Promoting safe walking and cycling to improve public health: lessons from The Netherlands and Germany.
OBJECTIVE
We examined the public health consequences of unsafe and inconvenient walking and bicycling conditions in American cities to suggest improvements based on successful policies in The Netherlands and Germany.


METHODS
Secondary data from national travel and crash surveys were used to compute fatality trends from 1975 to 2001 and fatality and injury rates for pedestrians and cyclists in The Netherlands, Germany, and the United States in 2000.


RESULTS
American pedestrians and cyclists were much more likely to be killed or injured than were Dutch and German pedestrians and cyclists, both on a per-trip and on a per-kilometer basis.


CONCLUSIONS
A wide range of measures are available to improve the safety of walking and cycling in American cities, both to reduce fatalities and injuries and to encourage walking and cycling.
Pucher
John
J
Bloustein School of Planning and Public Policy, Rutgers University, 33 Livingston Avenue, Room 363, New Brunswick, NJ 08901-1900, USA. pucher@rci.rutgers.edu
Dijkstra
Lewis
L
D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001334:Automobile Driving / Q000331:legislation & jurisprudence; D001642:Bicycling / Q000293:injuries* / Q000502:physiology / Q000706:statistics & numerical data; D002958:City Planning; D003625:Data Collection; D005858:Germany / Q000453:epidemiology; D006293:Health Promotion; D006801:Humans; D035846:Law Enforcement; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012111:Residence Characteristics; D012449:Safety / Q000706:statistics & numerical data*; D014186:Transportation / Q000379:methods; D014481:United States / Q000453:epidemiology; D014504:Urban Health / Q000706:statistics & numerical data*; D016138:Walking / Q000293:injuries* / Q000502:physiology / Q000706:statistics & numerical data