correlates of child pedestrian and cyclist motor vehicle collisions (PCMVC) in different settings is needed to promote an evidence-based approach to road safety. Methods We conducted a cross-sectional study across multiple urban/suburban environments in Canada (Calgary, Toronto, Montreal, Laval, Peel Region). All public elementary schools were included (n=1030). We examined the role of land use/social environments, road environments and traffic safety interventions on the rates of child PCMVC within 1000 m of schools. Multivariable negative binomial regression was conducted for all cities and by individual city. In a subset of schools (n=389), we examined associations when controlling for active school transportation (AST). Results Mean PCMVC rate per school ranged from 0.13 collisions/year in Peel to 0.35 in Montreal. Child PCMVC were correlated with land use, social and road environments and traffic safety interventions. In fully adjusted models, social and land use features remained the most important correlates. New immigrant population had the largest positive association with child PCMVC (incidence rate ratio (IRR): 1.26, 95% CI 1.06 to 1.50), while old housing (pre-1960) density was most protective (IRR: 0.83, 95% CI 0.77 to 0.90). AST was associated with PCMVC, but it had no effect on the relationships between PCMVC and other social/environmental correlates. Conclusion The built environment and social factors influence rates of child PCMVC. Opportunities to reduce child PCMVC exist through modifications to city design and road environments and implementing traffic safety interventions.
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Affiliation(s)
- Linda Rothman
- School of Occupational and Public Health, Ryerson University, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children, SickKids Research Institute, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Naomi Schwartz
- School of Occupational and Public Health, Ryerson University, Toronto, Ontario, Canada
| | - Marie-Soleil Cloutier
- Centre Urbanisation Culture Société, Institut National de la Recherche Scientifique, Montreal, Québec, Canada
| | - Meghan Winters
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Colin Macarthur
- Child Health Evaluative Sciences, The Hospital for Sick Children, SickKids Research Institute, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Brent E Hagel
- Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Alison K Macpherson
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Nisrine El Amiri
- Child Health Evaluative Sciences, The Hospital for Sick Children, SickKids Research Institute, Toronto, Ontario, Canada
| | | | - Andrew William Howard
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Orthopaedic Surgery, Child Health and Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
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Uthkarsh P, Babu YRM, Gangaboraiah A. Road traffic injuries among schoolchildren from Rural and Urban Districts of South India: A cross-sectional study. INDIAN JOURNAL OF MEDICAL SPECIALITIES 2022. [DOI: 10.4103/injms.injms_71_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Useche SA, Hezaveh AM, Llamazares FJ, Cherry C. Not gendered… but different from each other? A structural equation model for explaining risky road behaviors of female and male pedestrians. ACCIDENT; ANALYSIS AND PREVENTION 2021; 150:105942. [PMID: 33338915 DOI: 10.1016/j.aap.2020.105942] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 11/16/2020] [Accepted: 12/05/2020] [Indexed: 06/12/2023]
Abstract
UNLABELLED As alternative transportation is getting more and more fashionable, and more people worldwide are "shifting" to walking trips, even for their daily commuting, traffic crashes suffered by pedestrians are still a great concern for road safety and public health researchers and practitioners. In this regard, risky or "aberrant" road behaviors have emerged, during the last few years, as a key issue to be considered for crash prevention. Nevertheless, the idea of a "generic pedestrian" is getting re-evaluated, and analyzing key features, such as gender, seems to be crucial for understanding pedestrians' performance and safety outcomes. OBJECTIVE The objective of this study was to examine the effect of gender on pedestrians' both deliberate (traffic violations) and undeliberate (errors) risky walking behaviors, considering a set of theoretically based demographic and psychosocial variables as their potential predictors. METHOD For this cross-sectional study, data from 1070 Spanish pedestrians (60 % females and 40 % males, aged between 16 and 79) from the 17 regions of Spain, responding to an electronic questionnaire, were analyzed through a multi-group structural equation modeling (MGSEM) approach. RESULTS Although age, handheld device-interaction, and sensation-seeking seem to have a similar effect on the errors and violations reported by both genders (similarities), factors such as risk perception, educational level and the misbehaviors observed in other road users are significant predictors only in the case of male pedestrians. On the other hand, road distractions have been shown to play a significant role in females' errors and violations, while males' road distractions seem to only affect their involuntary risky behaviors. CONCLUSION The findings of this study support the influence of gender in the statistical explanation of both deliberate and undeliberate walking risky road behaviors, also depicting the differential role of certain demographic and psychosocial factors when we compare male and female pedestrians.
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Affiliation(s)
- Sergio A Useche
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, 46022, Spain; INTRAS (Research Institute on Traffic and Road Safety), University of Valencia, Valencia, 46022, Spain.
| | - Amin Mohamadi Hezaveh
- Civil and Environmental Engineering, University of Tennessee, Knoxville, TN 37996-2313, United States.
| | | | - Christopher Cherry
- Civil and Environmental Engineering, University of Tennessee, Knoxville, TN 37996-2313, United States.
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Abstract
The analysis of pedestrian–vehicle crashes makes a significant contribution to sustainable pedestrian safety. Existing research is based mainly on the statistical analysis of traffic crashes involving pedestrians and their causes, without the identification of areas vulnerable to traffic crashes that involve pedestrians. The main aim of this paper is to identify areas vulnerable to school-aged pedestrian–vehicle crashes at a local level to support the local authorities in implementing new urban traffic safety measures. The vulnerable areas were determined by computing the severity index (SI) based on the number of fatal, serious, and slight casualties throughout the 2011–2016 period in a large urban agglomeration (Bucharest). As well as the vulnerable areas, the triggering factors and the time intervals related to school-aged pedestrian–vehicle crashes were identified. The outcomes of the study showed that the vulnerable areas were concentrated only in districts 2 and 4 of Bucharest, and they were associated with high vehicle speed and pedestrians’ unsafe crossing behavior. The findings revealed that speed and age are triggering factors in generating school-aged pedestrian–vehicle crashes. The identified time peaks with a high number of traffic crashes correspond to the afternoon time intervals, when scholars go home from school. The identification of the areas vulnerable to school-aged pedestrian crashes may help local authorities in identifying and implementing measures to improve traffic safety in large urban agglomerations.
