103 Racial disparities in pedestrian deaths in the united states, 1999–2015

Purpose Racial disparities in violent injury are well documented but disparities in injuries from non-violent means are less studied. Nearly 5000 pedestrians are killed by motor vehicles annually in the US and 1 50 000 are injured. We examined whether racial disparities exist in pedestrian deaths. Methods/Approach Using CDC annual mortality data, 1999–2015, each death was classified into one of five mutually exclusive racial/ethnic categories: White, Black/African American, Asian/Pacific Islander, American Indian/Alaska Native, and Latino. Individuals categorised as Latino were not included in any other group. Deaths missing race/ethnicity were excluded. We compared death rates between racial groups annually and across the rural-urban continuum using Kruskal-Wallis tests. Given substantial geographic segregation, we separately analysed those counties with ≥10 deaths among multiple racial/ethnic groups. Results We identified 49 494 pedestrian deaths over 17 years. The overall average pedestrian death rate was 1.4/100,000 population per year, with a decline from 1.8 in 1999 to 1.0 in 2015. The median death rate was lowest for Asians, at 0.8/100,000 (IQR=0.6–1.0), followed by Whites, at 0.9 (IQR=0.7–1.0). Blacks and Latinos had similar mortality rates at 1.4 (IQR=1.0–1.5) and 1.2 (IQR=0.9–1.6) respectively. Native Americans had the highest rate of pedestrian death at 2.6 (IQR=2.4–2.9); p=0.0001. Although death rates varied across urbanisation levels, disparities were consistent. Seventy-three U.S. counties had ¥10 pedestrian deaths among Blacks, Latinos and Whites. In these counties, the median death rate was 1.2 for Whites (IQR=0.8–1.5), 1.4 (IQR=1–2.1) for Blacks, and 1.4 (IQR=1.0–1.9) for Latinos; p=0.011. Conclusions Significant racial disparities in pedestrian death rates exist even in racially diverse counties and were not accounted for by urbanisation. Significance and Contributions to Injury and Violence Prevention Science Having identified these disparities, future studies can target prevention efforts by identifying social, environmental and geographic contributors, as well as those areas of the country accounting for greatest disparity burden.