U.S. Department of Transportation
Federal Highway Administration
1200 New Jersey Avenue, SE
Washington, DC 20590
202-366-4000


Skip to content
Facebook iconYouTube iconTwitter iconFlickr iconLinkedInInstagram

Safety

FHWA Home / Safety / Pedestrian & Bicycle / National Strategies for Advancing Child Pedestrian Safety

National Strategies for Advancing Child Pedestrian Safety

Release Date: October 2001

View PDF version (271 KB) PDF icon, download Acrobat Reader







Editors

Richard A. Schieber, MD, MPH
Department of Health and Human Services
Centers for Disease Control and Prevention
National Center for Injury Prevention and Control

Maria E. Vegega, PhD
U.S. Department of Transportation
National Highway Traffic Safety Administration
Traffic Safety Programs

To order additional copies, go to:
www.cdc.gov/ncipc/pedestrian/
-- or --
www.nhtsa.dot.gov

TheNational Strategies for Advancing Child Pedestrian Safetyis a publication of the National Center for Injury Prevention and Control, part of the Centers for Disease Control and Prevention, and the National Highway Traffic Safety Administration, part of the U.S. Department of Transportation.

Centers for Disease Control and Prevention
Jeffrey P. Koplan, MD, MPH
Director

National Center for Injury Prevention and Control
Sue Binder, MD
Director

Division of Unintentional Injury Prevention
Christine Branche, PhD
Director

National Highway Traffic Safety Administration
Jeffrey W. Runge, MD
Administrator

Traffic Safety Programs
Rose A. McMurray
Associate Administrator

Office of Traffic Injury Control Programs
Marilena Amoni, MS
Director

We acknowledge the conference support provided by the National SAFE KIDS Campaign® and Nestlé. Production services were provided by staff of the Office of Communication Resources, National Center for Injury Prevention and Control.

Disclaimer

The recommendations presented in this publication were generated during a meeting of diverse public and private organizations and agencies. They do not necessarily represent the official policy of the Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, nor of the National Highway Traffic Safety Administration, U.S. Department of Transportation. Rather, they represent the priorities identified by an expert group convened by these two agencies.

Suggested Citation: Schieber RA, Vegega ME (Editors). National Strategies for Advancing Child Pedestrian Safety. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, 2001.


...Dedicated to children walking, everywhere

Introduction

Few news stories are as disturbing as that of a child killed while crossing the street. The photograph below, winner of the 1958 Pulitzer Prize, is still unsettling. Why did it happen? What could have prevented it? And why is it still happening more than forty years later?

crash site photo: William Seaman/Minneapolis Star TribuneIt only takes a moment for lives to change forever. The young child in this photograph, trying to cross busy street, was struck by a garbage truck as it rounded the corner. We can easily imagine the tremendous imbalance of momentum here—a truck weighing tons, striking a child weighing just pounds. No protective device, no safety gear could have eliminated that disparity.

By design, our society depends heavily on motor vehicle transportation. It sustains our economy and influences our culture profoundly. And yet, every day, each of us is a pedestrian who needs and deserves to share the road safely with motorists.

The right to walk safely seems fundamental, especially for children, yet each year for more than a decade, more than 700 children have died from injuries sustained while walking, over 500 of these in traffic. Although the fatality rate has declined somewhat during this period, it could be attributable to improvements in pre-hospital and emergency medical care or to a decline in walking as a mode of transportation. As we encourage individuals to get out and walk to combat obesity and other health conditions, we must make sure that they have a safe environment in which to do so.

Many intelligent and caring people, including professionals and advocates, have worked for years to reduce child pedestrian deaths in our country. Experts in motor vehicle safety, public health, city planning, school safety, child development, and engineering have wrestled with the problem, each approaching it from his or her specialty's point of view. But these approaches are limited because the entire solution does not rest within a single specialty. Child pedestrian safety is one of the most complex societal problems we face in injury prevention today.

Effective solutions to the child pedestrian safety problem must be multifaceted and arise from a collaboration among experts from diverse fields. This need inspired the creation of the Panel to Prevent Pedestrian Injuries, an interdisciplinary conference held in September 1998 to focus on reducing childhood pedestrian injuries in the United States. Three organizations came together to spearhead the effort and support the conference—the Centers for Disease Control and Prevention, working to protect the nation's health; the National Highway Traffic Safety Administration, addressing road safety; and the

National SAFE KIDS Campaign, advocating for the safety of our children. State-of-the-art position papers were commissioned on key topics in pediatric pedestrian injuries, including epidemiology, education, engineering, sociology, psychology, and research. These papers were the basis of discussion at the conference and are included in a separate document of conference proceedings. Nearly 100 individuals representing more than 25 professions participated in this invitational, interdisciplinary conference held in Atlanta, Georgia. Conferees from the United States, Canada, the United Kingdom, and Australia identified key barriers to reducing pedestrian injuries and discussed critical next steps needed to be effective. The suggestions from that meeting are provided as strategies here.

