Examining the Effect of Pedestrian Crashes on Vulnerable Populations in North Carolina

N C Med J. 2021 Jul-Aug;82(4):237-243. doi: 10.18043/ncm.82.4.237.


Background: Over the last several years, pedestrian fatalities have increased in North Carolina; however, fatalities represent a small proportion of the total number of nonfatally injured pedestrians. Therefore, we linked statewide motor vehicle crash (MVC) and emergency department (ED) visit data to better understand the circumstances and characteristics of pedestrians treated in North Carolina emergency departments (EDs) for injuries related to crashes.

Methods: We linked information for pedestrians and bicyclists from 2017 North Carolina police-reported MVCs to population-based ED visit data using hierarchical deterministic methods.

Results: We linked 45% of pedestrian crash records to ED visit records (N = 1383 incident ED visits). The rate of pedestrians treated in North Carolina EDs for their injuries was 13.6 ED visits per 100,000 person years. For pedestrian injuries treated in North Carolina EDs, rates (per 100,000 person years in parentheses) were higher among men (15.5) and Black pedestrians (22.7) than women (10.6) and White pedestrians (8.2). Sociodemographic characteristics associated with serious injuries included age, sex, race/ethnicity, and expected source of payment for the ED visit. Crash characteristics associated with serious injuries included posted speed limit, ambient light, number of lanes, and striking vehicle type.

Limitations: The study involved the use of secondary data, not collected specifically for pedestrian injury surveillance.

Conclusions: Pedestrian injuries and fatalities place a considerable burden on the population of North Carolina, especially among persons of color and older adults. Injury prevention programs are actively addressing this problem, but more needs to be done.

MeSH terms

  • Accidents, Traffic
  • Aged
  • Emergency Service, Hospital
  • Female
  • Humans
  • Male
  • North Carolina / epidemiology
  • Pedestrians*
  • Vulnerable Populations
  • Wounds and Injuries* / epidemiology