CHILD PEDESTRIAN ACCIDENTS IN SAN DIEGO 1

Transcription

1 CHILD PEDESTRIAN ACCIDENTS IN SAN DIEGO 1 Child Pedestrian Accidents in San Diego Neighborhoods Colin T. Stowell San Diego Fire-Rescue Department San Diego, California

2 CHILD PEDESTRIAN ACCIDENTS IN SAN DIEGO 2 Certification Statement I hereby certify that this paper constitutes my own product, that where the language of others is set forth, quotation marks so indicate, and that appropriate credit is given where I have used the language, ideas, expressions, or writings of another. Signed:

3 CHILD PEDESTRIAN ACCIDENTS IN SAN DIEGO 3 Abstract The rate of pedestrian accidents involving children varies widely across communities in the City of San Diego. Identifying the community characteristics associated with an elevated risk of this type of victimization is essential in developing strategies to improve pedestrian safety. There is a disproportionately higher rate of pedestrian accidents involving children in certain neighborhoods as compared to others in the City of San Diego. The purpose of this research project was to identify and examine the communities in San Diego that experience a higher number of pedestrian accidents involving children. The research questions addressed by this project were: (a) Which communities in San Diego experience a disproportionately high number of such accidents involving children? (b) What factors influence the risk of pedestrian accidents for children in certain communities? (c) Are there differences in the safety awareness and walking practices of children in communities with higher accident rates as compared to communities with lower rates? (d) Are there disparities in pedestrian safety programs available to children across communities? To address these questions, this study employed a series of descriptive research methodologies; retrospective analysis of accident reports, review of current safety programs, surveys of comparable fire departments, interviews with safety and school administrators, student surveys, and systematic observations of juvenile walking behaviors. The results suggest that the levels of pedestrian accidents are linked to a series of community structural and demographic characteristics. Indeed, at highest risk for pedestrian accidents are minority children residing in socioeconomically distressed neighborhoods. Recommendations included (a) development of strategies to reduce pedestrian risk in identified neighborhoods, (b) parental participation in the assessment of pedestrian hazards in neighborhoods, (c) increased funding of pedestrian training programs, and (d) additional neighborhood traffic enforcement.

4 CHILD PEDESTRIAN ACCIDENTS IN SAN DIEGO 4 Table of Contents Certification Statement 2 Abstract 3 Table of Contents 4 Introduction 5 Background and Significance 6 Literature Review 9 Procedures 17 Results 23 Discussion 36 Recommendations 40 References 43 Appendix A: Distribution of Pedestrian Accidents in San Diego, Appendix B: Demographics of Southeastern and Del Mar/Mira Mesa SRA 48 Appendix C: Interview Questions for Safe Kids Program Coordinator 52 Appendix D: Interview Questions for School Principals 53 Appendix E: Pedestrian Safety Quiz 54 Appendix F: Observational Survey Tally Sheet 56 Appendix G: Survey on Child Pedestrian Safety 57

5 CHILD PEDESTRIAN ACCIDENTS IN SAN DIEGO 5 Child Pedestrian Accidents in San Diego Neighborhoods It is widely acknowledged by emergency responders and community risk professionals that certain neighborhoods in the City of San Diego have a higher rate of pediatric pedestrian accidents as compared to other neighborhoods. What is not known are which specific communities experience this higher rate and factors that contribute to this elevated risk level. Although many assumptions can be made as to why some communities are affected by pedestrian accidents more than others, an analysis of the demographic and socioeconomic differences of those communities, while considering the engineering and environmental factors in those neighborhoods, is needed to understand better the issues that contribute to higher occurrences of such accidents. Pediatric pedestrian emergencies result in not only a financial burden to the families of the victims; they also carry significant emotional and psychological impacts to family, emergency responders, and the community as a whole. The problem is a disproportionately higher rate of pedestrian emergency incidents involving children 5 to 11 years in certain neighborhoods as compared to other communities in the City of San Diego. The purpose of this research project is to address the gap in knowledge regarding an important public and community health problem. Specifically, this research will identify which communities experience a higher number of pedestrian accidents involving children between the ages of 5 to11 years and to examine the environmental and behavioral factors that influence these higher numbers as compared to other communities in the City of San Diego. This project used a descriptive research methodology through retrospective analysis of pediatric pedestrian accident reports, a review of current educational programs related to pedestrian safety, surveys from other fire departments, and personal interviews with safety coalition and school administrators. Written tests and observational surveys were also used to assess elementary school student s