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Barranco-Ruiz Y, Guevara-Paz AX, Ramírez-Vélez R, Chillón P, Villa-González E. Mode of Commuting to School and Its Association with Physical Activity and Sedentary Habits in Young Ecuadorian Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2704. [PMID: 30513629 PMCID: PMC6313456 DOI: 10.3390/ijerph15122704] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 11/06/2018] [Accepted: 11/23/2018] [Indexed: 12/16/2022]
Abstract
Active commuting to and from school (ACS) could help to increase daily physical activity levels in youth; however, this association remains unknown in Ecuadorian youth. Thus, the aims of this study were (1) to determine the patterns of commuting to and from school and (2) to analyze the associations between ACS, physical activity (PA), and sedentary habits in Ecuadorian youth. A total of 732 students (65.3% males), aged 10⁻18 years (children = 246, young adolescents = 310, older adolescents = 162) from the central region of Ecuador participated in this study. A self-report questionnaire, including the usual mode and frequency of commuting, distance from home to school (PACO-Questionnaire), and PA and sedentary habits (YAP-Questionnaire), was used. Most of the sample lived ≤2 km from school; however, they were mainly passive commuters (96%). The most common mode of commuting was by car (to school = 43.4%, from school = 31.6%; p < 0.001). Children presented significantly higher scores (0⁻4) in PA outside school and total PA compared with older adolescents (2.20 ± 0.97 vs. 1.97 ± 0.96; p = 0.013 and 2.30 ± 0.76 vs. 2.09 ± 0.74, p = 0.019, respectively), as well as the lowest scores in sedentary habits (1.51 ± 0.65, p < 0.001). PA at school and total PA were positively associated with ACS (OR 3.137; 95% CI, 1.918 to 5.131; p < 0.001, and OR 2.543; 95% CI, 1.428 to 4.527; p = 0.002, respectively). In conclusion, passive modes of transportation were the most frequently used to commute to and from school in young Ecuadorians. PA at school and total PA were positively associated with ACS. Thus, interventions at school setting could be an opportunity to improve PA levels and additionally ACS in youth from the central region of Ecuador.
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Affiliation(s)
- Yaira Barranco-Ruiz
- Promoting Fitness and Health through Physical Activity Research Group (PROFITH), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain.
- Escuela de Cultura Física, Universidad Nacional de Chimborazo, Riobamba 060110, Ecuador.
| | | | - Robinson Ramírez-Vélez
- Centro de Estudios Para la Medición de la Actividad Física CEMA, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá 111221, Colombia.
| | - Palma Chillón
- Promoting Fitness and Health through Physical Activity Research Group (PROFITH), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain.
| | - Emilio Villa-González
- Promoting Fitness and Health through Physical Activity Research Group (PROFITH), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain.
- Escuela de Cultura Física, Universidad Nacional de Chimborazo, Riobamba 060110, Ecuador.
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Reduction of pediatric pedestrian hazardous road conditions in a school drop-off zone using video review. J Trauma Acute Care Surg 2017; 83:S227-S232. [PMID: 28570345 DOI: 10.1097/ta.0000000000001599] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND In 2012, 76,000 pedestrians were struck by motor vehicles. This resulted in 20% of all pediatric mortalities between the ages of 5 and 15. We hypothesize that children are exposed to increased risk as pedestrians to motor vehicle injury when arriving to school and that identification of these hazards would improve targeting of injury prevention efforts. METHODS Within a county containing 355 public schools, we identified a primary school with 588 students located in an urban setting with concerns for a high-risk traffic environment. Field surveys observed traffic patterns and established an optimal surveillance period 30 minutes before school. Three observation periods, from two discreet and blinded locations, were conducted from January to March 2016. Videos were evaluated by two independent reviewers to identify and score quantifiable hazards. Three controlled observations were conducted on non-school days, followed by three post-intervention observations from October to December 2016. Comparison was made using Student's t test. Data was analyzed using SAS version 9.4 (SAS Institute Inc., Cary, NC). RESULTS We identified nine safety hazards including double parking (29.3 ± 5.5), dropping off in a bus stop (23.3 ± 7.6), and jaywalking (9.3 ± 3.1). Combining all hazards seen in each observation resulted in an overall hazard average of 83.0 ± 3.6 events/period. Comparing control periods to school observation identified significantly increased hazard events on school days (p < 0.0001). Targeted safety intervention demonstrated a 26% reduction in hazard events (p < 0.0005). CONCLUSION We identified the most common hazards associated with children arriving at a primary school in an urban setting, used our analysis to develop an intervention, and demonstrated the impact of our intervention. Our novel use of video review to identify hazards provides a metric against which the impact of pedestrian road safety interventions might be measured. LEVEL OF EVIDENCE Epidemiological, level II; Therapeutic, level IV.
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Jamshidi E, Moradi A, Majdzadeh R. Environmental risk factors contributing to traffic accidents in children: a case-control study. Int J Inj Contr Saf Promot 2016; 24:338-344. [PMID: 27282919 DOI: 10.1080/17457300.2016.1183031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The aim of this study is to identify environmental risk factors related to road accidents in children of Tehran. This case-control study was performed in 2013. The cases were injured pedestrians aged 5-15 who were admitted to major hospitals supervised by Tehran University of Medical Sciences. The sample size for the cases was 273 and for the control group was 546. For the completeness of the clusters, 7 extra persons in case (total = 280) and 14 persons (total = 560) in control group were included. The interference of confounding variables assessed through forward conditional logistic regression. Result shows occurrence of traffic accidents was significantly associate with the width of the alleys or (<5 m: OR = 8.4, 95% CI: 3.3-21.5; 5-8 m: OR = 4.7, 95% CI: 1.8-12.2), distance from home to school((<100 m: OR = 1.7, 95% CI: 1.0-2.8), existence of parking lot (OR = 1.5, 95% CI: 1.0-2.3), traffic congestion (OR = 4.1, 95% CI: 2.6-6.4), traffic speed (OR = 2.1, 95% CI: 1.3-3.2) and existence of pedestrian bridges(OR = 4.2, 95% CI: 2.6-6.8). In the light of the important role of environmental factors in the occurrence of child traffic accidents, alleviating structural risk factors in addition to education and enforcement need more systematic efforts and planning by policymakers and urban planners to attain pedestrian safety goals.
