| This dissertation describes the epidemiology of child pedestrian injury in New York City and seeks to determine if there are environmental or vehicle-related factors that are amenable to injury reduction and prevention. Utilizing police accident reports for 693,283 motor vehicle crashes from 1991 to 1997, the study presents the epidemiology of 29,217 pedestrians between the ages of 5 and 19 injured during the study period. Population-based injury rates, ecologic correlates of injury, and case-fatality rates are calculated. In addition, registration data on 18,247 vehicles involved in child pedestrian injury are analyzed to examine the role of drivers and vehicle body type in the occurrence and severity of injury.; There was a decline in the annual incidence of pediatric pedestrian injury over the seven-year study period. The injury rate for the entire city was 2.9 per 1000 children at risk, ranging from a low of 1 per 1000 in some police precincts to a high of nearly 7 pediatric pedestrian injuries per 1000 in other police precincts. The correlation of injury rates with per capita crime was clear and consistent across all age groups (r = 0.73 for 5 to 19 years old, p < 0.001), while the inverse association of injury rates with per capita income was largely limited to the youngest age group (r = −0.67 for 5 to 9 years old, p < 0.001).; Taxis were associated with an increased risk, adjusted for mileage, for the occurrence of pediatric pedestrian injury. (RR = 1.5 95% CI 1.4, 1.6). In a logistic regression model controlling for driver age, driver gender, and vehicle weight, injuries caused by a light trucks or vans, when compared to passenger cars, were more than twice as likely to result in death (OR = 2.6 95% CI 1.6, 4.4). For the 5 to 9 year-old age group, light trucks and vans were five times as likely to be associated with fatal injury (OR = 5.1 95% CI 2.5, 10.3).; The results provide a basis for developing control and prevention strategies through education, engineering, and enforcement interventions. |