6 CHILD PEDESTRIAN ACCIDENTS IN SAN DIEGO 6 knowledge of pedestrian safety and walking behaviors. The research questions to be investigated by this project are: (a) Using retrospective analysis of emergency incident data, which communities have a disproportionately high number of pedestrian emergency incidents involving children 5 to 11 years in the City of San Diego? (b) What risk factors and behaviors influence or are responsible for the higher number of pedestrian emergency incidents in certain communities? (c) What is the awareness level and understanding of children 5 to 11 years related to safe walking practices and pedestrian rules in communities with higher numbers of pedestrian emergency incidents as compared to other communities? (d) What formal or informal pedestrian safety programs are in place for children in communities with higher numbers of pedestrian emergency incidents as compared to other communities? Background and Significance Every year approximately 39,000 children are injured and 630 killed from being struck by vehicles in the United States (Centers for Disease Control and Prevention, 2011). Further, nearly one in four traffic deaths among children under the age of 14 are pedestrian related. Although pedestrian death rates continue to decline, pediatric pedestrian injury still ranks among the most serious causes of unintentional childhood injuries and deaths. In 2005, the total lifetime costs associated with motor vehicle-pedestrian injuries and death among children less than 14 years of age was approximately $711 million, with $566 million attributed to hospitalization as a result of pedestrian injuries (Safe Kids Gainesville Hall, 2005). Previous studies have shown that the risk for such accidents vary, with children, older adults, and the lower socioeconomic population are most susceptible to pedestrian collisions (Chakravarthy, Anderson, Ludlow, Lotfipour, & Vaca, 2010). With respect to minors, factors such as developing sensory and cognitive skills, impulsivity, and poor parental supervision contribute to the higher frequency of

7 CHILD PEDESTRIAN ACCIDENTS IN SAN DIEGO 7 accidents affecting this population (American Academy of Pediatrics, 2009). According to the most recent data available in the California Statewide Integrated Traffic Records System (SWITRS) there were 105 children injured or killed while walking in the City of San Diego from (Statewide Integrated Traffic Records System-Annual report, 2010). Nationally, pedestrian related deaths involving children between the ages of 5-9 years ranks seventh among the leading causes of unintentional injury deaths (Centers for Disease Control and Prevention, 2011). Evidence suggests that such accidents pose a somewhat bigger health threat in San Diego County where child pedestrian deaths ranks second only behind deaths associated with being an occupant in a motor vehicle accident (Causes of unintentional injury, 2009). Although an important safety concern, competing funding priorities have eliminated most pedestrian safety education programs available through the school district in San Diego. The decreasing number of available programs has left a void that is only partially filled by federal and state funded programs such as Safe Routes to School (SRTS) in addition to some voluntary public safety presentations initiated by active Parent Teacher Association (PTA) groups (M. Moran, personal communication, November 15, 2013). According to Mary Beth Moran with the San Diego County Safe Kids Coalition (2013), funding from SRTS has been successful with making traffic engineering changes and implementing enforcement strategies in some of the high risk neighborhoods, but the coalition recognizes that childhood pedestrian injuries continue to be prevalent and disproportionately affect children in these crowded and lower income areas. Research indicates that children in lower income, densely populated, urban residential areas are more vulnerable to pedestrian related injury with some reports citing children in lower income neighborhoods being as much as 5.7 times more likely to be injured as pedestrians (American Academy of Pediatrics, 2009).

