| INTRODUCTION: In an urban environment, improving pedestrian safety is a public health challenge. For every death attributable to road injuries, there are hundreds of injured people and, in richer countries, decreases in the number of pedestrian deaths may reflect a reduction of walking as a mode of transportation. The predominant preventive strategies have limited or no effect on traffic volume, which is the most important predictor of the number of pedestrians injured by motor vehicles. Moreover, environmental interventions are usually limited to sites that have had the greatest number of deaths or injuries. The purpose of this thesis is to describe the contribution of environmental factors such as traffic volume, local walking practices and street geometry, on the number and the distribution of pedestrian injuries in an urban setting.;RESULTS: The descriptive analyses showed a great deal of dispersion of collision sites within neighbourhoods. The multivariate analyses showed the significant effects, independent of traffic volume, of the presence of an artery and of a fourth leg at the intersection, and of pedestrian volume in the neighbourhood, on the number of pedestrian injuries at intersections. The multi-level analysis showed extensive spatial variation in the effect of traffic volume. This spatial variation in the number of casualties, and the socioeconomic gradient observed, were in large part explained by traffic volume, the presence of an artery and of a fourth leg at the intersection.;DISCUSSION: The great dispersion of collision sites supports an approach which is not limited to sites with the highest number of injured pedestrians. This thesis suggests that preventive strategies based on environmental and population approaches could considerably reduce the number of injured pedestrians, as well as road injury inequalities across urban neighbourhoods.;Keywords : Injuries, Road safety, Pedestrians, Cyclists, Collisions, Motor vehicles, Public health, Social inequalities in health;METHOD: The design of the study is descriptive and cross-sectional. The main data sources were Urgences-sante ambulance service records (road injuries), the Origin-Destination survey (traffic volume), the Geobase for the Montreal road network (street geometry) and the census of Canada (local walking practices, socioeconomic position). The descriptive analyses included map locations (x, y coordinates) for all collision sites. Multilevel regression models nested intersections in census sectors and in boroughs. |
