title: Association between neighbourhood marginalization and pedestrian and cyclist collisions in Toronto intersections.
abstract: OBJECTIVE
  Pedestrian and cyclist collisions comprise a significant proportion of preventable injury. In urban settings, collision rates have been linked to various socio-demographic factors. We sought to determine whether neighbourhood marginalization affects pedestrian and cyclist collisions in the Greater Toronto Area.
  
  
  METHODS
  For 114 intersections, pedestrian and cyclist collisions were extracted from the Toronto Traffic Data Centre database. We used a geographic information system approach to determine census Dissemination Areas and an associated Ontario Marginalization Index (ON-Marg) for each intersection. We performed a logistic regression to examine the associations between the four ON-Marg dimensions (residential instability, material deprivation, dependency, ethnic concentration) and pedestrian and cyclist collisions.
  
  
  RESULTS
  The odds of sustaining a collision were independently associated with residential instability for both pedestrians (OR 1.84, 95% CI 1.21-2.84, p=0.006) and cyclists (OR 2.04, 95% CI 1.34-3.16, p=0.001). Higher overall collision rates (both pedestrian and cyclist) were associated with both ethnic concentration (OR 1.56, 95% CI 1.05-2.37, p=0.033) and residential instability (OR 2.16, 95% CI 1.43-3.38, p=0.001). Material deprivation and dependency were not significant risk factors for intersection collisions in this model.
  
  
  CONCLUSIONS
  Collisions involving pedestrians and cyclists are more common in areas of increased residential instability and ethnic concentration in Toronto. Intersections in neighbourhoods with these characteristics could be targeted for strategies to reduce pedestrian and cyclist injury risk in urban settings.
authors.affiliation: Division of Neurosurgery, Injury Prevention Research Office, Keenan Research Centre, St. Michael's Hospital. CUSIMANOM@smh.ca.
authors.forename: Jordan D
authors.initials: JD
authors.lastname: Silverman
authors.forename: Michael G
authors.initials: MG
authors.lastname: Hutchison
authors.forename: Michael D
authors.initials: MD
authors.lastname: Cusimano
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001642:Bicycling / Q000293:injuries*; D002648:Child; D004779:Environment Design / Q000706:statistics & numerical data*; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012307:Risk Factors; D012737:Sex Factors; D062487:Social Marginalization; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data*; D016138:Walking / Q000293:injuries*; D055815:Young Adult
keywords: ON-Marg; Pedestrian collisions; cyclist collisions; neighbourhood; risk factors; social marginalization