8 CHILD PEDESTRIAN ACCIDENTS IN SAN DIEGO 8 San Diego Fire-Rescue Department (SDFD) provides fire protection and emergency medical services to more than 1.3 million people covering 331square miles comprising of 52 recognized communities (City of San Diego, 2013). In Fiscal Year 2013 (FY2013) the department responded to 129,221 emergency incidents, of which 87% were medical responses (FY2013 Annual Report, 2013). In 2012, SDFD responded to 412 incidents involving pedestrian emergencies of which 32 involved children between the ages of 5-11 years. Although the number pediatric pedestrian emergency incidents are statistically a small share of the total number of incidents citywide, the disproportionate concentration in certain communities is significant and cause for concern. Even with a budget of just over $200 million for FY2014, SDFD does not have a dedicated Community Risk Reduction Officer within the organization to work with high risk populations to improve safety awareness and practices. The disproportionate number of pediatric pedestrian emergency incidents in certain neighborhoods is significant to the City of San Diego and SDFD because it suggests that there may be a combination of underlying environmental, social, and behavioral factors that contribute to the elevated risk in these areas. Higher numbers of pediatric pedestrian emergencies affecting these neighborhoods result in unnecessary financial costs and emotional distress related to medical care of victims and that suffered by the families. Beyond its value to SDFD, the results from this research may also be of use to several public agencies including San Diego County Health and Human Services Agency and the Safe Kids Coalition which serve as the agencies that manage grant funding and public programs aimed at improving the safety of children. This research paper is relevant to several objectives listed in Units 1 and 2 of the Executive Analysis of Community Risk Reduction curriculum related to comparing and contrasting community risk, the levels of risk prevention, and assessing the hazards and casual

9 CHILD PEDESTRIAN ACCIDENTS IN SAN DIEGO 9 factors in one s community (Executive Analysis of Community Risk Reduction Student Manual, 2012, Units 1 & 2). These units explain the role of the Executive Fire Officer (EFO) in identifying community risk and the potential impacts if those risks are not addressed, while also stressing the importance of recognizing both the challenges and benefits associated with reducing the community risk. The analysis which was developed in this applied research paper (ARP) align with the activities listed under Step II of the Community Risk-Reduction Model (Executive Analysis of Community Risk Reduction Student Manual, 2012, p. 1-8) and would be considered a Secondary Prevention level designed to mitigate or modify events to reduce the severity of occurrence affecting a high risk population (p. 12). This ARP also relates to the United States Fire Administration (2010) first strategic goal to Reduce risk at the local level through prevention and mitigation (United States Fire Administration Strategic Goals, 2010, p. 14) and is specifically applicable to the operational initiative to expand public fire and safety education through various avenues to all segments of the population, especially those at high risk (p. 18). Literature Review The following literature review focused on four distinct areas: (a) studies related to the demographics of neighborhoods and populations with higher rates of pedestrian injuries and death, (b) risk factors that contribute to higher rates of pediatric pedestrian accidents, (c) behavior and emotional factors that influence the frequency of child pedestrian accidents, and (d) the effectiveness of existing programs and available funding for child pedestrian safety. The exposure to traffic appears to be a straightforward cause and effect of a child pedestrian accident. However, such perceptions greatly oversimplify the true nature of such incidents. Indeed, pedestrian accidents are generally complex events which are the result of the

10 CHILD PEDESTRIAN ACCIDENTS IN SAN DIEGO 10 confluence of many contributing factors such as pedestrian and driver behavior, weather, lighting, vehicle and traffic engineering, and the presence of other distractions. Such factors, particularly when combine with the impulsiveness of children, these accidents become even more complicated and unpredictable events. Therefore, these outcomes are best understood as resulting from a complex web of behavioral, social, and environmental conditions. Demographic characteristics of a child including age, sex, race/ethnicity, and the socioeconomic status of their community are the most consistent predictors of pedestrian injury and have been shown to disproportionately affect particular groups (Schieber & Vegega, 2002). An increased risk for pedestrian injuries occurs when certain social factors manifest in a dangerous environment. The primary social group for a child is their family. Some of the environmental factors that define a child s awareness of safety include; parental involvement, income level and highest level of education within the family unit. Family income often determines the neighborhood a child lives in, type of housing, dependency on walking, separation of play areas from traffic, and parental supervision. The highest level of education achieved by a parent often influences their life style, which in turn correlates with health related behaviors and accepted risk exposures of the family (Schieber & Vegega, 2002). The younger a child is, the more at risk they are for traffic related pedestrian injuries simply due to their limited awareness and unsafe behaviors. Age is also a big determinant of risk since it largely determines a child s independence and mobility. Since children under one year of age are dependent on their caretaker for mobility, they have far less exposure to traffic environments. As a child gets older, he/she becomes more mobile with less supervision and travels further independently. Risk dramatically increases as a child gets older and more mobile, and remains high through the age of six when it begins to decrease until the age of 11 (Winn &

