Journal article
Where Do Older Pedestrians Experience a Risk of Being Killed in a Motor Vehicle Crash?
Journal of the American Geriatrics Society (JAGS), Forthcoming
20 Nov 2025
PMID: 41263546
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Population-level interventions are needed to address the overrepresentation of older pedestrians in deaths from traffic crashes. Data are absent on whether specific publicly licensed or public establishments are associated with increased risk to older pedestrians, despite their attractiveness as partners for government efforts. We conducted a nationwide location-based case-control study to examine the associations between publicly licensed or public establishments of daily living for older adults and the location of pedestrian fatalities in motor vehicle crashes. We also assessed etiological heterogeneity by pedestrian age and time of day.
Between 2017 and 2018, there were 10,529 locations where a pedestrian was killed (case location) across the 380 Metropolitan Statistical Areas of the conterminous United States. For each case location two matched control locations were selected. The density of residential living facilities and walkable destinations for older adults was measured within a 1-km radial buffer of each location. Data were analyzed using conditional logistic regression models, adjusting for matching factors, neighborhood composition and walkability metrics.
There was a dose-response relationship between the density of older adult walkable destinations (hospitals, health care delivery venues, health services, pharmacies, senior centers, libraries, community centers) and location case-control status by age group of the fatally struck pedestrian. The strongest pattern was observed for the 65+ age group: Adjusted Odds Ratio (AOR) = 1.61 (95% CI: 1.26-2.06) for Q2; AOR = 2.58 for Q3 (95% CI: 1.99-3.34); and AOR = 3.44 for Q4 (95% CI = 2.61-4.52). Only among the age 50-64 and 65+ age groups was the highest category of density of residential facilities (assisted living facilities, skilled nursing facilities, continuing care retirement communities) associated with fatality location case-control status.
Future research might explore whether prioritizing traffic safety programs near destinations where older adults commonly frequent, such as medical centers, prevents older adult pedestrian fatalities.
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Details
- Title
- Where Do Older Pedestrians Experience a Risk of Being Killed in a Motor Vehicle Crash?
- Creators
- Kathryn G Burford - Columbia UniversityKathryn M Neckerman - Population CouncilJames W Quinn - Columbia UniversityMichael D M Bader - Johns Hopkins UniversityGina S Lovasi - Drexel UniversityStephen J Mooney - University of WashingtonNicole G Itzkowitz - Columbia UniversityDirk Kinsey - Bryn Mawr CollegeAndrew G Rundle (Corresponding Author) - Columbia University
- Publication Details
- Journal of the American Geriatrics Society (JAGS), Forthcoming
- Publisher
- Wiley
- Number of pages
- 11
- Grant note
- R00LM012868 / U.S. National Library of Medicine R01AA028552 / National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism 5T32ES007322-21 / NIEHS NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative; Dana and David Dornsife School of Public Health; Epidemiology and Biostatistics
- Web of Science ID
- WOS:001618837800001
- Scopus ID
- 2-s2.0-105022640105
- Other Identifier
- 991022133523704721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Geriatrics & Gerontology
- Gerontology