Local Infrastructure and Economy Predicts Traffic Related Fatalities in Children

Infographic · Aug 2025 · 1 min read

In brief

County-level analysis of 158 US counties reveals that poor walkability infrastructure predicts higher pediatric motor vehicle fatality rates, with each decile increase in walkability associated with 7% decreased mortality. Social vulnerability and population density also correlate with traffic deaths, suggesting infrastructure improvements could reduce child fatalities.

Counties with poor walkability infrastructure have significantly higher pediatric traffic fatality rates (7% decrease per decile improvement in walkability).
Social vulnerability, food area deprivation, and low population/school density independently correlate with increased pediatric MVC mortality.
Local infrastructure improvements (walkability, school density) offer actionable policy targets to reduce child traffic deaths at the county level.
Traditional crash-focused interventions miss critical upstream factors: built environment and socioeconomic vulnerability predict pediatric MVC risk.
158 high-population US counties analyzed (2017-2021 FARS data) show infrastructure metrics outperform demographic factors in predicting fatalities.

Written by the GCMD Library team from the infographic.

A three-column comparison layout with icons representing different surgical procedures. Each column contains statistical data presented with percentage figures and bullet points. The design uses a clinical color palette with blue and gray tones, and includes simple anatomical illustrations for each procedure type.

Zane J. Hellmanna, Elena Graetzb , Shahyan Rehmana, Miranda Mooreb, Eric B. Schneiderb, Emily R. Christison-Lagaya, Daniel G. Solomon

Purpose

Previous research on pediatric motor vehicle collisions (MVC) and fatalities has primarily focused on patient demographics and crash specific information. This study evaluates whether various measures of local infrastructure, including the National Walk Index (NWI), population density, and public school density, or macroeconomic forces, encapsulated in Social Vulnerability Index (SVI) and food area deprivation (PFA) can predict which counties are most at risk for pediatric traffic fatalities.

Methods

Counties with more than 100,000 children in the most recent US census and ≥1 pediatric traffic fatality as identified in the Fatality Analysis Reporting System (FARS) between 2017 and 2021 were included in the study. Poisson regression modeling was used to identify county level infrastructure and macroeconomic forces that predicted increasing MVC related average annual mortality rate per 100,000 children.

Results

There were 158 counties that met inclusion criteria. Univariate Poisson regression demonstrated that NWI, SVI, PFA, population density, and school density each individually correlated with MVC related mortality rate (p < 0.001 for all predictors). When controlling for SVI and population density, multivariable Poisson regression demonstrated that each decile increase in walkability was associated with a 7 % decrease in MVC related mortality rate (IRR 0.93, 95 % CI 0.91–0.96).

Conclusion

Areas with poor walkability predict the likelihood of pediatric traffic fatality. These findings highlight tangible local and state policy changes that could be implemented to decrease the likelihood of traffic-related child fatality rates in specific counties.

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