11 CHILD PEDESTRIAN ACCIDENTS IN SAN DIEGO 11 Anderson, 2003). According to the Winn and Anderson 2003 report, for the period from there were more pedestrian injuries for children ages 1-7 years of age and more pedestrian related hospitalized children ages 1-10 than there were injuries due to being an occupant in a motor vehicle for those same age groups. Minorities experience an increased risk of being struck by a vehicle (Hilton, 2006). Race/ethnicity has been shown to play a significant role in pedestrian fatalities and injuries. National data show that minorities of all age groups have a higher rate of pedestrian fatalities than the non-hispanic white population (Hilton, 2006). Studies have also shown that minority groups are often underreported related to emergency incidents for various reasons such as cultural related attitudes, familiarization with emergency services, health care concerns, and a general skepticism of public agencies which would likely increase the disparity even more in pedestrian injury rates among minority populations (Sciortino, Vassar, Radetsky, & Knudson, 2005). Similar racial disparities also exist for California, where pedestrian injury rates are higher for African-American children (2.4 fatalities and 41.4 injuries per 100,000 annually) and for Hispanic children (2.0 and 25.4 per 100,000) than for white children (1.4 and 13.2 per 100,000) (Winn & Anderson, 2003). San Diego County data for 2010 mirrors state statistics showing African Americans having the highest pedestrian injury and death rates followed by Hispanics. African Americans in San Diego are also over-represented among deaths, where they comprise 5% of the city s population yet account for 15% of pedestrian deaths (County of San Diego, Health and Human Services Agency, 2010). Boys are more likely than girls to be injured in a pedestrian accident which may be due to a difference in their exposure level and activities. Rather than being biologically predisposed to injury, boys may be more at risk as a result of different preconceived notions and beliefs that

12 CHILD PEDESTRIAN ACCIDENTS IN SAN DIEGO 12 they don t need to be as careful or supervised as closely as girls (Schieber & Vegega, 2002). What s considered acceptable behavior for a boy, the activities they frequently participate in, and their physical agility all appear to increase a boy s risk of pedestrian injury. Exceptional physical agility actually increases ones risk to being hit by a car, while physical limitations reduce the risk which most likely is due to mobility and decreased exposure respectively (Christoffel & Schofer, 1996). National data indicate that 64% of all children killed in 2010 while walking were male and the rate of pedestrian injury for boys was more than double the rate for girls (National Highway Traffic Safety Administration, 2010). California statistics reflect the same disparity between genders with boys having an injury rate of 27.9 per 100,000 as compared to girls with 14.8 per 100,000 (Winn & Anderson, 2003). Several socioeconomic status and demographic factors influence the risk of a pedestrian being struck by a vehicle such as highest level of parental education, proficiency in speaking and understanding English, ethnicity, and population density. However being a member of a low income family is the greatest predictor of pedestrian injury (Chakravarthy, Anderson, Ludlow, Lotfipour, & Vaca, 2010). According to Chakravarthy (2010) a child in Orange, California is nearly 9 times as likely to be a victim of a pedestrian accident in the poorest quartile of neighborhoods as they are in the wealthiest quartile. The study showed that although many socioeconomic factors contribute to the pedestrian risk of a child, a neighborhoods poverty rate alone results in the greatest disparity of pedestrian injuries. The environment plays a crucial role in the risk of child pedestrian accidents and is directly related to other factors such as social structural status of the community. Child pedestrian injuries are significantly more prevalent in urban neighborhoods, with 75% of all related accidents occurring in such settings and rates proportionate to population density

