title: National Safe Routes to School program and risk of school-age pedestrian and bicyclist injury.
abstract: Safe Routes to School (SRTS) was a federally funded transportation program for facilitating physically active commuting to and from school in children through improvements of the built environment. There is evidence that SRTS programs increase walking and bicycling in school-age children, but their impact on pedestrian and bicyclist safety has not been adequately examined. We investigate the impact and effects of the SRTS program on school-age pedestrian and bicyclist injuries in a nationwide sample in the United States.
  
  
  
  Data were crash records for school-age children (5-19 years) and adults (30-64 years), in 18 U.S. states for a 16-year period (1995-2010). Multilevel negative binomial models were used to examine the association between SRTS intervention and the risk of pedestrian and bicyclist injury in children aged 5-19 years.
  
  
  
  SRTS was associated with an approximately 23% reduction (incidence rate ratio = 0.77, 95% confidence interval = 0.65-0.92) in pedestrian/bicyclist injury risk and a 20% reduction in pedestrian/bicyclist fatality risk (incidence rate ratio = 0.80, 95% confidence interval = 0.68-0.94) in school-age children compared to adults aged 30-64 years.
  
  
  
  Implementation of the SRTS program appears to have contributed to improving traffic safety for school-age children in the United States.
authors.affiliation: Department of Surgery, New York University School of Medicine, New York; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York. Electronic address: Charles.DiMaggio@nyumc.org.
authors.forename: Charles
authors.initials: C
authors.lastname: DiMaggio
authors.affiliation: Department of Surgery, New York University School of Medicine, New York.
authors.forename: Spiros
authors.initials: S
authors.lastname: Frangos
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York; Department of Anesthesiology, College of Physicians and Surgeons, Columbia University, New York, New York; Center for Injury Epidemiology and Prevention at Columbia University Medical Center, New York, New York.
authors.forename: Guohua
authors.initials: G
authors.lastname: Li
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001642:Bicycling / Q000293:injuries* / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D000069636:Pedestrians / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018570:Risk Assessment; D017751:Safety Management / Q000379:methods*; D017678:Sex Distribution; D014481:United States; D016138:Walking / Q000293:injuries*
keywords: Environment and public health; Injuries; Motor vehicles; Prevention and control