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No Accident: Traffic and Pedestrians in the Modern City

John Rennie Short a; Luis Mauricio Pinet-Peralta a
a
Department of Public Policy, University of Maryland Baltimore County, Baltimore, MD, USA
Online publication date: 17 December 2009
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Modern City', Mobilities, 5: 1, 41 — 59
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Mobilities
Vol. 5, No. 1, 41–59, February 2010
No Accident: Traffic and Pedestrians in the

Modern City
JOHN RENNIE SHORT* & LUIS MAURICIO PINET-PERALTA

Department of Public Policy, University of Maryland Baltimore County, Baltimore, MD, USA
ABSTRACT This paper considers the rise of traffic accidents in the creation of the modern
1745-0101
Mobilities
10.1080/17450100903434998
RMOB_A_443851.sgm
Original
Taylor
5102010
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jrs@umbc.edu
00000February
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RennieShort
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city. The notion of accidents is deconstructed. There is a brief review of current literature on
mobilities and then evidence is presented of the shifting configuration of vehicle–pedestrian
accidents. The epidemic of traffic accidents of cities in developing world is noted and
explained. The incidence of pedestrian traffic accidents is shown to reflect socio-economic
characteristics such as age, class and status. A review of the literature provides evidence of the
ways to ameliorate pedestrian injuries. Walksheds are suggested as a focus of concern. The
creation of a more pedestrian-friendly city is proposed.
KEY WORDS: traffic accidents, pedestrian safety, urban design, urban walksheds
The Modern City

At the heart of modernity is the connection between speed, the machine and the city.
In his 1909 manifesto of Futurism, Filippo Tommaso Marinetti (1876–1944) glorified
the man at the wheel and the beauty of speed. He associated speed with courage in
action and slowness with stagnant prudence. His glorification of the speeding automo-
bile in the city prefigures its subsequent centrality to urban development.
Cities were reimagined and then reengineered to promote high speed. Virilo (1986;
1995; 2005) tells a story of the destruction of the sociability of the city by the logic of
acceleration. In a more nuanced interpretation, Latham and McCormack (2008)
explore the ways in which the speed and the ‘countervailing eddies of slowness’
define the experience of the city. However, in terms of urban traffic and the marginal-
ization and displacement of the self-propelled human body, Virilio’s image of the city
as a site of acceleration seems closer to the mark. In this paper, we will explore one of
the little discussed consequences of this transformation, the risk of bodily accidents in
what are described as ‘traffic accidents’.
The modern city is designed largely around the use of motor vehicles despite the
inherent risks in machine–body coexistence, part of the brisk pace of city life. Indeed,
*Correspondence Address: John Rennie Short, Department of Public Policy, University of Maryland
Baltimore County, Baltimore, MD, USA. Email: jrs@umbc.edu
1745-0101 Print/1745-011X Online/10/010041–19 © 2010 Taylor & Francis
DOI: 10.1080/17450100903434998
42 J. R. Short & L. M. Pinet-Peralta
in the immediate prehistory of automotive ascendancy, the Futurists downplayed any