13 CHILD PEDESTRIAN ACCIDENTS IN SAN DIEGO 13 (Mazurek, 1994). Children of low income families tend to live in more dense, urban residential neighborhoods where they are at much greater risk of experiencing pedestrian injury. In part this may be due to the fact that urban neighborhoods have fewer designated play areas, increased traffic, and a higher number of cars parked on the street, all of which translate into increased risk to children living or playing in those neighborhoods (Schieber & Vegega, 2002). Moreover, children living in a multiple-family residence (most common in dense urban centers) have almost three times the risk of pedestrian injuries as compared to children living in a single-family detached residence (Jacobsen et al., 2000). Children are most likely to be struck by a motor vehicle on a residential street near their home with the most common cause being the pedestrian dart-out or dash where a child runs out into the road out of view of the motorist. This type of accident accounts for 43% of all pedestrian incidents involving 5-9 year olds (Pedestrian and Bicycle Information Center, ) and in 2010 more than 80% of child pedestrian deaths occurred at non-intersection locations (National Highway Traffic Safety Administration, 2010). Time of day is also seen as a significant factor in child pedestrian accidents, with the highest risk time between 3 and 7 PM during which 36% of fatalities occur (American Academy of Pediatrics, 2009). And although counterintuitive, the majority of pedestrian accidents occur under optimal driving conditions during daylight and dry road conditions (Nance, Hawkins, Vivarelli-O Neil, & Winston, 2004). According to the National Highway Traffic Safety Administration (NHTSA), the number of pedestrian fatalities decreased by 49% in children under 14 years during the ten year period of , with the greatest percent drop (57%) in the 4-7 age group (National Highway Traffic Safety Administration, 2007). Statistics on the number of kids who walk to school indicates this decrease is most likely a result of less walking and lower exposure to traffic. In 1969, 42% of all

14 CHILD PEDESTRIAN ACCIDENTS IN SAN DIEGO 14 schoolchildren and 89% of those living within a mile from school walked or rode their bicycle to and from school (US Department of Transportation, Federal Highway Administration, 1969). Recent statistics show only about 16% of schoolchildren walk or ride bicycles to school, with 37% of those living within one mile of school being driven to school (Centers for Disease Control and Prevention, 2008). Parent surveys conducted by the Centers for Disease Control and Prevention (2005) found that the major barriers preventing children from walking to school are distance (62%), traffic dangers (30%), weather (19%), and crime (12%). Behaviors, awareness levels, and parental beliefs place children at significant risk when exposed to traffic conditions and contribute tremendously to the occurrences of pedestrian accidents. Children lack the cognitive and behavioral abilities to negotiate traffic, understand the meaning of road signs, see cars in their peripheral vision, and have difficulty judging distances and speeds or anticipating driver behaviors (American Academy of Pediatrics, 2009). While children as young as nine years can learn the skills to cross streets safely, it is unlikely they will practice these skills regularly because of their cognitive and behavioral abilities when distracted or involved in play. The necessary cognitive skills and abilities to negotiate traffic are not fully developed until the age of 11 or 12 (Jacobsen et al., 2000). Many parents are not aware of these developmental limitations and tend to overestimate their child s ability to be safe in traffic situations as a pedestrian. Adult supervision and role modeling is critically important to engraining successful and safe pedestrian behaviors in children. Unfortunately, not only do parents overestimate their child s ability to act safely in traffic, they themselves lack basic knowledge about pedestrian injury and do not adequately teach children about road safety (American Academy of Pediatrics, 2009, p. 4).

15 CHILD PEDESTRIAN ACCIDENTS IN SAN DIEGO 15 Research first began on child pedestrian safety in the 1970 s and received national attention with the Department of Transportation (DOT) publication of School Trip Safety and Urban Play Areas in The first modern Safe Routes to School (SRTS) program in the US began in the Bronx, NY in 1997 which funded pedestrian safety improvement projects and education. The following year Congress funded two pilot programs in California and Massachusetts, and then in 2005 passed federal legislation to establish the National SRTS program which has apportioned nearly $1.5 billion to states as of September 2012 to be used for school zone infrastructure projects or other related safety initiatives (National Center for Safe Routes to School, 2013). Currently all 50 states operate SRTS programs benefiting over 15,000 schools. The California Department of Transportation (Caltrans) SRTS construction program was the first state legislative effort to direct federal highway traffic safety funds towards child pedestrian safety. The program directs $20 to $25 million annually to traffic related child pedestrian safety improvement projects. San Diego Safe Kids Coalition is the local chapter with Safe Kids Worldwide and one of 600 coalitions worldwide that partner together with communities to provide families the education, resources, and expertise to keep kids safe. Safe Kids of San Diego coordinates with state and federal SRTS programs to conduct school site traffic assessments referred to as walk audits with a goal to identify and modify traffic flow patterns, provide child and parental safety education materials, partner with high risk schools to create safety plans, and make traffic engineering and enforcement recommendations (M. Moran, personal communication, November 15, 2013). Safe Kids has established a five step process aimed at improving the safety of children walking known as the five E s : evaluation, encouragement, education, enforcement, and engineering (M. Moran, personal communication,

