title: Gender and age differences in components of traffic-related pedestrian death rates: exposure, risk of crash and fatality rate.
abstract: BACKGROUND
  This ecological study aimed i) to quantify the association of age and gender with the three components of pedestrians' death rates after a pedestrian-vehicle crash: exposure, risk of crash and fatality, and ii) to determine the contribution of each component to differences in death rates according to age and gender in Spain.
  
  
  METHODS
  We analyzed data for 220 665 pedestrians involved in road crashes recorded in the Spanish registry of road crashes with victims from 1993 to 2011, and a subset of 39 743 pedestrians involved in clean collisions (in which the pedestrian did not commit an infraction). Using decomposition and quasi-induced exposure methods, we obtained the proportion of increase in death rates for each age and gender group associated with exposure, risk of collision and fatality.
  
  
  RESULTS
  Death rates increased with age. The main contributor to this increase was fatality, although exposure also increased with age. In contrast, the risk of collision decreased with age. Males had higher death rates than females, especially in the 24-54 year old group. Higher fatality rates in males were the main determinant of this difference, which was also related with a higher risk of collision in males. However, exposure rates were higher in females.
  
  
  CONCLUSIONS
  The magnitude and direction of the associations between age and gender and each of the three components of pedestrians' death rates differed depending on the specific component explored. These differences need to be taken into account in order to prioritize preventive strategies intended to decrease mortality among pedestrians.
authors.affiliation: Doctorate Program in Clinical Medicine and Public Health, University of Granada, Granada, Spain. mariaa.onieva@gmail.com.
authors.forename: María Ángeles
authors.initials: MÁ
authors.lastname: Onieva-García
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, Avda. de la Investigación, 11, 18016, Granada, Spain.|Centros de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
authors.forename: Virginia
authors.initials: V
authors.lastname: Martínez-Ruiz
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, Avda. de la Investigación, 11, 18016, Granada, Spain.|Centros de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Lardelli-Claret
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, Avda. de la Investigación, 11, 18016, Granada, Spain.|Centros de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
authors.forename: José Juan
authors.initials: JJ
authors.lastname: Jiménez-Moleón
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, Avda. de la Investigación, 11, 18016, Granada, Spain.|Centros de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Amezcua-Prieto
authors.affiliation: Centros de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.|Department of Biostatistics, School of Medicine, University of Granada, Avenida de Madrid 11, 18012, Granada, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: de Dios Luna-Del-Castillo
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, Avda. de la Investigación, 11, 18016, Granada, Spain.|Centros de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
authors.forename: Eladio
authors.initials: E
authors.lastname: Jiménez-Mejías
keywords: Age; Crash; Exposure; Fatality; Gender; Mortality; Pedestrian