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Affiliation(s)
- Ensiyeh Jamshidi
- a Department of Health Education and Promotion , School of Public Health, Tehran University of Medical Sciences , Tehran , Iran.,b Community Based Participatory Research Center , Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences , Tehran , Iran
| | - Ali Moradi
- c Asadabad Health and Treatment Network , Hamadan University of Medical Sciences , Hamadan , Iran
| | - Reza Majdzadeh
- d Community Based Participatory Research Center, School of Public Health , Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences , Tehran , Iran
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Associations Between the Neighborhood Environment and Moderate-to-Vigorous Walking in New Zealand Children: Findings from the URBAN Study. Sports Med 2016; 46:1003-17. [DOI: 10.1007/s40279-016-0533-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Cutumisu N, Bélanger-Gravel A, Laferté M, Lagarde F, Lemay JF, Gauvin L. Influence of area deprivation and perceived neighbourhood safety on active transport to school among urban Quebec preadolescents. Canadian Journal of Public Health 2014; 105:e376-82. [PMID: 25365273 DOI: 10.17269/cjph.105.4561] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 08/28/2014] [Accepted: 08/15/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study examines associations between area deprivation and perceived neighbourhood safety with active transport to school among preadolescents living in urban Quebec. METHODS A sample of 809 preadolescents aged 9 to 13 years and one each of their parents living in urban Quebec were recruited by a polling firm for a telephone interview about the Opération WIXX multimedia communication campaign. Opération WIXX was launched in 2012 by Québec en forme to promote physical activity among preadolescents. Logistic regression models predicted active transportation to school (as reported by both the child and his or her parent) from area-level material and social deprivation and from parental and children's perceptions of neighbourhood safety while controlling for socio-demographic variables. RESULTS Child and parental reports of active commuting to school were highly concordant (Kendall's tau=0.70, p<0.001). Children whose parents felt at ease to let their children actively commute to school (OR=1.75, 95% CI 1.25-2.45; p=0.001) and who lived in areas characterized by the highest material (OR=2.02, 95% CI 1.09-3.76; p=0.026) and social (OR=3.69, 95% CI 2.12-6.42; p<0.001) deprivation were more likely to report actively commuting to school. Parents who felt at ease to let their children actively commute to school (OR=1.60, 95% CI 1.15-2.21; p=0.005) and who lived in neighbourhoods characterized by a higher social deprivation (OR=1.70, 95% CI 1.04-2.79; p=0.036, OR=2.01, 95% CI 1.23-3.29; p=0.006, OR=2.72, 95% CI 1.59-4.63; p<0.001) were more likely to report that their child actively commuted to school. CONCLUSION Active commuting to school is associated with parental perceptions of safety and area deprivation.
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Affiliation(s)
- Nicoleta Cutumisu
- Centre de recherche du CHUM, Département de médecine sociale et préventive, École de santé publique, Université de Montréal.
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Gorios C, de Souza RM, Gerolla V, Maso B, Rodrigues CL, Armond JDE. Acidentes de transporte de crianças e adolescentes em serviço de emergência de hospital de ensino, Zona Sul da cidade de São Paulo. Rev Bras Ortop 2014. [DOI: 10.1016/j.rbo.2013.10.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Gorios C, de Souza RM, Gerolla V, Maso B, Rodrigues CL, Armond JDE. Transport accidents among children and adolescents at the emergency service of a teaching hospital in the southern zone of the city of São Paulo. Rev Bras Ortop 2014; 49:391-5. [PMID: 26229833 PMCID: PMC4511626 DOI: 10.1016/j.rboe.2014.04.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Accepted: 10/10/2013] [Indexed: 11/30/2022] Open
Abstract
Objective to describe the victim profile and circumstances of transport accidents involving children and adolescents who were attended at a teaching hospital in the southern zone of the city of São Paulo. Methods this was an individual observational case series study among patients up to the age of 19 years who were attended at a hospital in the southern zone of the city of São Paulo, state of São Paulo, Brazil, due to traffic accidents. The files notifying suspected or confirmed cases of violence and accidents (SIVVA files) covering January to December 2012 were analyzed. Results among the 149 cases notified, 64.4% related to males and 35.6% to females. The transport accidents were predominantly among males, irrespective of age. The main injury diagnoses were superficial head trauma (24.8%) followed by multiple non-specified trauma (36.4%), in both sexes. Conclusion transport accidents among children and adolescents occurred more often among males. The main transport accidents among the children and adolescents attended as emergency cases were caused by motor vehicles and motorcycles. Among the accident victims, the largest proportion was attended because of being run over.
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Affiliation(s)
| | | | | | - Bruno Maso
- Universidade de Santo Amaro, São Paulo, SP, Brazil
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Mello Jorge MHP, Martins CBG. [Child, teenager, and traffic: some important considerations]. Rev Assoc Med Bras (1992) 2013; 59:199-208. [PMID: 23684213 DOI: 10.1016/j.ramb.2012.11.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Accepted: 11/05/2012] [Indexed: 11/25/2022] Open
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Barton BK, Ulrich T, Lyday B. The roles of gender, age and cognitive development in children's pedestrian route selection. Child Care Health Dev 2012; 38:280-6. [PMID: 21299593 DOI: 10.1111/j.1365-2214.2010.01202.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Thousands of American children under the age of 10 years are injured annually as pedestrians. Despite the scope of this public health problem, knowledge about behavioural control and developmental factors involved in the aetiology of child pedestrian safety is limited. The present study examined the roles of gender, age and two aspects of cognitive development (visual search and efficiency of processing) in children's safe pedestrian route selection. METHODS Measures of cognitive functioning (visual search and efficiency) and selections of risky pedestrian routes were collected from 65 children aged 5-9 years. RESULTS Boys, younger children and those with less developed cognitive functioning selected riskier pedestrian routes. Cognitive functioning also subsumed age as a predictor of risky route selections. CONCLUSIONS Our findings suggest developmental differences, specifically less developed cognitive functioning, play important roles in children's pedestrian decision making. Directions for future examination are discussed.
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Affiliation(s)
- B K Barton
- Department of Psychology and Communication Studies, University of Idaho, Moscow, ID 83844-3043, USA.
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Understanding the determinants of active transportation to school among children: Evidence of environmental injustice from the Quebec longitudinal study of child development. Health Place 2012; 18:163-71. [PMID: 21937255 DOI: 10.1016/j.healthplace.2011.08.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2010] [Revised: 08/26/2011] [Accepted: 08/27/2011] [Indexed: 12/25/2022]
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Nevelsteen K, Steenberghen T, Van Rompaey A, Uyttersprot L. Controlling factors of the parental safety perception on children's travel mode choice. ACCIDENT; ANALYSIS AND PREVENTION 2012; 45:39-49. [PMID: 22269483 DOI: 10.1016/j.aap.2011.11.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Revised: 10/10/2011] [Accepted: 11/10/2011] [Indexed: 05/31/2023]
Abstract
The travel mode of children changed significantly over the last 20 years, with a decrease of children travelling as pedestrians or cyclists. This study focuses on six to twelve year old children. Parents determine to a large extent the mode choice of children in this age category. Based on the analysis of an extensive survey, the research shows that traffic infrastructure has a significant impact on parental decision making concerning children's travel mode choice, by affecting both the real and the perceived traffic safety. Real traffic safety is quantified in terms of numbers of accidents and road infrastructure. For the perceived traffic safety a parental allowance probability is calculated per road type to show that infrastructure characteristics influence parental decision making on the children's mode choice. A binary logistic model shows that this allowance is determined by age, gender and traffic infrastructure near the child's home or near destinations frequently visited by children. Since both real and perceived traffic safety are influenced by infrastructure characteristics, a spatial analysis of parental perception and accident statistics can be used to indicate the locations where infrastructure improvements will be most effective to increase the number of children travelling - safely - as pedestrians or cyclists.