risks and celebrated machine–body meshing as a means to a high-speed, dynamic
superhumanity. Such eventual transformation was made possible, according to the
Futurism’s founding myth, when poet Filippo Marinetti emerged from a ditch after
crashing his beloved Fiat, spewing mud and apparently, the Manifesto of Futurism,
which begins ‘We want to sing the love of danger, the habit of energy and rashness’
and famously continues ‘We declare that the splendor of the world has been enriched
by a new beauty: the beauty of speed. A racing automobile with its bonnet adorned with
great tubes like serpents with explosive breath … a roaring motor car which seems to
run on machine-gun fire, is more beautiful than the Victory of Samothrace’ (Flint, 1972,
p. 41). By the early 1930s, Le Corbusier further enshrined swift automobility, proposing
his ‘autostrades’ as concrete ribbons threading skyscrapers’ canopies, elevated above
mere city streets and devoid of pedestrians for optimum vehicular velocity. Speed and
the fantasy of infinite mobility were at the heart of modernism and its physical embod-
iment in urban modernity. Norton (2008), for example, tells the story of American cities;
at the beginning of the twentieth century, city streets had a variety of users, people as
well as cars, and multiple users, a place for children playing, people walking, neighbors
chatting. From the 1900s to the early 1930s, a battle was fought between, on the one
hand, the multiple users and interests decrying the onslaught of cars on streets and the
growing dominance of auto traffic, the term ‘death cars’ was frequently used, and on
the other hand, automotive interests which continually invoked freedom as a rallying
cry. The automotive interests won. From our perspective today it seems a foregone
conclusion but the 25-year period in the early twentieth century reminds us of the battle
for alternative conceptions of the primary purpose of city streets.
This urban restructuring of the city streets as pathways for automobiles with
pedestrians shunted to the sidewalks has a high human cost. High-speed machines
mangle bodies and kill pedestrians and yet these costs are largely absent from urban
studies and discussions of urban safety. A recent book with the title The Safe City
(Berg et al., 2006) makes for interesting reading, as much for what it does not
include as for what it does include. While issues of terrorism and crime abound in
the book, one issue receives scant attention despite the book’s title, which is the risk
of bodily injury and fatality from traffic accidents. Such neglect is not uncommon in
the recent urban literature where terrorist campaigns and crime waves dominate
safety issues, yet there is a huge silence on the issue of traffic safety and especially
pedestrian injuries and fatalities. There have been a number of commentators who
have drawn attention to the issue of traffic and pedestrian safety (Hass-Klau, 1990),
numerous empirical studies (e.g., Chapman et al., 1982; Graham & Glaister, 2003)
as well as the continuing concern of such commentators as Mayer Hillman (Hillman,
1993; Karpf, 2002). However, the issue has failed to gain traction in the wider and
broader urban studies literature. And yet the issue is of some importance. Across the
world almost over 10 million people are crippled or injured each year, and approxi-
mately 1.2 million people are killed every year due to road accidents, approximately
3,250 people every day, (Peden et al. 2004). That is the equivalent of a World Trade
Center disaster on the world’s roads each and every day. One writer even refers to a
global epidemic of road deaths (Dahl, 2004). The total economic cost is estimated at
1 percent of the GNP of low-income countries and 2 percent in high-income
countries (Jacobs et al., 2000).
Traffic and Pedestrians in the Modern City 43
No Accident
Even the quickest review of recent and classic urban texts reveals little consideration
of this issue. Why the silence? Two reasons stand out. First, there is the notion of the
accidental, of random events that are to be endured rather than explained. The term
‘accident’ is revealing; it initially meant an event, anything that happens. Now
the word commonly refers to an unforeseen event, a mishap. But the predictable
covariance of road deaths with social phenomena belies this connotation of
‘accident’. The young and the vulnerable and the poor and the marginal are
more likely to be hit by a car than the rich and the powerful. While road deaths
have declined among rich countries, they have increased among poor countries.
These statistics suggest an ordered causation rather than random occurrences.
Road traffic accidents are not mishaps but events that are both explainable and
preventable. The relative silence shrouding this serious issue is itself a political
act. The incidence of pedestrian fatalities and injuries is skewed toward the
more marginal and vulnerable members of society. Yet this consistent finding
has failed to capture the attention of most critical theorists. Most pedestrian
fatalities occur in poor countries and have greater impact on the poor, the young
and the old. Pedestrian injuries are just one strand in webs of multiple depriva-
tions that bind people in disadvantaged positions. To see traffic fatalities and
injuries through the lens of marginalization theory is to offer a very different
perspective on them as accidents (see Cutler & Malone, 2005).
Second, there is the silence accorded to all events that have a constant background
quality. The fact that road traffic accidents happen all the time makes them blend into
the fabric of the taken for granted. Too regular to generate much notice, they become
mere white noise rather than events to be analyzed. Their very consistency and regu-
larity allows them to fade into an unexamined, rarely discussed space. The urban
spectaculars such as the collapse of the World Trade Center, overwhelms and ulti-
mately silences the murderous regularity of road traffic fatalities and injuries. Road
traffic ‘accidents’ are taken for granted cost of contemporary urban living, a seeming
inevitability that allows attention to be drawn to the more unusual, rare events; they
are just too mundane, too anonymous, too ordinary to generate much interest.
However, the rising concern with the everyday ordinary nature of the lived urban
experience should prompt a reconsideration of road safety and risk.
The ‘ordinary’ quality assigned to road traffic accidents is, if you excuse the unin-
tended pun, no accident: there is also a vast array of interests concerned with making
them ordinary. These interests include the motor vehicle manufacturers, road builders,
construction companies as well as a society that does not want to question the fatal
costs of a culture and cities dominated by fast moving vehicles. The current usage of
the term ‘accidents’ to refer to fatal and damaging machine–body interactions in the
city is incorrect, misleading and deceptive in shifting the phenomenon from social
outcome to random event.
Perrow (1999) introduced the notion of ‘normal accidents’ that may be unforesee-
able yet are inevitable. Perrow based his initial work on the near meltdown of Three
Mile Island. Drawing a wider perspective on high-risk technologies, he argues that
accidents occur when systems become more complex and interconnected. These
conditions are increasingly met in cities where traffic patterns are more complex and a
variety of users share busier roads. The ubiquitous nature of motorized transport in
many cities, in comparison to the obvious singularity of nuclear power station renders
it, in the minds of many, as safe or relatively innocuous. Yet a heavy piece of metal –
the average weight of a US car in 2006 was 4142 lbs. (1878 kg) – traveling at even
30 miles per hour, operated by someone, perhaps listening to the radio, drinking
coffee or using his cell phone, times the thousands of other drivers on a road in the
average city constitutes a complex technological system with lots of room for human
error. The result is a relatively high risk of being involved in a car crash. Our need for
urban vehicular traffic has in part blinded us to its inherent and inevitable risks to
health and safety. Popular perceptions of risks, in general and in relation to traffic
accident risk in particular, are based more on intuition and judgment, rather than
objective assessments (Slovic, 2002).
In this paper, after reviewing some mobilities literature and presenting some general
background data, we will concentrate on pedestrian injuries, because they are margin-
alized by recent urban safety scholarship: there is no rush to publish or comment on

