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A National Study on the Comparative Burden of Pedestrian Injuries from Falls Relative to Pedestrian Injuries from Motor Vehicle Collisions

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Abstract

Pedestrian injuries from falls are an understudied cause of morbidity. Here, we compare the burden of pedestrian injuries from falls occurring on streets and sidewalks with that from motor vehicle collisions. Data on injurious falls on streets and sidewalks, and pedestrian-motor vehicle collisions, to which Emergency Medical Services responded, along with pedestrian and incident characteristics, were identified in the 2019 National Emergency Medical Services Information System database. In total, 118,520 injurious pedestrian falls and 33,915 pedestrians-motor vehicle collisions were identified, with 89% of the incidents occurring in urban areas. Thirty-two percent of pedestrians struck by motor vehicles were coded as Emergent or Critical by Emergency Medical Services, while 19% of pedestrians injured by falls were similarly coded. However, the number of pedestrians whose acuity was coded as Emergent or Critical was 2.1 times as high for injurious falls as compared with pedestrians-motor vehicle collisions. This ratio was 3.9 for individuals 50 years and older and 6.1 for those 65 years and older. In conclusion, there has been substantial and appropriate policy attention given to preventing pedestrian injuries from motor vehicles, but disproportionately little to pedestrian falls. However, the population burden of injurious pedestrian falls is significantly greater and justifies an increased focus on outdoor falls prevention, in addition to urban design, policy, and built environment interventions to reduce injurious falls on streets and sidewalks, than currently exists across the USA.

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Acknowledgements

Dr. Rundle was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism (R01AA028552) and the Columbia Center for Injury Science and Prevention, Centers for Disease Control and Prevention (CDC) grant no. R49CE003094. Dr. Lo was supported by a grant from the Davee Foundation (Excellence in Emergency Medicine Grant). The study sponsors had no role in the study design; the collection, analysis, and interpretation of data; writing the report; or the decision to submit the report for publication. The research presented in this paper is that of the authors and does not reflect the respective official policies of the individual funding agencies.

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Authors and Affiliations

  1. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA

    Andrew G. Rundle

  2. ESO Solutions LLC, Austin, TX, USA

    Remle P. Crowe

  3. Department of Emergency Medicine, Ohio State University, Wexner Medical Center, Columbus, OH, USA

    Henry E. Wang

  4. Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, NY, USA

    John R. Beard

  5. Department of Emergency Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA

    Alexander X. Lo

  6. Center for Health Services & Outcomes Research, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Alexander X. Lo

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  1. Andrew G. Rundle
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  3. Henry E. Wang
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  5. Alexander X. Lo
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Contributions

AGR and AXL conceptualized and designed this study. AGR, RPC, and AXL analyzed the data. All authors (AGR, RPC, HEW, JRB, and AXL) participated in the interpretation of results and the development of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Alexander X. Lo.

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Rundle, A.G., Crowe, R.P., Wang, H.E. et al. A National Study on the Comparative Burden of Pedestrian Injuries from Falls Relative to Pedestrian Injuries from Motor Vehicle Collisions. J Urban Health 101, 181–192 (2024). https://doi.org/10.1007/s11524-023-00815-x

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