The pedestrian injury death rate among children ages 14 and under declined 42 percent, and the pedestrian-motor vehicle death rate declined 44 percent from 1987 to 1997. Much of this decline is due to a reduction in exposure to traffic (children are walking less). However, pedestrian injury remains the second leading cause of unintentional injury-related death among children ages 5 to 14. While the majority of pedestrian deaths and injuries are traffic-related, children from birth to age 2 are more likely to suffer non-traffic-related pedestrian injuries, including those occurring in driveways, in parking lots and on sidewalks. Although pedestrian injuries are not as common as motor vehicle occupant injuries, a disproportionate number of the injuries sustained by child pedestrians are severe.

Children are particularly vulnerable to pedestrian death because they are exposed to traffic threats that exceed their cognitive, developmental, behavioral, physical and sensory abilities. This is exacerbated by the fact that parents overestimate their children’s pedestrian skills. Children are impulsive and have difficulty judging speed, spatial relations, distance and velocity. Auditory and visual acuity, depth perception and proper scanning ability develop gradually and do not fully mature until at least age 10.

PEDESTRIAN DEATHS AND INJURIES

• In 1997, nearly 830 children ages 14 and under died from pedestrian injuries. Of these, 675 died in motor vehicle-related traffic crashes and an additional 151 died in non-traffic-related incidents.
  
• In 1998, an estimated 20,000 children ages 14 and under suffered motor vehicle-related pedestrian injuries.
  
• Between 25 and 50 percent of child pedestrian injuries require hospital admission.
  
• In 1998, 13 children ages 14 and under were killed as pedestrians in school bus-related incidents.
  

WHEN AND WHERE PEDESTRIAN DEATHS AND INJURIES OCCUR

• In 1998, 45 percent of child pedestrian deaths occurred between 4 p.m. and 8 p.m.; 82 percent occurred at non-intersection locations.
  
• For all ages, traffic-related pedestrian death rates are twice as high in urban areas as in rural areas and non-traffic related pedestrian death rates are twice as high in rural areas compared to urban areas.
  
• Toddlers (ages 1 to 2) sustain the highest number of pedestrian injuries, primarily due to their small size and limited traffic experience. More than half of all toddler pedestrian injuries occur when a vehicle is backing up.
  
• Children ages 14 and under are more likely to suffer pedestrian injuries in areas with high traffic volume, a higher number of parked vehicles on the street, higher posted speed limits, absence of a divided highway, few pedestrian-control devices and few alternative areas to play in.
  
• Childhood pedestrian injuries occur more often in residential areas and on local roads that are straight, paved and dry.
  
• Nearly 13 percent of motor vehicle traffic-related childhood pedestrian deaths are a result of a hit and run incident.
  

WHO IS AT RISK

• Children ages 5 to 9 are at the greatest risk from traffic-related pedestrian death and injury. More than one quarter of all children ages 5 to 9 who are killed in traffic crashes are pedestrians.
  
• Sixty-two percent of the traffic-related childhood pedestrian deaths in 1998 were among males.
  
• Black children are twice as likely to die from traffic-related pedestrian injuries as white children.
  
• American Indian and Alaska Native children have pedestrian traffic death rates four times that of the U.S. as a whole.
  
• Children living in areas that have a high population density of children, household crowding, high housing density, low socioeconomic status, poor supervision, and no safe play environments are more likely to suffer pedestrian injury.
  
• More than 70 percent of non-traffic-related childhood pedestrian deaths occur among children ages 4 and under. Young children are at increased risk of pedestrian death and injury in driveways and other relatively protected areas.
  
• The parents of children suffering from pedestrian-related injury are three times less likely to practice other preventive behaviors and are more likely to be single parents as well as young mothers.
  

PEDESTRIAN INJURY PREVENTION EFFECTIVENESS

• Environmental modifications are effective at reducing pedestrian-motor vehicle-related incidents.
  
• Enforcement of traffic laws, including apprehension of hit and run drivers, is effective in reducing traffic-related pedestrian death and injury.
  
• Practical, skills-based pedestrian safety training efforts have demonstrated improvements in children’s traffic behavior.
  
• Greater penalties, such as impounding the vehicles of drivers who are unlicensed or driving with a suspended or revoked license, are proven to reduce pedestrian death and injury.
  

PEDESTRIAN LAWS AND REGULATIONS

• There are a multitude of state and local laws that affect childhood pedestrian injuries, including setting low speed limits in residential areas, protecting pedestrians in crosswalks, providing for pedestrian walkways, prohibiting vehicles from passing school buses while loading and unloading passengers, providing for crossing guards and requiring that pedestrians not cross streets at locations other than designated crosswalks.