everyday traffic accidents involving pedestrians as there is to pontificate in the wake
of 9/11. Then we will review a range of recent papers that explore the causal connections
between urban design and traffic ‘accidents’. We will introduce the notion of ‘walkshed’
as a unit of analysis and conclude with intimations of more progressive changes.
The paper is part review and part an attempt to right the balance in discussions of
urban traffic. As the more affluent move around by car and limousine, the pedestrian
becomes the minor player in transport discussions, and as cities are restructured to fit
the needs of the car, the needs of the pedestrian are even less considered. But even the
car driver has to step out of the car at times. While not everyone drives a car, most of
us are pedestrians at some time. However, as soon you step out of your car in many if
not most cities, you become a second-class citizen: it is as if your full rights only exist
when you drive a car. Walk in the city, and you are pushed to the sides of the road, a
telling phrase and metaphor. When a car hits a child it is often treated as an accident,
when a child hits a car it is considered vandalism. When Short (1989) writes in The
Humane City of cities designed as if only some people matter, he references specifi-
cally car drivers in contrast with pedestrians. Cities are biased toward the needs of the
drivers rather than the rights of the pedestrians, despite the obvious inequality. A
heavy metal object traveling at even relatively low speeds does more damage to a
human body than the body does to the car. People get killed and maimed; cars merely
get scratched and dented.
A Wider Context
The wider context for this paper is the mobilities literature and the growing empirical
material on motor vehicle and pedestrian accidents. We will review, briefly, each in turn.
This paper is situated in a wider context of mobility literature that has a number of
dimensions including the notion of automobilities and walkabilities. A key paper by
Sheller and Urry (2006) identifies a new mobility paradigm that is undermining the
sedentary nature of traditional social science theories. They draw attention to the
importance of multiple mobilities and new dematerialized mobilities. There is now a
growing emphasis on movement rather than stasis and fluidity rather than structure; a
shift marked by relational notions of the ‘space of flows’ (Castells, 1996) and embod-
ied in the title of recent works such as ‘liquid life’ (Bauman, 2005) and the ‘liquid
city’ (Short, 2007).
The notion of automobility is part of this ‘mobility turn’, a recognition that the
automobile plays a central life in social life, identity and mobility (Featherstone et al.,
2005). This body of work draws attention to the pervasive culture of the car, but tends
to downplay the competing and complementary role of walking. Walking is still very
much associated in popular imagination with images of Romantic poets and transcen-
dalist philosophers– an important element of the contact with nature but little studied
in the current sociological literature as an important form of mobility or identity in the
contemporary city. While we draw upon this mobilities and automobility literature we
feel that it is still imbued with an emancipatory tinge; it tends to celebrate the ease and
speed of movement and pays less attention to the notion of competing mobilities in
the juxtaposition of automobility and walkability. And as a consequence rather less
attention is given in the discussion of automobility’s negative affects for pedestrians.
The rise of the car is at the expense of the pedestrian. The rise of automobility is at the
rising costs and danger of walkability. We identify the notion of the walkshed to
develop the themes of competing and unequal mobilities in the contemporary city. By
reimagining the city as a series of walksheds we refocus on the citizen as a walker and
the city as a place of walking. And by concentrating on pedestrian injuries and fatali-
ties we highlight the physical costs to pedestrians of cities structured for and by the
automobile.
Two studies in particular implicitly inform our concerns. The first is the general
notion of space-time activity, as first outlined by Hägerstrand (1970) who formulates
space time paths shaped around pegs, which structure our day, and prisms, which
define accessible spaces available in specific time periods. Hägerstrand’s framework
allows us to imagine more clearly the city as a place of people and machines sharing
space time paths. Normark (2007) echoes this theme in the concept of ‘enacting
mobility’. Following a space time path through the city has a different drama whether
you are a walker or a driver. The second is the more instrumental concern of Engwicht
(1992; 1999) who characterizes city streets as dual spaces for movement and
exchange. Engwicht’s basic belief, and one that we endorse, is that there are too many
movement spaces for cars and not enough exchange spaces for pedestrians.
The second context for our paper is the empirical material from the traffic accident
and fatality literature. The data, flawed and partial though they may, give us some
handle on the scale of and distribution of the issue. A cursory discussion is necessary
if we are to understand the changing configuration of traffic accidents worldwide, a
vital antidote to the overwhelming car-orientated perspective and rich city, developed
world bias of the mobilities and automobility literature.
An estimated 1.2 million deaths occur each year worldwide due to road accidents
and millions of people are crippled or injured each year. The majority of these deaths,
about 70 percent, occurs in developing countries. Sixty-five percent of deaths involve
pedestrians and 35 percent of pedestrian deaths are children.
Road traffic injuries are part of the global burden of injury. Table 1 shows the lead-
ing causes of death and disability adjusted life years (DALYs). While road traffic
accidents ranked ninth in 1990, they are estimated to rise to third by 2020 (Mathers &
Loncar, 2005; Nantulya & Reich, 2002). There are 1.195 million deaths caused each
Table 1. Ranking of the 10 leading causes of global burden of illness by DALYs
1990 2020
Rank Condition Rank Condition
1 Lower respiratory infections 1 Ischemic heart disease