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Affiliation(s)
- Kristof Nevelsteen
- Spatial Application Division Leuven, K.U. Leuven, Celestijnenlaan 200E, 3001 Heverlee, Belgium.
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Poulos RG, Chong SSS, Olivier J, Jalaludin B. Geospatial analyses to prioritize public health interventions: a case study of pedestrian and pedal cycle injuries in New South Wales, Australia. Int J Public Health 2012; 57:467-75. [DOI: 10.1007/s00038-012-0331-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Revised: 10/28/2011] [Accepted: 01/05/2012] [Indexed: 10/14/2022] Open
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Targeting pediatric pedestrian injury prevention efforts: teasing the information through spatial analysis. ACTA ACUST UNITED AC 2012; 71:S511-6. [PMID: 22072037 DOI: 10.1097/ta.0b013e31823a4b70] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Pediatric pedestrian injuries remain a major cause of childhood death, hospitalization, and disability. To target injury prevention efforts, it is imperative to identify those children at risk. Racial disparities have been noted in the rates of pediatric pedestrian injury and death. Children from low-income families living in dense, urban residential neighborhoods have a higher risk of sustaining pedestrian injury. Geographic information systems (GIS) analysis of associated community factors such as child population density and median income may offer insights into prevention. METHODS Using trauma registry E-codes for pedestrian motor vehicle crashes, children younger than 16 years were identified, who received acute care and were hospitalized at the University of Chicago Medical Center, a Level I pediatric trauma center, after being struck by a motor vehicle from 2002 to 2009. By retrospective chart review and review of the Emergency Medical Services run sheets, demographic data and details of the crash site were collected. Crash sites were aggregated on a block by block basis. A "hot spot" analysis was performed to localize clusters of injury events. Using Gi* statistical method, spatial clusters were identified at different confidence intervals using a fixed distance band of 400 m (≈ ¼ mile). Maps were generated using GIS with 2000 census data to evaluate race, employment, income, density of public and private schools, and density of children living in the neighborhoods surrounding our medical center where crash sites were identified. Spatial correlation is used to identify statistically significant locations. RESULTS There were 3,521 children admitted to the University of Chicago Medical Center for traumatic injuries from 2002 to 2009; 27.7% (974) of these children sustained injuries in pedestrian motor vehicle injuries. From 2002 to 2009, there were a total of 106 traumatic deaths, of which 29 (27.4%) were due to pedestrian motor vehicle crashes. Pediatric pedestrian motor vehicle crash sites occurred predominantly within low-income, predominantly African-American neighborhoods. A lower prevalence of crash sites was observed in the predominantly higher income, non-African-American neighborhoods. CONCLUSIONS Spatial analysis using GIS identified associations between pediatric pedestrian motor vehicle crash sites and the neighborhoods served by our pediatric trauma center. Pediatric pedestrian motor vehicle crash sites occurred predominantly within low-income, African-American neighborhoods. The disparity in prevalence of crash sites is somewhat attributable to the lower density of children living in the predominantly higher income, non-African-American neighborhoods, including the community immediately around our hospital. Traffic volume patterns, as a denominator of these injury events, remain to be studied.
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Barton BK, Huston J. The roles of child, parent and environmental factors in pedestrian supervision. Int J Inj Contr Saf Promot 2011; 19:153-62. [PMID: 22145908 DOI: 10.1080/17457300.2011.635210] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Pedestrian injuries are a significant health risk to children, particularly those 5-9 years of age. Surprisingly, few studies have explored parent-related factors that may moderate this risk. We examined parental supervision choices in the context of child pedestrian experience, parent perceptual factors and varying levels of environmental risk. A series of street crossing scenarios were used to examine the roles of child, parent and environmental factors in determining parents' supervision choices. Parents recognised differing levels of risk across environmental conditions and altered their supervision choices accordingly. Child age and parental risk perception were significantly predictive of supervision choices. Our results demonstrate that parents assess multiple factors when determining the intensity of supervision necessary for their children. Notably, parents adjust their supervision in direct relation to changes in the physical environment. Implications of these findings for injury prevention and future research are discussed.
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Affiliation(s)
- Benjamin K Barton
- Department of Psychology and Communication Studies, University of Idaho, PO Box 443043, Moscow, ID 83844-3043, USA.
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Licaj I, Haddak M, Pochet P, Chiron M. Contextual deprivation, daily travel and road traffic injuries among the young in the Rhône Département (France). ACCIDENT; ANALYSIS AND PREVENTION 2011; 43:1617-1623. [PMID: 21658487 DOI: 10.1016/j.aap.2011.02.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2010] [Revised: 01/10/2011] [Accepted: 02/02/2011] [Indexed: 05/30/2023]
Abstract
This study investigated the effect of the socioeconomic level of the municipality of residence on personal injury road traffic accident risk among young persons of 10-24 years of age in the Rhône Département. This effect was assessed by comparing incidences of injuries (n=2792 casualties) on the basis of three denominators: the resident population of young people, the number of users of each mode and the distances covered by each mode. The results are presented for each type of road users (pedestrians, car passengers, car drivers, motorised two-wheeler riders, cyclists, public transport users). Young persons from deprived municipalities use motorised-two wheelers, bicycles and the car (as passengers and drivers) less frequently, they walk more and take public transports more often than those from other municipalities. When considering injury risk, motorised two wheeler injuries among adolescent males, for example, are significantly less frequent in deprived municipalities. But the motorised two-wheeler riders as well as car passengers from deprived municipalities are characterized by an excess injury risk, whether the selected denominator is the number of users or the kilometres travelled by this mode. For the first time in France, this study has enabled a comparison of the effects of a contextual socioeconomic indicator (the type of municipality of residence, deprived, or not) on daily travel practices and injury incidences among the population, among the users of each mode and per km of travel.