This document is not intended to be a government plan of action, nor to provide recommendations to the government. Rather, these strategies are intended to be used by anyone interested in reducing pedestrian injuries among children, while encouraging them to explore their environment by walking. We urge you to review these strategies, consider them, and implement them. We hope this document will inspire you to dedicate yourself to improving the safety of child pedestrians everywhere.


GOALS

To enhance the well-being and safety of children by:

  • Reducing their risk of injury while walking

  • Increasing their physical activity level

  • Creating a more pedestrian-friendly environment


STRATEGIES

1

Enhance public awareness about the need to improve safety for child pedestrians while promoting the health and environmental benefits of walking.

Create coordinated national, state, and local public information campaigns that increase public awareness and understanding of:

  1. The interdependent relationship among personal health, safety, community livability, and environmental protection;

  2. Pedestrians as road users who, like motorists and bicyclists, need to be safe in traffic;

  3. The manner and degree to which engineering solutions can enhance pedestrian safety (e.g., traffic calming, separation of pedestrians from motor vehicle traffic, and better crosswalk controls);

  4. The usefulness and cost-effectiveness of traffic law enforcement.

Photo: children exiting the school

2

Modify the behavior and attitudes of both pedestrians and drivers to improve sharing the road.

  1. Develop and encourage strategies that improve sharing the road, and increase mutual respect of pedestrians and motorists by teaching both groups the rules of the road.

  2. Help the public understand the degree to which excessive speed increases stopping distances and thus increases the risk of pedestrian death.

  3. Encourage the public to support enforcement of posted speed limits (especially in school zones and residential areas), laws that prohibit passing of school buses, and yield-to-pedestrian laws. Support the development and use of innovative technologies, such as red light cameras to help enforce traffic laws.

  4. Develop, evaluate, and disseminate programs to educate parents and drivers about children's abilities and limitations as pedestrians in traffic. These programs should take into account different parenting styles and abilities. Encourage parents to supervise their children in traffic and to teach their children age-appropriate pedestrian safety rules.

3

Modify the physical environment to better support pedestrian traffic.

  1. At the national level:

    1. Establish transportation policies that encourage local communities to integrate pedestrian access and safety into every phase of transportation planning.

    2. Foster collaboration among federal agencies and national professional groups to help develop and promote public policy that leverages resources to achieve the most effective programs without duplicating efforts.

    3. Develop road construction standards that are more conducive to safe walking.

    4. Compile and disseminate local “best practices” that foster pedestrian safety, especially those that emphasize the use of low-cost solutions and new technologies.

    5. Help teach traffic engineers and engineering students how to retrofit streets and roads to make them safer. Develop and disseminate curricula, sponsor professional conferences, and assist with continuing education.

  2. At the state and local levels:

    1. Encourage state and local officials to revise laws, ordinances, and practices to promote the construction of sidewalks and traffic-calming measures, such as roundabouts, speed humps and other road designs.

    2. Encourage city planners, engineers, real estate developers, and landscape architects to consider pedestrian safety—particularly for children and persons with disabilities—when designing new communities or modifying existing ones.

    3. Encourage local officials, designers, and planners to enhance pedestrian accessibility and safety when building or remodeling schools, recreational sites, and businesses.

4

Develop and conduct effective safe-walking programs.

Photo: child pushing the pedestrian traffic light button
  1. Ensure that programs to prevent child pedestrian injuries receive public and private support sufficient to provide programs in all states. This may require corporate and Congressional champions and a national spokesperson.

  2. Encourage federal agencies responsible for road safety to make available effective pedestrian safety training activities for children. Encourage federal, state, and local departments of education to establish safe routes to school.

  3. Encourage states to develop pedestrian safety plans that reflect community needs. Encourage each state department of transportation to establish and adequately staff a pedestrian safety office to coordinate and conduct training programs, conduct public information and education campaigns, and develop local programs throughout the state.