2 Diarrheal diseases 2 Unipolar major depression
3 Perinatal conditions 3 Road traffic injuries
4 Unipolar major depression 4 Cerebrovascular disease
5 Ischemic heart disease 5 Chronic Obstructive Pulmonary Disease
6 Cerebrovascular disease 6 Lower respiratory infections
7 Tuberculosis 7 Tuberculosis
8 Measles 8 War
9 Road traffic injuries 9 Diarrheal diseases
10 Congenital abnormalities 10 HIV
Adapted from Peden et al., 2004
year by road traffic accidents, and they constitute 6.5 percent of preventable deaths. In
2002, road traffic accidents caused 1.5 percent of deaths of children under 15 years
old and 5 percent of deaths of adults aged 15–59 years. Road traffic accidents injure
between 20 million and 50 million each year, and the estimated costs are $518 billion
in medical care and $326 billion in productivity losses (Jacobs et al., 2000). The esti-
mated costs to low- and middle-income countries amount to US$65 billion, more than
the amount of money received in all forms of aid.
While traffic deaths have increased across the globe, from 990,000 in 1990 to
nearly 1.2 million in 2002, there has been a marked spatial shift. Fatalities have
declined in the developed world due to better vehicle design, improvements in safety
standards such as drunk driving enforcement, higher seat belt usage, better traffic
management schemes and the implementation of road safety programs. The decline is
also the result of changes in pedestrian behavior in the city. The unforeseen conse-
quences are new health risks. People, and especially children, may avoid traffic acci-
dents because they are not playing in the street, and their recreation is now more
sedentary. Reduced traffic fatalities and accidents may have been purchased at the
cost of other health outcomes. Neighborhoods and cities built around the automobile
promote a more sedentary lifestyle, which is associated with the development of vari-
ous health conditions, including heart disease, obesity, diabetes, asthma and mental
illness (Kawachi & Berkman, 2003). Berke et al. (2007) argue that overweight and
obesity are associated with non-walkable neighborhoods. When roads become too
dangerous for children to play and for pedestrians to use, physical activity is then
limited to the inside of the homes and the associated negative health outcomes (Farley
et al., 2007). This limitation in physical activity and prolonged exposure to various
indoor pollutants can have significant and powerful health consequences. There is
now a considerable body of literature that suggests a clear link between urban form
and obesity levels (Krisberg, 2006; Lopez, 2004; Sui, 2003; Vandergrift & Yoked,
2003). A car-orientated urban sprawl is part of the mix of factors creating the obesity
epidemic particularly in children; in part, because keeping children safe from traffic
means taking them off the streets. Physical activity is thereby reduced. This is a
complex situation, and more detailed research is necessary to tease out the specific
explanatory threads between urban forms that prioritize vehicular traffic, thus restrict-
ing everyday physical activity that connects to increased obesity especially among
children.
In the United States, for example, traffic accident fatalities have been falling and
are now at their lowest level in three decades. The pattern, replicated in other rich
countries, is of a steady increase in the number of fatalities throughout the twentieth
century as vehicular traffic increased, peaking at over 55,000 deaths per year by the
later 1960s. Since then the rate of fatalities per vehicle miles of travel has declined
from approximately 11 per 100 million vehicle miles of travel to just less than 2 by
2000. While pedestrians account for only 12 percent of all traffic fatalities, expressed
as per passenger mile they are 36 times more likely than those of vehicle occupants.
The absolute number of fatalities is still high in the United States. In 2003, there was
total of 42,643 deaths and 2.89 million injuries, and the total costs amounted to
$230 billion or 2.3 percent of the national GNP. The death rate is the equivalent of
two fully loaded 747 jets crashing into each other every week. Imagine the media
coverage and the academic rush to print in the wake of this pattern of events. A total
of over 3 million people were killed on US roads in the twentieth century. Road traffic
crashes are still the leading cause of injury-related death and the leading cause of
death for persons aged 1–34. Traffic safety programs receive only 1 percent of the US
Department of Transportation budget.
While road traffic deaths and injuries have been declining in developed countries,
they have been on the rise in developing countries. From 1975 to 1998, Canada’s fatal-
ity rate declined by 63 percent, while China’s increased by 234 percent; fatality rates
declined by 27 percent in the United States but increased by 383 percent in Botswana
(Peden et al., 2004). Low- and middle-income countries now have 85 percent of injury
deaths and 90 percent of the annual DALYs. Table 2 shows that the countries with the
higher death rates from traffic accidents were all poor developing countries. Africa is
a continent with 10 percent of global road traffic deaths yet only 4 percent of global
Table 2. Countries with the highest rates of motor vehicle crash deaths per million, 2002
Country Death rate
Sierra Leone 643

Islamic Republic of Iran 595
Angola 580
Iraq 527
United Arab Emirates 506
Liberia 481
Niger 431
Mongolia 429
Lebanon 412
Burkina Faso 403
Source: Peden et al., 2004

vehicle registrations (Odero, 2004). The death and injury rates in low- and middle-
income countries are probably much higher due to endemic underreporting.
The escalation in traffic deaths and injuries in poorer countries is due to a rapid
increase in motorized vehicle traffic without a corresponding rise in safety improve-
ments. There is a growing disparity between increases in vehicular traffic and the abil-
ity to manage this traffic safely. Coping with increased vehicles in cities is a learned
experience. It took almost 80 years for the developed countries to effectively reduce
the rate of fatalities and injuries. New traffic layouts had to be tested, planned and
built, new behaviors had to be learned and new norms of car driving and pedestrian
behavior had to be established, maintained and ingrained. All this takes time and
money. Disparities in wealth feed directly into spending on road safety. While
Pakistan and Uganda spend $0.07 and $0.09 per capita, respectively, on road safety, a
high-income country such as the United Kingdom spends nearly $39.00 (in 1980 US
dollars) (Bishai et al., 2003).
Most developing countries have seen a very sharp increase in road fatalities and
injuries. A major reason is rapid motorization without a corresponding increase in

road safety. In Vietnam, for example, the motorization is largely the result of a signif-
icant increase in two-wheeled motorcycles. There were 4 million of these vehicles
registered in 1995 but 14 million by 2004. In the same period road traffic fatalities
increased five times. In Hanoi, for example, roads are very narrow; motorcycles and
pedestrian often share the same public space; speed limits are often broken; stop signs
and pedestrian crossings are rarely adhered to; taxis and cars do not have sea belts and
child car seats are not available. Motorcycles are often overloaded with multiple
family members, and child passengers rarely use crash helmets. In the country as a
whole, approximately 40 people die every day in traffic accidents and almost 80 a day
suffer from debilitating head injuries. While the global mortality rate due to traffic
accidents was 19 per 100,000 population, this figure was 27 per 100,000 for Vietnam
(Peden et al., 2004). Over 4,100 children die every year in Vietnam from traffic acci-
dents, almost 11 children a day.
Pedestrians are particularly vulnerable in this developing world escalation of road
traffic injuries. While pedestrians account for approximately 12 percent of road traffic
deaths in the United States, they constitute 50 percent, 45 percent and 35 percent in
Ethiopia, Kenya and Malawi, respectively. In Delhi, India, 55 percent of road fatali-
ties are pedestrians and bicyclists (Mohan, 2002). While most fatalities in the devel-
oped world are passengers in vehicles, most fatalities in developing countries are
pedestrians, bicyclists and public transport passengers, especially those in multi
passenger vehicles such as buses. While 10,000 crashes in the United States lead to
66 deaths, the same number in Kenya results in 1,786 and 3,181 in Vietnam. And
because of poorer medical provision, crashes are more likely to lead to fatalities than
in the more affluent countries. There is often limited and sometimes no effective
emergency medical response. Again, there is an emphasis on the dramatic: while
medical provision and aid from the rich world is often available for the spectacular
and highly televised event – the earthquake, the hurricane, the tsunami – the steady
slaughter on the roads fails to evoke such generous responses.
A summary of the global distribution of traffic accidents: traffic fatalities and inju-
ries are increasing at a global aggregate level, although there has been a marked
decline in the rich world. Since 1979, traffic fatalities have declined 50 percent in
Canada, 46 percent in Great Britain, 48 percent in Australia and 18 percent in the