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Affiliation(s)
- Idlir Licaj
- Ifsttar (Institut français des sciences et technologies des transports, de l'aménagement et des réseaux), UMR T9405 (Umrestte), 25 Avenue François Mitterrand, Bron F-69675, France
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Doukas G, Olivier J, Poulos R, Grzebieta R. Exploring differential trends in severe and fatal child pedestrian injury in New South Wales, Australia (1997-2006). ACCIDENT; ANALYSIS AND PREVENTION 2010; 42:1705-1711. [PMID: 20728620 DOI: 10.1016/j.aap.2010.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2009] [Revised: 02/16/2010] [Accepted: 04/19/2010] [Indexed: 05/29/2023]
Abstract
The study explores trends in severe and fatal child pedestrian injuries in New South Wales (NSW), over the 10-year period 1997-2006, in comparison to adults and for various subgroups. Data on pedestrian injury (reported as fatalities or hospitalisations) were obtained from the Traffic Accident Database System (TADS; Roads and Traffic Authority of New South Wales) which captures road traffic events reported to police, and from the NSW Admitted Patients Data Collection (APDC) which captures all hospital inpatient separations. Annual percentage changes in injury counts and rates were compared using Poisson regression. A substantial drop in the pedestrian injury rate was observed; however, the rate of decline was steeper for children (aged less than 15 years) than for adults. The drop in child pedestrian injury was manifest in both the police report data and the hospital admission data. The annual percentage decrease was significantly greater for boys than for girls, and the three major urban centres compared with elsewhere in the state. No differences were detected in the annual rate decrease between school days and non-school days (a proxy for safe school zones), or between different road types (a proxy for restricted speed limits). Past research suggests that injury rate reductions are not solely due to decreased exposure. There remains, however, limited data on the extent of pedestrian mobility. Differences in relative reduction in pedestrian injury rates suggest a differential benefit arising from road safety initiatives.
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Affiliation(s)
- George Doukas
- NSW Injury Risk Management Research Centre, UNSW, Australia
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Martin ND, Grabo DJ, Tang L, Sullivan J, Kaulback KR, Weinstein MS, Lindenbaum GA, Cohen MJ. Are Roadside Pedestrian Injury Patterns Predictable in a Densely Populated, Urban Setting? J Surg Res 2010; 163:323-6. [DOI: 10.1016/j.jss.2010.03.073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2010] [Revised: 03/22/2010] [Accepted: 03/30/2010] [Indexed: 10/19/2022]
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Pediatric Pedestrian Injuries and Associated Hospital Resource Utilization in the United States, 2003. ACTA ACUST UNITED AC 2010; 68:1406-12. [DOI: 10.1097/ta.0b013e3181b28b05] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Pfeffer K, Fagbemi HP, Stennet S. Adult pedestrian behavior when accompanying children on the route to school. TRAFFIC INJURY PREVENTION 2010; 11:188-193. [PMID: 20373239 DOI: 10.1080/15389580903548576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVE Pedestrian injuries are a major cause of morbidity and mortality to children, especially boys. Adults serve as pedestrian role models and provide learning opportunities for children when walking to school. The research objectives were to investigate adult pedestrian behavior when accompanying boys and girls. METHODS Behavioral observation of 140 adult pedestrians accompanying 4- to 9-year-old children was done in British residential locations. Observations took place at light-controlled crossings, speed-restricted school safety zones, and mid-block unmarked crossing sites. Behaviors observed included stopping at the curb, waiting at the curb, looking left and right before and during road crossing, holding hands, talking, and walking straight across. RESULTS In general, adults modeled safe road crossing behaviors. Adult safe behavior scores were higher when accompanying girls than when accompanying boys. No statistically significant differences were found by child age group. The fewest safe pedestrian behaviors were observed at light-controlled crossings. CONCLUSIONS Adult pedestrians behave differently when with boys and girls and at different types of road crossing site. Interventions aimed at reducing pedestrian injuries to children may need to take these different everyday experiences into consideration.
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Affiliation(s)
- K Pfeffer
- School of Psychology, University of Lincoln, Lincoln, UK.
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Carver A, Timperio A, Hesketh K, Crawford D. Are safety-related features of the road environment associated with smaller declines in physical activity among youth? J Urban Health 2010; 87:29-43. [PMID: 19949995 PMCID: PMC2821603 DOI: 10.1007/s11524-009-9402-3] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study examined how objective measures of the local road environment related to safety were associated with change in physical activity (including active transport) among youth. Few longitudinal studies have examined the impact of the road environment on physical activity among children/adolescents in their neighborhoods. Participants were children aged 8-9 years (n = 170) and adolescents aged 13-15 years (n = 276) in 2004. Data were collected in 2004 and 2006 during follow-up of participants recruited initially in 2001 from 19 primary schools in Melbourne, Australia. Walking/cycling to local destinations was parent-reported for children and self-reported by adolescents. Moderate-to-vigorous physical activity (MVPA) during nonschool hours was recorded using accelerometers. Road environment features in each participant's neighborhood (area within 800 m radius of their home) were measured objectively using a Geographical Information System. Linear regression analyses examined associations between road features and changes in active transport (AT) and MVPA over 2 years. Children's AT increased but MVPA levels decreased in both age groups; on average, younger girls recorded the greatest declines. The number of traffic/pedestrian lights was associated with DeltaAT among younger girls (B=0.45, p=0.004). The total length of walking tracks (in meters) was associated with AT among younger girls (B = 0.0016, p = 0.015) and adolescent girls (B = 0.0016, p = 0.002). For adolescent boys, intersection density was associated with AT (B = 0.03, p = 0.030). Slow points were associated with MVPA among younger boys before school (B = 1.55, p = 0.021), while speed humps were associated with MVPA among adolescent boys after school (B = 0.23, p = 0.015). There were many associations for adolescent girls: for example, the total length of local roads (B = 0.49, p = 0.005), intersection density (B = 0.05, p = 0.036), and number of speed humps (B = 0.33, p = 0.020) were associated with MVPA during nonschool hours. Safety-related aspects of the built environment are conducive to physical activity among youth and may help stem age-related declines in physical activity. Passive road safety interventions may promote AT and physical activity among less active girls, in particular.
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Affiliation(s)
- Alison Carver
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia.
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Application of Electronic Surveillance and Global Information System Mapping to Track the Epidemiology of Pediatric Pedestrian Injury. ACTA ACUST UNITED AC 2009; 66:S10-6. [DOI: 10.1097/ta.0b013e3181937bc8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Carver A, Timperio A, Crawford D. Playing it safe: The influence of neighbourhood safety on children's physical activity—A review. Health Place 2008; 14:217-27. [PMID: 17662638 DOI: 10.1016/j.healthplace.2007.06.004] [Citation(s) in RCA: 304] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2006] [Revised: 06/18/2007] [Accepted: 06/19/2007] [Indexed: 11/20/2022]
Abstract
Compared with previous generations, children spend less time playing outdoors and have lower participation rates in active transport. Many studies have identified lack of neighbourhood safety as a potential barrier to children's physical activity. This review describes concerns regarding 'stranger danger' and road safety, and discusses empirical studies that examine associations between neighbourhood safety and physical activity among youth. Variability of perceptions of safety between parents and youth are examined; 'social traps' are identified; and physical/social environmental interventions aimed at improving neighbourhood safety are discussed. A research agenda is suggested for further study of perceived and objective measures of neighbourhood safety and their associations with children's physical activity.
