1. Child Pedestrian Accidents The Effect of Interventions Over a 6 Year Period Thomas S. Renshaw, M.D. Professor of Orthopaedic Surgery Yale University

2. Pediatric trauma in the USA Kills more children than all diseases combined Each year 22,000 deaths

3. Ten Most Common Causes Pedestrian accidents Drowning Bicycle accidents Falls from heights Scald burns Flame burns Suicides Assaults Choking Smoke inhalation

4. Why? Young Children: Think that if they can see a driver, the driver can see them. They think that cars can stop instantly

5. Young Children: They can’t tell where sounds come from They can’t judge how fast traffic is moving

6. Young Children: They have a field of vision 1/3 that of adults They don’t recognize danger or react to it They think of cars as friendly, living creatures

7. Child Pedestrian Injuries The 2 nd leading cause of death in ages 5-9, behind cancer Account for 30-50% of all trauma hospitalizations

8. Child Pedestrian Injuries 18,000 annual hospital admissions Fatality rate is 4%

9. Child pedestrian injuries in New Haven, CT have been reduced by 61% over a six year period.

10. From 223 in 1992-93 To 87 in 1998-99

11. Data Collection New Haven, CT Two 18 month periods 1992-93 and 1998-99

12. Data Collection Hospital records School bus company information City departments of: Police Traffic and Parking Planning Public Housing Economic Development School Districts

13. Collision Mapping 26 census districts in New Haven Each collision was mapped Correlated with season of year, day of week, time of day Correlated with demographics

14. Demographics Population density Race, gender, age Income Persons per household Housing units per acre

15. Comparable for Both Periods PopulationTraffic volume up 3% Speed limitsRight turn on red laws Parking statusPublic parks One-way streetsCross walks Walk signalsCrossing guards

16. High Risk Factors Both Times Non-white population Households with >1 person per room More children per acre

17. High Risk Factors Both Times Occupied units per acre Families below poverty line Lower median incomes

18. Five Interventions Occurred Educating the children Increased school bussing Educating the motorists Decentralized public housing Increased traffic tickets and warnings

19. Education for children Traffic safety programs in all elementary school grades twice a year (from zero/year)

20. Increased school bussing From 35% of children to 73% More door to door pick-ups Fewer streets to cross 30-45 minutes on the bus = fewer daylight hours to play outside

21. Educating the Motorists Public safe driving campaign Flyers in public areas Billboards Mailings

22. Decentralized public housing Largest complex demolished Transfers to smaller projects Vouchers for subsidized private housing A nationwide trend to decrease crime and poverty

23. Increased traffic tickets and warnings by 22% In high risk areas At high risk times

24. Never underestimate the power of the Police

25. Results 1992-93223 injuries 1998-99 87 injuries a 61% reduction

26. Other Intervention Options for High Risk Areas Post crossing guards at high risk times

27. Other Intervention Options for High Risk Areas Install highly visible warning signs for motorists

28. Other Intervention Options for High Risk Areas Crosswalks should be well-lit and painted in bright colors Bright yellow with zebra design Embed rows of small lights or reflectors in the asphalt Install flashing signs over the middle of crosswalks Self-flagging crosswalks Not like this

29. Other Intervention Options for High Risk Areas Sidewalks added and fenced or barrier curbed

30. Other Intervention Options for High Risk Areas Traffic lights reset to give children more time to cross busy intersections

31. Other Intervention Options for High Risk Areas Playgrounds should be safe and clean

32. Other Intervention Options for High Risk Areas** One-way streets One side parking bans Speed bumps

33. Other Intervention Options for High Risk Areas** Pedestrian overpasses Ban cell phone use by drivers ** very difficult to accomplish politically

34. Child pedestrian injuries and deaths can be reduced without political battles and without changing the intractable problems of poverty and overpopulation.

35. You can do this in your community!

36. “Never doubt that a small group of people can change the world, in fact it’s the only thing that ever has.” …… Margaret Mead

37. Thank you! Click here to return to Unit