United States (Evans, 2003). In contrast, fatalities and injuries are on the increase in
low- and middle-income countries where a surge in vehicular traffic is not matched by
corresponding improvements in safety or medical provision. Nine out of every 10
traffic fatalities occur in low- and middle-income countries where the most vulnerable
are pedestrians, cyclists and public transport users. Among pedestrians, the poor, the
young and the old are at especially high risk.
Worldwide, more than one-third of all traffic-related deaths result from pedestrian–
vehicle crashes. Child traffic injuries are a major health risk in urban areas around the
world in rich as well as poor countries (Durkin et al., 1999). Hewson (2004) has
argued that the United Kingdom has one of the worst records among European
nations in child pedestrian safety. He highlights the fact that neighborhood depriva-
tion has a negative effect on safety rather than individual deprivation. White et al.
(2000) show with reference to Scotland that the risk of death for child pedestrians is
related to socio-economic status. They show that children from socio-economically
disadvantaged families have a higher risk of physical injury, and their injuries are
more severe and that the risk of pedestrian injury is over 50 percent higher for the
children of single mothers. This statistic reinforces the finding that accidents are not
random across the population.
In the United States, 6,000 pedestrians are killed each year and 90,000 are injured.
A pedestrian or bicyclist is killed every four minutes. About a quarter of all traffic-
related pedestrian deaths occur among children up to the age of 14 (Freeman et al.,
2004). Among children aged from 5 through 14, the motor-vehicle crash death rate is
more than five times that of drowning, the second most common cause of uninten-
tional injury. About half of all deaths among adolescents occur as a result of motor-
vehicle crashes, with a death rate two times higher than the second most common
cause of external injury (U.S. Department of Health and Human Services, Health
Resources and Services Administration, Maternal and Child Health Bureau, 2005).
Grossman (2000) identified several risk factors for traffic-related deaths describing an
important link between the urban environment and human vulnerability. Living in
neighborhoods with high traffic volume, few playgrounds and few safe crossings
increases the risk of being hit by a moving vehicle.
In Mexico, for example, motor-vehicle collisions represent the majority of the cases
for morbidity and mortality (Hijar-Medina, 2000). The apparent inability of pedestri-
ans to safely cross intersections is a main contributor to injury, especially where traf-
fic signals are exclusively for drivers and in some cases no bridges or lights are
available to pedestrians. Boys with siblings who play on the streets for long hours also
have higher risks for traffic injury, particularly in urban settings (Celiz et al., 2003).
Researchers identify a decreasing tendency for pedestrian injury in Mexican adoles-
cents; probably because of less street play than in previous generations and a decrease
in general physical activity. Injuries are more common among children but fatalities
more common among the elderly (Celis et al., 2003).
Urban Design and Road Safety

Urban transport debates are dominated by performative criteria; the overriding
concerns revolve around questions of how we can make traffic move more efficiently
and more quickly through the urban environment. When safety is an issue, the empha-
sis is toward improving the safety of drivers and passengers rather than pedestrians.
Vehicle design considerations reduce pedestrian fatalities by 20 percent when they
focus more on the effects on pedestrians rather than on vehicle occupants (Crandall
et al., 2002; DiMaggio et al., 2006; Robertson, 1990). The emphasis tends to be on
changing pedestrian behavior with the underlying assumption that pedestrians must
be trained to acclimate to a car-dominated culture. Such policies and practices encour-
age a vehicle-centered perspective, where vehicles are given the power, control and
authority, leaving pedestrians at the mercy of drivers, even when limits are placed on
vehicular traffic (Cutler & Malone, 2005; Graham & Glaister, 2003).
In terms of children and road safety, for example, while the focus remains on
educating children, little evidence exists on pedestrian education effectiveness,
whereas urban traffic modification has shown to be more effective (Durkin et al., 1999;
Roberts, Norton et al., 1995). Freeman et al. (2004) evaluated several community-
based interventions on unintentional injury prevention in the United States, focusing
heavily on educational interventions targeting school-age children, and found little