  4. At the community level, create multidisciplinary coalitions to develop programs that emphasize safety aspects and the health and environmental benefits of walking. Encourage parents, teachers, school administrators, pediatricians, and other child care providers to identify and creatively solve local pedestrian safety problems. Such coalitions should seek to enroll nontraditional partners.

 

5

Conduct research to address gaps in knowledge and to translate research findings into effective programs and public policy.

  1. Evaluate existing childhood pedestrian safety programs by using a systematic review process to determine which ones are effective and deserve widespread replication. Such programs include:

    1. Educational programs, such as Safe Routes to School, Walking School Bus, Willie Whistle, Keep on Looking, and others designed to reduce dart-outs and help children cross streets safely.

    2. Traffic-calming strategies, such as roundabouts, speed humps, and other measures.

    3. Enforcement strategies, such as red light cameras and stricter ticketing of drivers who illegally pass school buses.

  2. Where sufficient data do not exist, use randomized controlled trials where feasible to measure intervention effectiveness.

  3. Conduct research to determine the costeffectiveness of promising programs.

  4. Fund research that links pedestrian safety to physical activity and a healthier environment.

  5. Identify behavioral indicators to help determine when a child is ready to cross the street independently. Assess the chronologic and developmental age, skill patterns, and teachable moments when children are most receptive to interventions.

  6. Determine what level of supervision children need at various stages of cognitive, social, skill, and behavioral development. Establish appropriate standards for such supervision.

  7. Develop, test, and evaluate programs that use teens to mentor young children in pedestrian safety.

Photo: mother and a child walking

6

Conduct surveillance to measure children's pedestrian injury rates, quantify the amount of walking children normally do, and identify risk factors for injury.

  1. Identify and validate useful indirect measures that predict the occurrence of a child pedestrian injury. Use these to monitor program effectiveness.

  2. Develop and test indicators of the prevalence of walking for transportation, the public's beliefs about the benefits and risks of walking, and the existence of environmental and social risks of walking.

  3. Define children's exposure to risk of pedestrian injury that includes, but is not limited to, factors related to the time the child spends in the street; traffic density, speed, and complexity; and road features such as the number of lanes and existence of marked or signed crosswalks. Develop and implement methods of collecting data on such exposure.

  4. Develop local risk factor surveillance systems to monitor how and why child pedestrians are injured, and to identify the environmental and behavioral modifications that could have prevented such injuries. Establish linkages to other data sources, particularly emergency department data and police crash reports.

Panel to Prevent Pedestrian Injuries

Meeting Participants
September 27–28, 1998
Atlanta, Georgia

A-K | L-Z

Name and Affiliation*

Area(s) of Expertise

Phyllis Agran, MD, MPH
Department of Pediatrics
Pediatric Injury Prevention Research Group
Health Policy and Research
University of California Irvine

Pediatrics
Epidemiology Research

Barbara Alberson, MPH
California Department of Health
State and Local Injury Control Section

Health Education

Heather Alhadeff, MS
Pedestrian Initiatives
Atlanta City Council

City Planning
Pedestrian Advocacy

Marilena Amoni, MS
Office of Traffic Injury Control Programs
National Highway Traffic Safety Administration

Traffic Safety Policy

Meri-K Appy
National Fire Protection Association (NFPA)

Health Education

Jerry Bolles
United Parcel Service
Corporate Fleet Safety

Business Safety

Christine Branche, PhD
Centers for Disease Control and Prevention
National Center for Injury Prevention and Control
Division of Unintentional Injury Prevention

Epidemiology Research

Ruth Brenner, MD, MPH
 
National Institute of Child Health and Human Development
Division of Epidemiology, Statistics, and Prevention Research

Epidemiology Research

Dan Burden
Walkable Communities, Inc.

Pedestrian Advocacy
Traffic Engineering

LaTanya Butler
Centers for Disease Control and Prevention
National Center for Injury Prevention and Control
Division of Unintentional Injury Prevention

Senior Program Administration

Kathy Kaufer Christoffel, MD, MPH
Children's Memorial Hospital

Pediatrics
Epidemiology Research

Elizabeth Crane, PhD, MPH
Centers for Disease Control and Prevention
National Center for Injury Prevention and Control
Division of Violence Prevention

Epidemiology Research

Michael Cynecki, MSCE
City of Phoenix
Street Transportation Department

Traffic Engineering

Robert Dallas, JD
SAFE KIDS™ of Georgia
Shaw & Evans, LLC

Law/Lobbyist

Steve Davidson, MEd
Office of Injury Control
Georgia Division of Public Health

State Injury Prevention
Program Administration

Lisa Dawson
Georgia Division of Public Health

Health Education

Lisa Deal, RN, ScD
The David and Lucile Packard Foundation

Philanthropy
Nursing

David DiLillo, PhD
Consultant

Psychology

John Fegan
Federal Highway Administration

Psychology
Traffic Engineering

Mark Fenton, MS
Walking Magazine

Communications
Pedestrian Advocacy

Sally Flocks, PhD
Pedestrians Educating Drivers on Safety (PEDS), Inc.

