Is it safe to walk in the Sunbelt? Geographic variation among pedestrian fatalities in the United States, 1999-2003.
BACKGROUND
Previous work using data from the 1980s showed higher rates of pedestrian mortality in the southern United States.


METHODS
This study was a descriptive analysis of state-specific mortality information from the National Center for Health Statistics for 1999-2002 and the National Highway Traffic Safety Administration for 2003.


RESULTS
Highest rates were in the southern rim ("Sunbelt") states for the U.S. population and for the non-Hispanic white population. Rural rates in the highest quartile were 2.1 (95% CI 1.8 to 2.6) times those in the lowest quartile. Urban rates in the highest quartile were 2.2 (95% CI 1.9 to 2.5) times those in the lowest quartile. Posted speed limits at crash sites were 2.6 (95% CI 2.0 to 3.4) times more likely to be > or = 35 mph (48.3 km/h) in the highest quartile than in the lowest quartile. Pedestrians killed in the highest quartile were 1.9 (95% CI 1.2 to 3.1) times more likely to have blood alcohol concentrations > or = 0.25 g/dL than pedestrians in the lowest quartile.


CONCLUSIONS
The highest pedestrian fatality rates concentrate in Sunbelt states experiencing rapid population growth in the past 50 years. This pattern may result from at least three features of these states: (a) a high percentage of urban vehicle miles traveled; (b) urban sprawl; and (c) a high prevalence of alcohol use - especially heavy use - among Sunbelt pedestrians.
Paulozzi
Leonard J
LJ
Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Mailstop K-63, Atlanta, GA 30341, USA. Lbp4@cdc.gov
D000063:Accidents, Traffic / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000435:Alcoholic Intoxication / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D012111:Residence Characteristics; D012307:Risk Factors; D012424:Rural Population; D015144:Southeastern United States / Q000453:epidemiology; D015206:Southwestern United States / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014505:Urban Population; D016138:Walking