16 CHILD PEDESTRIAN ACCIDENTS IN SAN DIEGO 16 November 15, 2013). A combination of these interventions is needed to be effective at increasing the safety of pedestrian children. Education and enforcement alone have shown limited effectiveness without street modifications and reduced traffic speed in high risk neighborhoods. Because of their limited abilities and judgment, society cannot adapt children to traffic; society has to adapt traffic to children (Jacobsen et al., 2000, p. 74). No randomized clinical trial has demonstrated that traffic safety educational programs reduce the rate of pediatric injuries, however reviews of skills-training programs have shown to improve attitudes, knowledge, and behaviors related to crossing the street (American Academy of Pediatrics, 2009). Whether existing educational programs substantially improve the behaviors of children in traffic conditions continues to be a topic of debate. Most studies have failed to show support for classroom educational programs aimed at simply increasing a child s knowledge and awareness of traffic safety (Schieber & Vegega, 2002). One study done by Livingston, Suber, Clancy, Passannante, & Lavery (2011) examined long term effectiveness of a one-time annual pedestrian safety program (WalkSafe) delivered through the schools. It found that although short and immediate term knowledge gains were seen in all ages, scores for younger children regressed to baseline knowledge levels within one year. These types of programs assume that by improving a child s knowledge of traffic dangers and encouraging their attitudes and behaviors related to safety, the child will apply this learned information to real life traffic situations for a relatively short period. Rather than simply focusing on improving the level of knowledge that may only influence how children might answer questions about road safety, studies recommend that other strategies be employed to supplement this academic foundation. Practical skills training methods demonstrated and reinforced in a variety of traffic situations lead to behavioral changes in

17 CHILD PEDESTRIAN ACCIDENTS IN SAN DIEGO 17 children and improved ability to navigate safely in traffic. Safety programs in which education was one component of a broader program including parental education, police enforcement of traffic laws, engineering and construction projects, and legislative changes have been successful in significantly reducing child pedestrian injury rates (American Academy of Pediatrics, 2009). Most safety training programs occur through the schools, however parent participation as trainers or role models is important and their involvement may add to the success of changing a child s behavior. A review of pedestrian safety programs for children concluded that effective solutions to the problem should be multifaceted involving experts from diverse fields of child development, traffic engineering, public health and safety agencies, legislators, and need to include strategies aimed at teaching adults the normal capabilities and vulnerabilities of children in different demographic groups (Schieber & Vegega, 2002). Procedures Methodology Several procedures were employed to examine the questions of central importance to this research study. Electronic surveys, personal interviews, review of state and local data on pedestrian accidents, and an analysis of incident reports for pedestrian injuries and deaths in the City of San Diego was conducted. Data showing current and historical trends provided quantitative perspective on the issue. The use of geographical information systems (GIS) software provided valuable information regarding the spatial distribution of incidents, which was used in the selection of comparative research sites across the city. Because of the low frequency of pedestrian injuries and death involving children between the ages of 5-11 years, the data analyzed in this paper was pooled over the four year period of This approach was used in an effort to minimize annual fluctuations in certain