Pedestrian Advocacy

Richard Franklin
Department of Public Works/Transportation Services
City of Atlanta

Public Works Administration

Sue Gallagher, MPH
Education Development Center, Inc.

Health Education

Virginia Galvin, MD,
Cobb/Douglas County Board of Health

MPH District Health Officer

Jane Garrison
Chatham County Environmental Health

Health Education
Pedestrian Advocacy

Charles Gauthier
National Association of State Directors of Pupil Transportation Services

Bus Safety Advocacy

M. Jean Gearing, PhD, MPH
DeKalb County Board of Health

Anthropology

Andrea Gielen, ScD, ScM
Johns Hopkins School of Public Health
Center for Injury Research and Policy

Health Education

Julie Gilchrist, MD
Centers for Disease Control and Prevention
National Center for Injury Prevention and Control
Division of Unintentional Injury Prevention

Pediatrics
Physical Activity
Epidemiology Research

Carole Guzzetta
National Safety Belt Coalition
National Safety Council

Child Injury Prevention
Advocach
Health Education

Jane Hansen
Atlanta Journal – Constitution

Communications

Jennifer Harville, MPH
Johns Hopkins University
Central Maryland Regional Safe Communities Center

Health Education

Spenser Havlick, PhD
University of Colorado Boulder City Council

Environmental Design

Timothy Hoyt, ME
Nationwide Insurance Enterprise

Insurance Industry

Belinda Jackson, MPH
National Highway Traffic Safety Administration

Regional Program Administration

Mary Jagim, RN, BSN, CEN
Emergency Nurses Association

Nursing

Bruce Jones, MD, MPH
Centers for Disease Control and Prevention
National Center for Injury Prevention and Control
Division of Unintentional Injury Prevention

Epidemiology Research

Frank Julian
Federal Highway Administration

Traffic Engineering

Richard Killingsworth, MPH
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Division of Nutrition and Physical Activity

Physical Activity

Bo Kimsey, PhD, MSEH
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Division of Nutrition and Physical Activity

Epidemiology Research

Catherine Kinney, PhD
Kinney Associates

Psychology

Jennie Kronenfeld, PhD
Arizona State University
School of Health Administration and Policy

Medical Sociology

Peter Lagerwey
Seattle Transportation

Pedestrian and Bicycle Safety
Program Administration

Garry Lapidus, PA-C, MPH
Connecticut Children's Medical Center

Epidemiology Research

Joey Ledford
Atlanta Journal – Constitution

Communications

Kristen Lindemer, MPH
Office of Injury Control
Georgia Division of Public Health

Health Education

Lauren Marchetti
University of North Carolina
Highway Safety Research Center

Health Education

Michael Martin
National Association for Pupil Transportation

Bus Safety Advocacy

Leigh Matusick
State of Florida Department of Highway Safety and Motor Vehicles
Florida School Crossing Guard Program

Crossing Guard Education

Robin Mayer
National Outreach Division
National Highway Traffic Safety Administration

Outreach Strategies

Barbara McCann
Surface Transportation Policy Project
Transportation and Quality of Life Campaign

Communications
Pedestrian Advocacy

Patrick McMahon, MRP
University of North Carolina
Highway Safety Research Center

City Planning

Angela Mickalide, PhD
National SAFE KIDS Campaign®

Child Safety Advocacy

Ted Miller, PhD
National Public Services Research Institute

Economics Research

John Moffat
Washington Traffic Safety Commission

Law Enforcement

Mark Norman, MS
Institute of Transportation Engineers

Traffic Engineering

Genevieve O'Donnell, MPH
National SAFE KIDS Campaign®

Child Safety Advocacy

David Oliver, MBA
Lowe's Company, Inc.