benefit in reducing the incidence of fatal pedestrian injury. A much more effective
intervention is educating vehicle drivers on the needs and rights of pedestrians (Richter
et al., 2005).
Environment, driver attitudes, pedestrian behavior and vehicle design all play a role
in controlling and preventing pedestrian injuries (Mock et al., 2004). Urban environ-
mental factors play an enormous role. Increased traffic volume (Roberts, Marshall
et al., 1995), increased density of curve in turn (Roberts, 1995), and vehicle speeds of
40 mph and greater are correlated with an exponential increase in injury risk (Mohan
et al., 2006; Peden et al. 2004). A range of key papers that explore these various
elements is presented in Table 3a–d. This table summarizes the main findings and
area of focus and thus represents a significant literature review in its own right.
In this section, we will concentrate on the connection between urban planning/
design and road safety. This relationship is part of a wider need identified by Corburn
(2004) to reconcile urban design/planning with public health. There was a tight nexus
between the two during much of the nineteenth century when the problems of the new
industrial city created many of the public health practices and institutions that exist
still today. The emphasis on clean water, better-designed houses and neighborhoods
all grew out of public health and urban planning principles forged in the rapidly grow-
ing and industrializing cities. The contagion effect of disease that affected the rich and
powerful as well as the poor and weak prompted citywide public policies. However,
by the late nineteenth and through most of the twentieth centuries, traffic deaths and
injuries were not seen as a public health issue in the same way and did not prompt the
previous level of strong legistlative advocacy. Traffic was seen primarily as an
economic issue not an urban health issue. Pedestrians were the cause of accidents and
thus needed to be educated and disciplined. Corburn calls for the re-engagement of
public health and urban planning in such areas as traffic management. And as Graham
and Glaister (2003) show, the local environment plays a very important role on pedes-
trian casualties. The character of local neighborhoods is important in determining
fatality and injury rates. Place is important.
A preventative framework can be built around three urban design/planning issues
that have an important effect on reducing the risk of pedestrian injuries. The first is
Table 3a. Injury prevention and control literature by major topic area
Speed reduction/Traffic calming

Country/city Subject/focus Case studies Description
Australia Area socioeconomic Poulos et al., 2007 Socioeconomic disadvantage is

differences & injury associated with transport injuries
US Speed humps Tester et al., 2004 Speed humps reduce injury rates
among children
US Slippery roads and Marmor M & Traffic crashes increase with wet
speed Marmor N, 2004 road conditions; adolescents at
higher risk
US Establishing speed Alicandri & Speed can be reduced through
limits Warren, 2003 strict engineering, enforcement
and judicial community actions
New Zealand Speed area Harre, 2003 Perceived speed is lower than
differences actual speed among drivers

US Urban traffic Posner et al., 2002 Risk of severe crashes increase
with speed
Australia Injury risk and speed Moore, Dolinis & Pedestrian injury risk is greater
Woodward,1995 when crossing high-volume
roads
New Zealand Injury risk and speed Roberts, Marshall & High traffic volume and speed
Lee-Joe,1995 are associated with increased
injury risk
New Zealand Injury risk and speed Roberts, Norton, Increased traffic volume & curb
Jackson, Dunn & parking are strongly associated
Hassall,1995 with increased risk of injury
US–UK Speed reduction Richter, Friedman, Speed cameras significantly
Berman & Rivkind, reduce case fatality rate from
2005 motor vehicle crashes
reducing the volume of traffic in urban neighborhoods. Traffic volume reduction has
the potential to reduce incidence of injury (Hijar et al., 2003; Roberts, Marshall et al.,
1995). The second focuses on environmental modifications that separate vehicular
traffic from pedestrians. The use of traffic signals, under/overpasses, wide sidewalks,
refuge islands and the installation of roundabouts and multi-way stop signs reduce
pedestrian crashes by 75 percent. Retting et al. (2003), for example, demonstrate that
modification of the built environment to enhance vehicle–pedestrian seperation and to
increase the visibility of pedestrians reduces the risk of vehicle–pedestrian crashes.
While there are many small-scale changes that can make cities more pedestrian
friendly – increased pedestrian visibility and conspicuity, better lighting, parking
restrictions, bus stop relocation – ultimately, of course, this requires a reorientation of
our cities so that urban neighborhoods are seen more as places to live in rather than as
places to drive through. The third is reducing vehicular speed. A major cause of injury
is the high speed of vehicular traffic. The lack of speed restrictions causes child traffic
deaths even more than increased exposure to traffic. Many pedestrians are killed and
seriously injured because cars and trucks are traveling too fast. With a vehicle travel-
ing at 20 mph, a pedestrian has only a 5% chance of being killed or seriously injured,
Table 3b. Injury prevention and control literature by major topic area
Driver education
México Adolescent driver Hidalgo-Solórzano Education programs may help

education et al., 2008 build awareness on road safety
France Risky Driving Nabi et al., 2005 Type A behavior individuals have
Behaviors higher risks for traffic injuries
Australia Risk-taking Turner, McClure Risk-taking behaviors are
behaviors & Pirozzo, 2004 associated with increased chances
of sustaining injuries
US Young driver Ferguson, 2003 Higher crash risk among young
behavior drivers
US Alcohol use and Villaveces et al., Alcohol-related mortality
injury risk 2003 decreases with increased
penalties and law enforcement

US Licensing laws Foss & Goodwin, Licensing effectiveness depends
and compliance 2003 on a combination of compliance
and enforcement
US Behavior change Carlson-Gielden & Opportunities of behavioral
and injury Sleet, 2003 sciences focused on injury
prevention prevention
US Road safety Lightstone et al., Young children more likely to be
education for 2001 hit by a vehicle at a midblock
young children location
at 30 mph the risk rises to 45%. Havant Borough Council in the United Kingdom saw
a casualty drop of 40 percent when a 20 mph speed limit was imposed on 20 miles of
road (Pilkington, 2000). In the state of Maryland, in the United States, a third of the
651 vehicle-related fatalities in 2006 were caused by speeding. When one of the coun-
ties, Montgomery, adopted speed cameras, the number of drivers going 10 percent
over posted limits dropped by 70 percent (Editorial, 2008). The simple message is
speed kills; vehicular speed kills pedestrians.
A combination of speed limit reductions, traffic-calming measures, driver educa-
tion and road engineering would help achieve long-term reductions in pedestrian
fatalities (U.S. Department of Transportation, 2004). In the past, emphasis was placed
on effecting change in pedestrian behavior, making them conform to the needs of fast
moving vehicles through urban streets. A more radical shift involves recreating cities
that privilege pedestrians over drivers.
The City as Urban Walkshed

