Background Pedestrian and bicyclist injuries and fatalities have increased since 2010 after a long downward trend. Trucks and SUVs, collectively called light trucks, have also increased in sales and size, which may affect pedestrians and bicyclists. Additionally, pedestrian and cyclist commuters vary by state and it has been speculated that an increase in such commuters may affect fatalities. Studying vulnerable road users can bestow clues on best practices for infrastructure and public health. Methods State level pedestrian and cyclist fatality data was obtained from the National Highway Transportation Safety Administration for 2018. Light truck registration by state was obtained from the Office of Highway Policy Information for 2018. Commuters who walk or bike to work were obtained from the American Community Survey from 2009 to 2011, from the latest Centers for Disease Control report. We performed multiple linear regression, accounting for total motor vehicle lane miles per 100 people, also obtained from the Office of Highway Policy Information for 2018. Multiple regression analysis was performed to assess predictors for pedestrian and cyclist fatalities with the predictors variables of light truck registration, lane miles per 100 people, and proportion of commuters who are vulnerable road users. Secondary analysis included simple linear regression of the predictor variables against each other. Results The multiple regression model, including proportion of light truck registration, lane miles per 100 people, and proportion of commuters who are vulnerable road users, accounted for 18% of the variability in the outcome variable (p = 0.03). An increased number of vulnerable road users were negatively associated with pedestrian and bicyclist fatality. Additionally, there appeared to be an association between motor vehicle lane miles per 100 people and proportion of light truck registrations that was also significant (p < 0.01). Conclusion The variables affecting vulnerable road user deaths are important to understand given their increased risk exposure on the road. This state level study identifies a potential protective variable with increased vulnerable road users being associated with a decrease in pedestrian and bicyclist death rates. Additionally, light truck proportions do not appear to have a significant effect on death rates.

Background Pedestrian and bicyclist injuries and fatalities have increased since 2010 after a long downward trend. Trucks and SUVs, collectively called light trucks, have also increased in sales and size, which may affect pedestrians and bicyclists. Additionally, pedestrian and cyclist commuters vary by state and it has been speculated that an increase in such commuters may affect fatalities. Studying vulnerable road users can bestow clues on best practices for infrastructure and public health. Methods State level pedestrian and cyclist fatality data was obtained from the National Highway Transportation Safety Administration for 2018. Light truck registration by state was obtained from the Office of Highway Policy Information for 2018. Commuters who walk or bike to work were obtained from the American Community Survey from 2009 to 2011, from the latest Centers for Disease Control report. We performed multiple linear regression, accounting for total motor vehicle lane miles per 100 people, also obtained from the Office of Highway Policy Information for 2018. Multiple regression analysis was performed to assess predictors for pedestrian and cyclist fatalities with the predictors variables of light truck registration, lane miles per 100 people, and proportion of commuters who are vulnerable road users. Secondary analysis included simple linear regression of the predictor variables against each other. Results The multiple regression model, including proportion of light truck registration, lane miles per 100 people, and proportion of commuters who are vulnerable road users, accounted for 18% of the variability in the outcome variable (p = 0.03). An increased number of vulnerable road users were negatively associated with pedestrian and bicyclist fatality. Additionally, there appeared to be an association between motor vehicle lane miles per 100 people and proportion of light truck registrations that was also significant (p < 0.01). Conclusion The variables affecting vulnerable road user deaths are important to understand given their increased risk exposure on the road. This state level study identifies a potential protective variable with increased vulnerable road users being associated with a decrease in pedestrian and bicyclist death rates. Additionally, light truck proportions do not appear to have a significant effect on death rates.