18 CHILD PEDESTRIAN ACCIDENTS IN SAN DIEGO 18 neighborhoods that experienced pedestrian accidents isolated to a short time period. Thus, pooling these data has a stabilized effect and is more reflective of the actual trends in pedestrian accidents between neighborhoods. The analysis period of also allowed for comparison of San Diego County and SDFD statistics to the most current data available through the state reporting system, SWITRS. Data for pedestrian incidents involving children ages 5-11 years from occurring in the City of San Diego was obtained through the SWITRS and geocoded using Transportation Injury Mapping System (TIMS) in order to analyze the geographic distribution of incidents and identify neighborhoods for study (Appendix A). Patient Care Reports (PCR) completed by emergency responders for all pedestrian patients between 5 to 11 years of age were used as a secondary data source to support and compare against SWITRS. PCR data was determined to be more reliable than the dispatch type data due to the inaccurate and incomplete patient and location information typically obtained at the time of the initial report to 911. A PCR is completed for all patient encounters and provided much cleaner data when looking at incident types, patient information, and incident location. The SWITRS and PCR data were analyzed for aggregate statistics, patient demographics, and locations. Two neighborhoods were selected as the study areas for this paper, one from an area that experienced a high number of pedestrian accidents, and from an area that experienced a low number. These neighborhoods were grouped with their respective census tract Subregional Area (SRA) and used for comparing the aggregate pedestrian incident data and a comprehensive demographic profile of those two SRA s. In addition to including a larger share of pedestrian accidents, the SRA was used as the primary unit of analysis because they provided a more comprehensive overview of the

19 CHILD PEDESTRIAN ACCIDENTS IN SAN DIEGO 19 demographic characteristics in areas experiencing highest and lowest number of pedestrian accidents (Appendix B). One elementary school proximate to the majority of the pedestrian accidents within each of the two identified SRA s for study was selected for sample student assessments and observational behavior surveys. Initial contact was made with the principals of the identified schools and to ascertain willingness to participate and receive the support of school staff. Personal interviews (Appendix C and D) were conducted with the county s Safe Kids program coordinator and the principals of each school. The objective of the interviews was to gather historical information on safety programs, informal or formal education programs available to students, perceived environmental safety issues particular to those school sites, existing traffic engineering concerns or recent project improvements related to pedestrian or traffic safety, and their opinions on improving the effectiveness of pedestrian safety programs. The author also participated, along with many public agencies, in one of the Walk Audits with the SRTS program at a local school to experience how environmental and infrastructural projects related to pedestrian safety are evaluated and recommended for improvement using grant funds. A written multiple choice test (Appendix E) was developed using national pedestrian safety curriculum and administered to the fifth grade students at both elementary schools. Fifth grade students were selected as the target study group due to their ability to better comprehend the test material with limited interpretation or examples required. In addition, this group appeared to be of central importance, as a preliminary data review indicated that 11 year olds had the highest percentage of pedestrian accidents within the age group and time under investigation. Test results were used to compare baseline knowledge of pedestrian traffic safety between the two student populations of the same school district having the same access to a formal

20 CHILD PEDESTRIAN ACCIDENTS IN SAN DIEGO 20 curriculum related to pedestrian safety. The surveys were also used to assess students on their method of transportation to and from school, parental involvement in teaching of safe walking practices, role modeling, and adult supervision while walking in traffic. Observational surveys were conducted in traffic areas adjacent to both elementary schools using multiple surveyors at different routes to and from the school. Surveyors used tally sheets (Appendix F) to record aggregate occurrences of unsafe walking behaviors according to a set of predetermined data points which evaluated the walking practices of that school s population. Although many types of unsafe behaviors, besides those related to walking, were observed, only the predetermined unsafe pedestrian practices were counted for comparative purposes. Observational data were collected on two separate days for 40 minutes at each site (20 minutes before and 20 minutes after school). A survey (Appendix G) was developed to solicit information on pedestrian safety programs in other fire jurisdictions and the level of involvement those departments may have in such programs. The survey also asked questions relating to perceptions of disproportionate pedestrian injury and death rates affecting certain neighborhoods within those jurisdictions and whether any research on the topic had been conducted in those locations. The survey was administered electronically to enhance the ease of distribution and the convenience of the respondents. The survey was comprised of a series of closed- ended questions in an effort to compile the results more accurately. The survey instrument was developed by the author and reviewed by SDFD chief officers. The survey was distributed via to most paid career fire departments in California using the California Professional Firefighters (CPF) directory, distribution groups provided by the SDFD Assistant Fire Chief for departments not included in the previous group, as well as the author s contacts from previously attended courses at the