Pedestrian Injury and the Built Environment: An Environmental Scan of Hotspots

Background: Pedestrian injury frequently results in devastating and costly injuries and accountsfor 11% of all road user fatalities. In the United States in 2006 there were 4,784 fatalities and 61,000 injuries from pedestrian injury, and in 2007 there were 4,654 fatalities and 70,000 injuries. In Canada, injury is the leading cause of death for those under 45 years of age and the fourth mostcommon cause of death for all ages Traumatic pedestrian injury results in nearly 4000hospitalizations in Canada annually. These injuries result from the interplay of modifiableenvironmental factors. The objective of this study was to determine links between the built environment and pedestrian injury hotspots in Vancouver.Methods: Data were obtained from the Insurance Corporation of British Columbia (ICBC) forthe 6 year period from 2000 to 2005 and combined with pedestrian injury data extracted from theBritish Columbia Trauma Registry (BCTR) for the same period. High incident locations (hotspots)for pedestrian injury in the City of Vancouver were identified and mapped using geographicinformation systems (GIS), and the characteristics of the built environment at each of the hotspot locations were examined by a team of researchers.Results: The analysis highlighted 32 pedestrian injury hotspot locations in Vancouver. 31 of 32hotspots were situated on major roads. Likewise, the majority of hotspots were located ondowntown streets. The 'downtown eastside' was identified as an area with multiple high-incidentlocations, including the 2 highest ranked pedestrian injury hotspots. Bars were present at 21 of the hotspot locations, with 11 of these locations being judged to have high alcohol establishmentdensity.Conclusion: This study highlighted the disproportionate burden of pedestrian injury centred onthe downtown eastside area of Vancouver. The environmental scan revealed that important passive pedestrian safety countermeasures were only present at a minority of high-incident locations. More importantly, bars were highly associated with risk of pedestrian injury. This study is the basis forpotential public health intervention by clearly indicating optimal locations for signalized pedestrian crosswalks.