On September 13, 1899, Henry Bliss stepped off a streetcar in Manhattan when he
was hit by a taxicab. He died the following morning. He was the first recorded
vehicle fatality in the Americas. The relationship between pedestrians and drivers of
vehicles has always been uneasy. As vehicular traffic increases so do the risks to
Table 3c. Injury prevention and control literature by major topic area
Environmental
México Impact Arreola-Rissa Impact-absorbing containers can

containment et al., 2008 significantly reduce incidence of road
devices traffic collisions
Japan Safe play areas Nakahara Child vehicle-related mortality
et al., 2004 decreases with more safe play areas
US School location & LaScala et al., Child pedestrian injuries associated with
pedestrian injury 2004 population densities, unemployment,
low income and traffic flow
US Road design Alicandri & Speed can be reduced through strict
Warren, 2003 engineering, enforcement and judicial
community actions
US Environmental Peek-asa & Effective environmental modification

interventions Zwerling,2003 requires changes in both behavior and
regulation
US Urban sprawl and Ewing R, et al., Sprawl is a significant factor for traffic
death risk 2003 fatalities
Europe Safe streets and Pucher J, Various environmental measures can
mortality Dijkstra, 2003 promote street safety
Germany and Pedestrian safety Pucher & Compact land use and city density
Netherlands in Europe Dijkstra, 2000 promotes walking and cycling
pedestrians. Attempts to regulate drivers and pedestrians date back to the nineteenth
century. Traffic signals were first installed in 1868 in the United Kingdom. In 1890, it
was first suggested that under/overpasses should be built for pedestrians. All these
safety measures took second place, however, to concerns with ensuring the free flow
of traffic (Ishaque & Noland, 2006). In the popular US magazine, The Saturday
Evening Post, as long ago as 1949, a journalist noted, ‘The pedestrian is much like
hunted animal always in season. Armored only by thin layers of clothing and his own
tender hide, he is being slaughtered at the rate of about thirty a day and mangled at
the rate of nearly 700 a day’ (Wittels, 1949).
In the twentieth century the city was restructured to prioritize vehicular traffic.
Streets lost their conviviality for pedestrians as they were engineered primarily as
routes for speeding traffic. In some small ways the tide has begun to turn, especially
in the developed world. Pedestrianization schemes are proving popular with city resi-
dents. Some streets are being remade so that traffic speed and movement is mini-
mized. Traffic-calming techniques are being introduced and the design principles of
the new urbanism call for more walkable streets. In numerous suburban subdivisions,
traffic-calming measures are built into street layouts of curvilinear lines and culs-de
with an emphasis on safety rather providing a grid of perpetual vehicular movement.
The notion of a slow city is taking root (Miele, 2008).
We can also reimagine the city as a series of urban walksheds. A walkshed is
the space-time cone of walkability centered at the primary residence or place of
work or play. Picturing the city as series of overlapping walksheds is an important
start to understanding, conceptualizing and mapping the city as a convivial place
Table 3d. Injury prevention and control literature by major topic area
Socioeconomic
Australia Area socioeconomic Poulos et al., Socioeconomic disadvantage is

differences & injury 2007 associated with transport injuries
United States Obesity and risk of Zhu et al., Obesity increases risk of death in
dying 2006 MVC
Canada Injury and Simpson Socioeconomic status determines
socioeconomic status et al.,2005 injury types among adolescents
Great Britain Deprivation and Hewson P, Poorer children more likely to get
increased mortality 2004 hurt compared with children in
higher income households
US Geographical patterns Eberhardt & Injury patterns differ between urban
of injury Pamuk,2004 and rural areas
US Socioeconomic status Estabrooks Lower income neighborhoods have