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Affiliation(s)
- Alison Carver
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, VIC, Australia.
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The incidence of injuries traveling to and from school by travel mode. Prev Med 2008; 46:74-6. [PMID: 17997148 DOI: 10.1016/j.ypmed.2007.09.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2007] [Revised: 09/04/2007] [Accepted: 09/04/2007] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To assess the absolute and relative risks of youth school-related travel using the New Zealand's no fault accident liability scheme and Census at School datasets. METHODS Injury risk associated with traveling to and from school was assessed by combining census data from the Accident Compensation Commission database, New Zealand's no fault liability accident scheme database and the Census at School survey. Population injury and cost was assessed for incidents during a 2-year period (1 July 2003 to 30 June 2005) and during normal school travel hours (7.30 a.m.-9.00 a.m., 3.00 p.m.-4.30 p.m., weekdays) for youth 5-17 years of age. RESULTS Overall, 7573 cases were identified as being school travel-related, representing 1.6% of total, and 11.4% school travel period injuries. Walking (30.7%), cycling (30.3%), and motor vehicles (27.7%) provided the majority of injuries. Risk of injury per million trips was highest for cycling (46.1), walking (10.3), and motor vehicle travel (6.1). CONCLUSION These data provide the first comprehensive examination of absolute risk of travel to and from school and by transport mode, showing that school-related travel is a relatively safe activity contributing to a minority of all injuries sustained by youth.
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Abstract
Pedestrian traffic injuries are a growing public health threat worldwide. The global economic burden of motor vehicle collisions and pedestrian injuries approximates $500 billion. In the United States, the number of pedestrian fatalities increased from 4675 in 2004 to 4881 in 2005. In addition nearly 60,000 injuries occurred during the same year. Injury patterns vary depending on the age, sex, and socioeconomic status of the individual. Children comprise one of the most vulnerable populations in pedestrian traffic injuries. Pedestrian injury remains the second leading cause of unintentional injury-related death among children aged 5 to 14 years. The burden of injury, upon the individual, families, and society, is frequently overwhelming. From recent data, pedestrian injuries and deaths are increasing in the United States and the World, and they require particular attention by emergency care providers and policy makers.
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Poudel-Tandukar K, Nakahara S, Ichikawa M, Poudel KC, Jimba M. Risk perception, road behavior, and pedestrian injury among adolescent students in Kathmandu, Nepal. Inj Prev 2007; 13:258-63. [PMID: 17686937 PMCID: PMC2598342 DOI: 10.1136/ip.2006.014662] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To examine the relationship between the perceived safety of specified road behaviors, self-described road behaviors, and pedestrian injury among adolescent students in Kathmandu, Nepal. METHODS A cross-sectional study was conducted among 1557 adolescents in grades 6-8 across 14 schools in Kathmandu using a self-administered questionnaire in 2003. A multiple logistic regression analysis was used to analyze the data. RESULTS Adolescents were more likely to suffer from pedestrian injury when they did not always "wait for green signals to cross the road". There were no significant associations between road behaviors such as "looking both ways along the road before crossing" or "playing in the road or sidewalks" and pedestrian injury. Adolescents who "perceived it safe to cross the road from any point" or "did not perceive it to be safer to cross the road at a zebra crossing" were less likely to "look both ways" or "wait for green signals" before crossing the road. Adolescents who "perceived it to be safe to play in the road" were more likely to play in the road or sidewalk. Similarly, this study showed a positive association between road safety education and adolescents' road crossing behaviors. CONCLUSION Adolescents' road behaviors, except for compliance with green signals, were not significantly associated with pedestrian injury. This suggests that a behavioral approach without modification of the traffic environment (such as provision of crossing signals) might not effectively prevent the occurrence of pedestrian injury in developing countries with poor traffic conditions.
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Affiliation(s)
- Kalpana Poudel-Tandukar
- Department of International Community Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
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Moody KD, Wright FV, Brewer KM, Geisler PE. Community mobility assessment for adolescents with an acquired brain injury: preliminary inter-rater reliability study. Dev Neurorehabil 2007; 10:205-11. [PMID: 17564861 DOI: 10.1080/13638490601104496] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The Community Mobility Assessment (CMA) is an observational assessment that evaluates safety of an adolescent with an acquired brain injury (ABI) during a community outing. It consists of a 3-point level of accomplishment scale for 40 functional items, divided into two components (physical and cognitive). The CMA identifies areas of strength and weakness and facilitates development of compensating strategies. This study was undertaken to determine how reliably therapists rate a client's performance using the CMA on a community outing. PARTICIPANTS Eight adolescents between the ages of 12 and 18 participated. All had an ABI and were involved in rehabilitation either as a day-patient or inpatient. METHODS Each teen was independently evaluated by one expert rater and one of two student raters (A or B), using the CMA during a standard 2-h community outing. ANALYSIS Descriptive statistics were computed for physical and cognitive component summary scores. Inter-rater reliability analyses used weighted Kappa statistics. A minimum Kappa score >0.70 was hypothesized a priori to indicate good reliability. RESULTS The mean score for the physical component = 92% (min = 82%, max = 100%), and for the cognitive component = 77% (min = 58%, max = 97%). Minimum weighted Kappa scores for the two rater pairings were 0.80 for the physical component and 0.70 for the cognitive component. CONCLUSIONS An acceptable Kappa score was reached for both components, indicating that with appropriate rater training, the CMA has good inter-rater reliability. Construct validity and responsiveness to change over a clinically meaningful follow-up period should now be evaluated.
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Affiliation(s)
- K D Moody
- Brain Injury Rehabilitation Team and Bloorview Research Institute, Toronto, Ontario, Canada
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Frattaroli S, Defrancesco S, Gielen AC, Bishai DM, Guyer B. Local stakeholders' perspectives on improving the urban environment to reduce child pedestrian injury: implementing effective public health interventions at the local level. J Public Health Policy 2007; 27:376-88. [PMID: 17164804 DOI: 10.1057/palgrave.jphp.3200103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Local-level public health interventions require action from multiple agencies, organizations and individuals, yet little is known about how best to work with stakeholders to facilitate change. We sought local stakeholders' perspectives on how best to address impediments to implementing interventions designed to reduce child pedestrian injury by improving the pedestrian environment. We conducted 20 in-person, key informant interviews with people who would be the likely advocates for environmental change to improve the pedestrian environment in one US city, Baltimore, Maryland. We discuss the importance of reframing child pedestrian injury risk as a livability issue, increasing awareness about the potential impact of environmental changes to improve public safety, and the need for a formal efficient process to facilitate communication between local government and other stakeholders. These findings provide public health professionals and advocates with useful insight into how local stakeholders view the issue and their perspectives on how best to achieve change.