Philanthropy

Sarah Olson, MS, CHES
Centers for Disease Control and Prevention
National Center for Injury Prevention and Control
Division of Unintentional Injury Prevention

Health Education

Immauri Patterson, MA
Fulton County Department of Health and Wellness

Health Education

I. Barry Pless, MD
McGill University

Pediatrics
Epidemiology Research

Kyran Quinlan, MD, MPH
Centers for Disease Control and Prevention
National Center for Injury Prevention and Control
Division of Unintentional Injury Prevention

Pediatrics
Epidemiology Research

Fred Rivara, MD, MPH
Harborview Injury Prevention and Research Center

Pediatrics
Epidemiology Research

Ian Roberts, MD, PhD
University of London
Institute of Child Health

Pediatrics

Epidemiology Research

Michael Ronkin
Oregon Department of Transportation
Bicycle and Pedestrian Program

State Pedestrian Program
Administration

Mark Rosenberg, MD, MPP
Centers for Disease Control and Prevention
National Center for Injury Prevention and Control

Director, National Center for Injury Prevention and Control

Heather Ryan
Consultant

Health Education

Jeffrey Sacks, MD, MPH
Centers for Disease Control and Prevention
National Center for Injury Prevention and Control
Division of Unintentional Injury Prevention

Epidemiology Research

Peter Scheidt, MD, MPH
Children's National Medical Center – George Washington University

Pediatrics Epidemiology Research

Richard Schieber, MD, MPH
Centers for Disease Control and Prevention
National Center for Injury Prevention and Control
Division of Unintentional Injury Prevention

Pediatrics

Epidemiology Research

Preston Schiller, PhD
Western Washington University

City Planning
Environmental Design

Joseph Schofer, PhD
Department of Civil Engineering and the Transportation Center
Northwestern University

Traffic Engineering

Cara Seiderman, MCRP, MCA
Cambridge Community Development Department

City Planning

David Sleet, PhD
Centers for Disease Control and Prevention
National Center for Injury Prevention and Control Division of Unintentional Injury Prevention

Health Education

Howard Spivak, MD
New England Medical Center

Pediatrics
Epidemiology Research

Mark Stevenson, PhD, MPH
Centers for Disease Control and Prevention
National Center for Injury Prevention and Control Division of Unintentional Injury Prevention

Epidemiology Research

Deborah Davis Stewart
Safe Ride News Publication

Communications

Leslie Teach, MPH
Centers for Disease Control and Prevention
National Center for Injury Prevention and Control
Division of Unintentional Injury Prevention

Health Education

Harold Thompson
National Safety Council
Partnership for a Walkable America

Program Administration

Nancy Thompson, PhD, MPH
Rollins School of Public Health
Emory University

Epidemiology Research
Psychology

James Thomson, PhD
University of Strathclyde

Health Education
Psychology

Cecil Threat
Centers for Disease Control and Prevention
National Center for Injury Prevention and Control
Division of Unintentional Injury Prevention

Program Administration

Andrew Tolmie, PhD
University of Strathclyde

Health Education
Psychology

Elizabeth Towner, PhD
University of Newcastle

Health Education

Maria Vegega, PhD
National Highway Traffic Safety Administration Office of Traffic Injury Control Programs
Safety Countermeasures Division

Psychology

Claudia Vousden, RN, MPH
State and Territorial Injury Prevention
Directors' Association

Nursing

David Wallace, MS
Centers for Disease Control and Prevention
National Center for Injury Prevention and Control
Division of Unintentional Injury Prevention

Epidemiology Research

John Wetmore
Perils for Pedestrians

Communications

Mark Widome, MD, MPH
Pennsylvania State University

Child Injury Prevention Advocacy
Pediatrics
Epidemiology Research

Bill Wilkinson
Campaign to Make America Walkable

Pedestrian Advocacy

Allan Williams, PhD
Insurance Institute for Highway Safety

Motor Vehicle Insurance
Industry Research

Diane Winn, RN, MPH
University of California Irvine
Pediatric Injury Prevention Research Group
Health Policy and Research

Epidemiology Research
Nursing

Charles Zegeer, MS
University of North Carolina
Highway Safety Research Center

Traffic Engineering

Joseph Zins, EdD
University of Cincinnati

Health Education

 

* Organizations listed reflect participants' affiliations at the time of the meeting.

Department of Health and Human Services
Centers for Disease Control and Prevention

SAFER · HEALTHIER · PEOPLETM

CDC logo National Safe Kids Campaign logo
Nestle logo NHTSA: People Saving People logo
Page last modified on July 5, 2011
Safe Roads for a Safer Future - Investment in roadway safety saves lives
Federal Highway Administration | 1200 New Jersey Avenue, SE | Washington, DC 20590 | 202-366-4000