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Abstract
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Literature on pedestrian injuries is extensive and predates current interest in walking as a transport mode. Broadly speaking, four different categories of risk factor are discussed. Firstly, characteristics associated with the victim, including behaviour (such as "distracted walking") and demographic factors (such as gender and ethnicity). Secondly, socio-cultural and household factors, such as family characteristics and household or local area deprivation. Thirdly, characteristics of the physical environment, such as speed limits or presence of pedestrian crossings. Finally, characteristics of the driver or rider colliding with the pedestrian (demographic, behavioural, or vehicle type).
Where different types of risk factors are associated with elevated injury risk, policy implications may differ. Planners can directly modify the physical environment: crossings can be added or removed, speed limits increased or reduced, footways widened or narrowed. Thus, if we find lower speed limits reduce pedestrian injury risk, this gives us a direct policy lever. Other factors are not directly modifiable in this way: so, for instance, if lower speeds (driver behaviour) are associated with reduced injury risk, this does not in itself tell us what we need to do. We also need information about the impacts of causal pathways connecting interventions (education, engineering, enforcement, etc.) to changes in driving speeds.
Causal pathways are likely to be linked, with feedback potentially acting in unpredictable ways. An intriguing aspect of injury risk is that some individually protective factors may not feed through into similarly positive results at societal level, implying potentially negative unintended consequences of apparently benign interventions. The most obvious example is the cycle helmet debate. A bike helmet may sometimes reduce injury severity for an individual experiencing a crash or collision, yet among rich countries, those safest for cycling have the lowest levels of helmet use. In safer countries, policy-makers focus on making cycling feel easy and safe, rather than on persuading or coercing cyclists to wear personal protective equipment - equipment which may even encourage drivers... |