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Affiliation(s)
- Shannon Frattaroli
- Johns Hopkins Bloomberg School of Public Health, Health Policy and Management, Baltimore, MD 21205, USA.
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Poudel-Tandukar K, Nakahara S, Ichikawa M, Poudel KC, Wakai S. Relationship between mechanisms and activities at the time of pedestrian injury and activity limitation among school adolescents in Kathmandu, Nepal. ACCIDENT; ANALYSIS AND PREVENTION 2006; 38:1058-63. [PMID: 16696929 DOI: 10.1016/j.aap.2006.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2005] [Revised: 12/02/2005] [Accepted: 04/05/2006] [Indexed: 05/09/2023]
Abstract
This study assessed the relationship between pedestrian activity at the time of injury, the type of vehicle involved and resulting activity limitation among school adolescents in the Kathmandu and Lalitpur districts of Nepal. A cross-sectional study of 1557 students in grades 6-8 across 14 schools was conducted using a self-administered questionnaire from August to September 2003. Twenty-three percent of adolescents reported pedestrian injuries, 38% were from urban and 21% from semi-urban areas. Adolescents were commonly injured by motorcycles and motor vehicles while crossing the road; however, while walking and playing, they were commonly injured by bicycles and motorcycles. Bicycles and motor vehicles were less likely to be involved in injury while crossing the roads and playing, respectively (p < 0.001). Activity was more likely to be limited for a longer period of time (> 7 days) with injuries endured while crossing the road (p < 0.001). In urban areas, boys and girls were more likely to be injured while crossing the road and walking, respectively (p < 0.05), and both were commonly injured by motorcycles. In semi-urban areas, boys and girls were commonly injured while walking and were more likely to be injured by motorcycles and bicycles, respectively (p < 0.05). In both areas, more boys than girls were injured while playing. These findings have important implications for pedestrian safety interventions in poor countries.
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Affiliation(s)
- Kalpana Poudel-Tandukar
- Department of International Community Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
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Xiang H, Zhu M, Sinclair SA, Stallones L, Wilkins JR, Smith GA. Risk of vehicle-pedestrian and vehicle-bicyclist collisions among children with disabilities. ACCIDENT; ANALYSIS AND PREVENTION 2006; 38:1064-70. [PMID: 16797463 DOI: 10.1016/j.aap.2006.04.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2006] [Revised: 03/07/2006] [Accepted: 04/15/2006] [Indexed: 05/10/2023]
Abstract
OBJECTIVES To examine the potential association between disability and risk of vehicle-pedestrian and vehicle-bicyclist collisions among children. METHODS Data from the 2002 National Transportation Availability and Use Survey for Persons with Disabilities (NTAUSPD) were analyzed. RESULTS Among 5019 persons who completed the survey, there were a total of 687 children between 5-17 years of age, including 299 respondents with and 388 without disabilities. After controlling for potential confounding variables, children with disabilities were more than five times more likely to have been hit by a motor vehicle as a pedestrian or bicyclist than children without disabilities (adjusted OR = 5.53, 95% confidence interval (CI): 1.43-21.41). For all children, regardless of their disability status, children who reported having some difficulty with traffic had a significantly higher risk of collisions (adjusted OR = 50.71, 95% CI: 7.35-349.86). The most commonly reported traffic difficulties for all children with and without disabilities were "Too few or missing sidewalks/paths," "Do not know when it's safe to cross," and "Insensitive/unaware drivers." CONCLUSIONS Existing effective transportation safety interventions should be effective in reducing the risk of vehicle-pedestrian and vehicle-bicyclist collisions in children with disabilities. Future research and safety interventions should focus on how to promote the use of existing effective transportation safety interventions among children with disabilities and their families.
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Affiliation(s)
- Huiyun Xiang
- Center for Injury Research and Policy, Columbus Children's Research Institute and Children's Hospital, Columbus, OH 43205, USA.
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Stirbu I, Kunst AE, Bos V, van Beeck EF. Injury mortality among ethnic minority groups in the Netherlands. J Epidemiol Community Health 2006; 60:249-55. [PMID: 16476756 PMCID: PMC2465557 DOI: 10.1136/jech.2005.037325] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To prepare a comprehensive overview of ethnic differences in injury related mortality in the Netherlands and to determine the role of area income and urbanisation degree. METHODS Data for the period 1995-2000 were obtained from the population and cause of death registries. Injury related death rates were compared for persons from Turkish, Moroccans, Surinamese, and Antillean/Aruban origin with rates for the native Dutch population. RESULTS Compared with the native Dutch population, all ethnic minorities combined had an increased mortality for all injuries together (RR = 1.29). Ethnic minorities experienced a significantly higher risk of death from pedestrian accidents (RR = 1.87), drowning (RR = 2.58), poisoning (RR = 1.76), fire and scalds (RR = 1.95), and homicide (RR = 3.24). Mortality for cyclists (RR = 0.53) and motorcycle drivers (RR = 0.47) was significantly lower among ethnic minorities compared with the native Dutch. Adjustment for area income and urbanisation decreased the mortality risk difference for most of the non-traffic injuries, but showed a difference in risk for car driver and passenger accidents (RR = 1.37). Compared with the native Dutch inhabitants, Surinamese and Antillean/Aruban population had a higher risk of total injury mortality (RR = 1.33 and 1.53 respectively), while Turkish and Moroccans had increased risk only for selected conditions. Inequalities in injury mortality were the highest among children and young adults, but persisted in the age group above 50 years old. CONCLUSION Ethnic differences in injury mortality in the Netherlands strongly depended on type of injury, ethnic group, sex, and age. Policies should be aimed at the prevention of high risk injuries among the most vulnerable ages and ethnic groups.
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Affiliation(s)
- I Stirbu
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, PO Box 1738, 3000 DR Rotterdam, Netherlands.