and physical activity et al., 2003 less control over environments that
promote physical activity
Great Britain Urban density & Graham & Increased population density
pedestrian deaths Glaister,2003 influences pedestrian injury
México Public health Hijar-Medina Mexican poor more affected by
disparities et al., 2003 traffic injuries
Scotland Road traffic injuries in White et al., Risk of death for child pedestrians is
disadvantaged areas 2000 highly related to class
for pedestrians. Measuring the safety and quality of life within a walkshed is an
alternative way to map and conceive of the city (see http://www.walkscore.com/
walkable-neighborhoods.shtml). The World Bank has begun a pilot project to
measure the walkability of cities in the developing world (http://www.cleanairnet.
org/caiasia/1412/article-60499.html).
There is growing literature on the role as well as the limits of increased pedes-
trian activity. In more walkable communities, individuals enjoy shorter distances to
grocery stores and other amenities (Lee & Moudon, 2006). These communities
have higher residential densities as well, so public transportation and public places
are more accessible compared with communities that are more sparsely populated.
It is possible that individuals who seek more active lives tend to live in these
‘walkable neighborhoods’ compared to those who would prefer more sedentary
lifestyles (Moudon et al., 2006). Nevertheless, the fact that the urban environment
plays a major role in the development and perpetuation of health inequities under-
scores the impact that local place itself has on barriers and opportunities for devel-
oping healthy behaviors (Brownson et al., 2001; Ewing et al., 2003; Gordon-
Larsen et al., 2003). Cervero and Duncan (2003) describe a study in San Francisco
where individuals who lived in areas where streets were organized in short blocks
and who had access to local stores in less than a mile, reported walking more than
those who lived in more sparsely organized communities. They conclude that
sprawl discourages walking with its many health benefits. Saelens, Sallis and
Frank (2003) show that communities where land-use mix is greater and density is
higher, engage in cycling and walking more than those who live in more isolated
communities.
For many years, the United States and other countries have supported policies that
promote car-dependent cities and suburbs, the construction of complex road projects
and land-use planning strategies where retail plazas and businesses are located far
from residential areas, effectively discouraging the use of non-motorized transporta-
tion and walking. In many residential areas that have sidewalks, these are commonly
incomplete and not meant to be used by pedestrians. Vehicles are used overwhelm-
ingly by Americans compared to other modes of transportation (Pucher & Dijkstra,
2000). Those who do not own a car must rely on either public transportation or non-
motorized transportation to reach their places of employment, school, and grocery
shop and even for recreational purposes. Walking in the car-dominated city has redis-
tributional consequences. Cervero and Duncan (2003) found that the poor walk more
compared to those with higher incomes, making them subject to a double burden by
putting them at higher risk for injuries (intentional and non-intentional) and health
risks associated with living conditions. Brownson et al. (2001) also found that indi-
viduals from lower income groups walk more and in heavier traffic compared to those
with higher incomes. Walking in the car-dominated city can be a dangerous enter-
prise. In the United States, pedestrian fatalities are 36 times more likely than vehicle
occupant fatalities per kilometer traveled.
Pedestrian fatalities reflect the relatively minor importance afforded to walking
compared to other modes of transport. Pedestrians and cyclists make up 45 percent of
all road deaths in the UK, a much higher figure than in other European countries such
as France (17 percent) and Germany (20 percent). In many European countries walk-
ing is much more prevalent than in the United States or United Kingdom. In Sweden,
Austria, Germany and the Netherlands, walking accounts for more than 20 percent of
the total share of transport compared with 6 percent in the United States. In these
countries, bicycling accounts for 20 percent to 50 percent of total share of transport
compared to 1 percent in the United States. These differences are partly due to
compact land-use policies and city density, but they feed into a culture and practice of
respecting the pedestrian and the bicyclist. Pucher & Dijkstra (2000) show that walk-
ing and bicycling in the United States is in fact more dangerous than in Europe,
evidenced by the much larger mortality rates among pedestrians and cyclists
compared to motor vehicle users. Many European countries have a more friendly
approach to non-motorized transport users and have integrated them into their
transport systems.
The creation of more pedestrian city is difficult but not impossible. Engineering
solutions, new planning methods and changes in attitude are required. Above all,
however we need a reexamination of the city, less as vehicle-dominated system and
more as place that is convivial to walkers as well as drivers, children as well as car
owners, people as well as machines.
Conclusion
Across the globe there is an epidemic of traffic injuries and fatalities that is particu-
larly marked in low- and middle-income countries. Almost 90 percent of traffic fatali-
ties occur in low- and middle-income countries. The most vulnerable are pedestrians,
cyclists and public transport users. The poor, the young and the old are at especially
high risk.
Injury control and prevention strategies as part of a broader and deeper reorienta-
tion of cities away from a car-dominated culture toward a vehicle–pedestrian sharing
culture can have significant impacts on morbidity, mortality, risk of injury and popu-
lation health. These strategies include:
● Limiting and controlling speed through active and passive measures that target
drivers’ decisions on how fast to drive and road conditions that indirectly force
drivers to reduce their average speeds;
● Organizing traffic away from residential areas, limiting inner city and business
area traffic flow, and encouraging alternative modes of transportation that focus
more on health benefits and non-motorized road users;
● Continuing public information programs targeting high-risk groups and vulnerable
urban populations;
● Integrating urban planning and development and public health to design built envi-
ronments that promote healthier lifestyles rather than safer behaviors.
Pedestrian injuries are not accidents. They are preventable. If the vulnerability of
the human body was the determining factor, then it is unlikely we would design our
transport system the way we have. ‘Accidents’ reflect and reinforce social differ-
ences: they are less accidents and more manifestations of wider and deeper inequali-
ties in society that reflect the relative power of a vehicle-dominated as opposed to a
pedestrian-dominated culture. We need an anti-Marinetti to write a program for the
future in which the city reflects the needs of the pedestrians and the frailties of the
human body rather than the needs of the drivers and the power of their vehicles. It is
perhaps fitting then that the same country that produced Mainetti is also home to the
CittaSlow movement.
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No Accident: Traffic and Pedestrians in the Modern City

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No Accident: Traffic and Pedestrians in the

JOHN RENNIE SHORT* & LUIS MAURICIO PINET-PERALTA

The Modern City

in the immediate prehistory of automotive ascendancy, the Futurists downplayed any

alized by recent urban safety scholarship: there is no rush to publish or comment on

Table 1. Ranking of the 10 leading causes of global burden of illness by DALYs

1 Lower respiratory infections 1 Ischemic heart disease

Adapted from Peden et al., 2004

Country Death rate

Sierra Leone 643

Source: Peden et al., 2004

injuries. A major reason is rapid motorization without a corresponding increase in

Canada, 46 percent in Great Britain, 48 percent in Australia and 18 percent in the

Urban Design and Road Safety

heavily on educational interventions targeting school-age children, and found little

Speed reduction/Traffic calming

Australia Area socioeconomic Poulos et al., 2007 Socioeconomic disadvantage is

differences actual speed among drivers

México Adolescent driver Hidalgo-Solórzano Education programs may help

penalties and law enforcement

The City as Urban Walkshed

México Impact Arreola-Rissa Impact-absorbing containers can

US Environmental Peek-asa & Effective environmental modification

Australia Area socioeconomic Poulos et al., Socioeconomic disadvantage is

US Socioeconomic status Estabrooks Lower income neighborhoods have

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