title: Walking, cycling and transport safety: an analysis of child road deaths.
abstract: OBJECTIVE
  To examine trends in road death rates for child pedestrians, cyclists and car occupants.
  
  
  METHODS
  Analysis of road traffic injury death rates per 100 000 children and death rates per 10 million passenger miles travelled.
  
  
  METHODS
  England and Wales between 1985 and 2003.
  
  
  METHODS
  Children aged 0-14 years.
  
  
  METHODS
  None.
  
  
  METHODS
  Death rates per 100,000 children and per 10 million child passenger miles for pedestrians, cyclists and car occupants.
  
  
  RESULTS
  Death rates per head of population have declined for child pedestrians, cyclists and car occupants but pedestrian death rates remain higher (0.55 deaths/100,000 children; 95% confidence interval [CI] 0.42 to 0.72 deaths) than those for car occupants (0.34 deaths; 95% CI 0.23 to 0.48 deaths) and cyclists (0.16 deaths; 95% CI 0.09 to 0.27 deaths). Since 1985, the average distance children travelled as a car occupant has increased by 70%; the average distance walked has declined by 19%; and the average distance cycled has declined by 58%. Taking into account distance travelled, there are about 50 times more child cyclist deaths (0.55 deaths/10 million passenger miles; 0.32 to 0.89) and nearly 30 times more child pedestrian deaths (0.27 deaths; 0.20 to 0.35) than there are deaths to child car occupants (0.01 deaths; 0.007 to 0.014). In 2003, children from families without access to a vehicle walked twice the distance walked by children in families with access to two or more vehicles.
  
  
  CONCLUSIONS
  More needs to be done to reduce the traffic injury death rates for child pedestrians and cyclists. This might encourage more walking and cycling and also has the potential to reduce social class gradients in injury mortality.
authors.affiliation: London School of Hygiene & Tropical Medicine, UK.
authors.forename: Beth
authors.initials: B
authors.lastname: Sonkin
authors.forename: Phil
authors.initials: P
authors.lastname: Edwards
authors.forename: Ian
authors.initials: I
authors.lastname: Roberts
authors.forename: Judith
authors.initials: J
authors.lastname: Green
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality* / Q000639:trends; D000293:Adolescent; D001334:Automobile Driving / Q000706:statistics & numerical data*; D001642:Bicycling / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D004739:England / Q000453:epidemiology; D006291:Health Policy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009026:Mortality / Q000639:trends; D012307:Risk Factors; D012449:Safety; D015996:Survival Rate; D014852:Wales / Q000453:epidemiology; D016138:Walking / Q000293:injuries*