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Sun Y, Zhou X, Jia C, Yan C, Huang M, Xiang H. Childhood injuries from motor vehicle-pedestrian collisions in Wuhan, The People's Republic of China. Injury 2006; 37:416-22. [PMID: 16480992 DOI: 10.1016/j.injury.2005.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2005] [Revised: 11/29/2005] [Accepted: 12/01/2005] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To examine motor vehicle-pedestrian collision injuries resulting in hospitalisation among children admitted into Wuhan Children's Hospital, The People's Republic of China. METHODS From the 1993 to 2004 inpatient data of Wuhan Children's Hospital, we identified injury cases from motor vehicle traffic crashes among children aged 18 years or less using the discharge diagnosis defined by the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). We examined characteristics of injuries from motor vehicle traffic crashes (ICD-9-CM = E810-E819) and then calculated the proportion of injuries from motor vehicle-pedestrian collisions (ICD-9-CM = E814) among all hospitalisations for childhood injuries (ICD-9-CM = 800-959). The trend of injuries from motor vehicle-pedestrian collisions from 1993 to 2004 was described. RESULTS Of the 12,939 injuries resulting in hospitalisation among children admitted into Wuhan Children's Hospital during 1993-2004, a total of 528 injuries were caused by motor vehicle traffic crashes. The majority of the injured children in motor vehicle traffic crashes were males (59.3%). In comparison with other traffic injuries, a higher proportion of motor vehicle-pedestrian collisions occurred among children aged 12-15 years. Motor vehicle-pedestrian collision injuries resulted in significantly longer lengths of stay in the hospital than other motor vehicle traffic injuries (19.4 days versus 14.3 days, respectively; t-test = 2.59, p-value < 0.05). The percentage of motor vehicle-pedestrian collision injuries among all hospitalisations for childhood injuries increased significantly from 1.6% (95% confidence interval [CI] = 1.2-2.1) in 1993 to 3.1% (95% CI = 2.7-3.6) in 2004 (p < 0.05). CONCLUSIONS Hospitalisations for injuries from motor vehicle-pedestrian collisions at this large children's hospital increased significantly in the past decade. These data underscore the need for additional research and a major concerted effort to prevent motor vehicle-pedestrian collisions among children in China.
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Affiliation(s)
- Yi Sun
- Department of Social Medicine, School of Public Health, Tongji Medical College, Wuhan, China
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Martins CBDG, Andrade SMD. Epidemiologia dos acidentes e violências entre menores de 15 anos em município da região sul do Brasil. Rev Lat Am Enfermagem 2005; 13:530-7. [PMID: 16211177 DOI: 10.1590/s0104-11692005000400011] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objetivo: analisar as características epidemiológicas dos acidentes e violências em menores de 15 anos, residentes em Londrina, Paraná, em 2001. Os dados de morbidade foram obtidos em prontuários dos hospitais gerais da cidade e, os de mortalidade, no Núcleo de Informação em Mortalidade. Foram estudadas 8854 crianças, representando incidência de 74,8/1000 crianças. As taxas de internação e de letalidade foram, respectivamente, de 4,2 e de 0,2%. A incidência foi maior nas crianças de dois anos de idade (109,0/1000), com predomínio do sexo masculino (60,7%). Prevaleceram as outras causas externas de traumatismos acidentais (61%), seguidas pelos eventos de intenção indeterminada (30,6%) e pelos acidentes de transporte (7,5%). A região corpórea mais afetada foi a cabeça (34,9%) e traumatismo superficial foi o tipo de lesão mais freqüente (32,4%). Os resultados contribuem para fornecer subsídios para o planejamento de ações de controle e prevenção desses agravos.
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Hewson P. Deprived children or deprived neighbourhoods? A public health approach to the investigation of links between deprivation and injury risk with specific reference to child road safety in Devon County, UK. BMC Public Health 2004; 4:15. [PMID: 15134585 PMCID: PMC419356 DOI: 10.1186/1471-2458-4-15] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2003] [Accepted: 05/10/2004] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Worldwide, injuries from road traffic collisions are a rapidly growing problem in terms of morbidity and mortality. The UK has amongst the worst records in Europe with regard to child pedestrian safety. A traditional view holds that resources should be directed towards training child pedestrians. In order to reduce socio-economic differentials in child pedestrian casualty rates it is suggested that these should be directed at deprived children. This paper seeks to question whether analysis of extant routinely collected data supports this view. METHODS Routine administrative data on road collisions has been used. A deprivation measure has been assigned to the location where a collision was reported, and the home postcode of the casualty. Aggregate data was analysed using a number of epidemiological models, concentrating on the Generalised Linear Mixed Model. RESULTS This study confirms evidence suggesting a link between increasing deprivation and increasing casualty involvement of child pedestrians. However, suggestions are made that it may be necessary to control for the urban nature of an area where collisions occur. More importantly, the question is raised as to whether the casualty rate is more closely associated with deprivation measures of the ward in which the collision occurred than with the deprivation measures of the home address of the child. CONCLUSION Conclusions have to be drawn with great caution. Limitations in the utility of the officially collected data are apparent, but the implication is that the deprivation measures of the area around the collision is a more important determinant of socio-economic differentials in casualty rates than the deprivation measures of the casualties' home location. Whilst this result must be treated with caution, if confirmed by individual level case-controlled studies this would have a strong implication for the most appropriate interventions.
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Affiliation(s)
- Paul Hewson
- Environment Directorate, Devon County Council, County Hall, Topsham Road, Exeter, UK.
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Hewson P. Deprived children or deprived neighbourhoods? A public health approach to the investigation of links between deprivation and injury risk with specific reference to child road safety in Devon County, UK. BMC Public Health 2004. [PMID: 15134585 DOI: 10.1186/1471-2458-4-15.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Worldwide, injuries from road traffic collisions are a rapidly growing problem in terms of morbidity and mortality. The UK has amongst the worst records in Europe with regard to child pedestrian safety. A traditional view holds that resources should be directed towards training child pedestrians. In order to reduce socio-economic differentials in child pedestrian casualty rates it is suggested that these should be directed at deprived children. This paper seeks to question whether analysis of extant routinely collected data supports this view. METHODS Routine administrative data on road collisions has been used. A deprivation measure has been assigned to the location where a collision was reported, and the home postcode of the casualty. Aggregate data was analysed using a number of epidemiological models, concentrating on the Generalised Linear Mixed Model. RESULTS This study confirms evidence suggesting a link between increasing deprivation and increasing casualty involvement of child pedestrians. However, suggestions are made that it may be necessary to control for the urban nature of an area where collisions occur. More importantly, the question is raised as to whether the casualty rate is more closely associated with deprivation measures of the ward in which the collision occurred than with the deprivation measures of the home address of the child. CONCLUSION Conclusions have to be drawn with great caution. Limitations in the utility of the officially collected data are apparent, but the implication is that the deprivation measures of the area around the collision is a more important determinant of socio-economic differentials in casualty rates than the deprivation measures of the casualties' home location. Whilst this result must be treated with caution, if confirmed by individual level case-controlled studies this would have a strong implication for the most appropriate interventions.
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Affiliation(s)
- Paul Hewson
- Environment Directorate, Devon County Council, County Hall, Topsham Road, Exeter, UK.
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