Association Between Neighbourhood Marginalization and Pedestrian and Cyclist Collisions in Toronto Intersections

Abstract

T raffic-related collisions comprise a significant proportion of preventable injury. In 2009 the World Health Organization ranked road traffic accidents the ninth leading cause of death, accounting for 1.21 million deaths and up to 50 million injuries per year. 1,2 Worldwide, nearly half of people who die in traffic collisions are vulnerable road users: pedestrians, cyclists and motorized 2-wheeler users. 2 In Canada, there were 199,337 road-traffic-related injuries and 2,889 fatalities in 2006; pedestrians comprised 13% and cyclists 3% of these deaths. 1 Though fatalities are fewer in developed countries and have decreased significantly over the last three decades, the physical, financial and psychosocial costs for the over 30,000 pedestrians and cyclists injured in Canada per year remain high. There is particular concern in large urban centres, where pedestrian and cyclist collisions may occur at higher rates due to increased vehicle and pedestrian traffic. Intersections are complex geographical entities with high potential for road traffic collisions; two thirds of Ontario cyclist-motorist collisions occur in intersections. 3,4 Preston and colleagues 5 found that 55% of accidents and 80% of fatal crashes in Minnesota occurred at stop-controlled intersections. Characteristics that increase the complexity of intersections include vehicle turning, pedestrian and traffic volumes, and built infrastructure, including number of lanes, presence of traffic-slowing methods (e.g., speed humps), roundabouts, bicycle lanes, paths or shared lanes, crosswalks, and transit stop usage. 6-8 Several studies have considered environmental, behavioural and socio-demographic risk factors for collisions in urban intersections. Environmental factors that increased collision risk included speed limits exceeding 50 km/h and lack of pedestrian signals. 9,10 Behavioural factors included alcohol intoxication, total driver violations, and lack of pedestrian supervision. 9,10 With respect to sociodemographic factors, injured pedestrians tend to be children and the elderly, predominantly male, Aboriginal, from low-income families or residing in neighbourhoods with low median home values. 9,10 Similar environmental, behavioural and demographic trends are expected for cyclists, but evidence is minimal in the literature to date.

Multiple-scale spatial analysis of paediatric, pedestrian road traffic injuries in a major city in North-Eastern Iran 2015–2019

“…With about a million people in the suburbs and a total population of 3,372,660, Mashhad has the largest suburban population in Iran [13], which translates into a large population of poor children [13]. Moreover, being a child, or a member of a low-income family, are two known risk factors for pedestrian accidents [14][15][16]. Paediatric, Pedestrian Road Traffic Injuries (PPRTIs) is, therefore, an important and crucial public health issue for this city, whose reduction would require effective interventions.…”

Examining the Relationship Between Access to Healthcare and Marginalization in Toronto

“…Another study conducted by Silverman (2013) also supports this claim. However, they examine the number of cyclist collisions in Toronto connecting them to socio-demographic factors in the Ontario Marginalization Index rather then health and disease (Silverman, 2013).…”

“…This study is particularly interesting as it takes place in Toronto as well. On-Marg data was applied to each intersection where the collisions occurred, and a logistic regression analysis was performed to examine the association between the four ON-Marg dimensions and the cyclist collisions (Silverman, 2013). Based on these dimensions, they concluded that local areal dependency and material deprivation were not significant factors in the cyclist collision (Silverman, 2013).…”

Spatial distribution of child pedestrian injuries along census tract boundaries: Implications for identifying area-based correlates

“…These results should provide guidance to the numerous studies aggregating health outcomes to the census tracts in which they occur, especially those investigating outcomes that may be geographically associated with census boundaries. Pedestrian injury in general, and child pedestrian injury in particular, is one area where the growing body of research [ 13 – 16 , 21 , 25 , 26 – 28 ] is becoming aware of inherently geographic issues within their studies–those identified through this investigation should be added to the list.…”