The Health and Safety Vulnerabilities of Poverty

"Simply put, poorer children are at an increased risk of getting hit by cars. Child pedestrian injury is a public health and health equity issue."
"Although progress has been made in reducing preventable pedestrian motor vehicle collisions, more work remains to be done. Our streets should be safe for all children to walk to school, to the playground or to the park."
Dr. Linda Rothman, senior research associate in child health evaluative sciences, Sick Children's Hospital, Toronto

"While in some cities children in low-income areas are more likely to walk to school, this association has not been found in previous studies in Toronto. Another potential explanation is that children from low-income families are more likely to walk to school unescorted, which may put them at increased risk of injury."
"Recent research has found differences in road safety features in high-income versus low-income areas, with more lower speed roadways and traffic-calming measures in higher income areas. A request-based process in many cities in relation to installing traffic safety features such as speed bumps may favour communities with higher income levels."
Research study, ER visits/risks of children from vehicular accidents

A new study suggests children from poorer areas of Ontario face a greater risk of getting hit by vehicles than those from wealthier areas because they are more likely to walk to school alone.  (Codie McLachlan / Star Edmonton)

Researchers from Sick Children's Hospital, York University and the Institute for Clinical Evaluative Sciences in Toronto studied available data on emergency department visits involving children from the years 2008 to 2015 who presented with injuries sustained by car accidents. The number of emergency room trips for that type of incident -- children hit by vehicles -- while having decreased by 18 percent over those years, actually increased for children from low-income neighbourhoods.

Children who live in high-income areas had 22 percent fewer visits to hospital emergency rooms as a result of being hit by cars. Whereas children from low-income neighbourhoods saw their numbers increase by 14 percent for the same reason. Authors in the study concluded that the differential between children in the highest-income areas suffering fewer hits by vehicles necessitating fewer ER visits than those in the lowest-income areas, differed by 48 percent.

Reducing health disparities with linkage to socio-economic status, point out the researchers, represents an overall social policy objective. The purpose of the study was to determine whether progress in the issue -- children getting hit by cars -- had materially advanced. Published in the April 2019 edition of the journal Injury Prevention, the study posits several possible reasons for the phenomenon without reaching a final conclusion.

New York City study

Mandating the creation of safer roads toward a safer walking environment for middle- and high-school kids who frequently walk alone, accounting for most emergency department visits after getting hit by vehicles is one potential solution, the study points out. As for younger children, benefits could be seen with well-maintained playgrounds given that a lack of such facilities could lead children to play instead in the streets, leading to greater exposure to traffic.

Strategies for the reduction of vehicle-pedestrian collision rates in poorer areas might begin by installing simple traffic-slowing measures such as the installation of speed bumps and signage urging more awareness, along with lower-speed roadways alongside traffic calming measures that tend to be seen more frequently in higher-income areas, extended equally to their lower-income counterparts.

The examined data excluded children who died at the scene of collisions, so deaths appear under-represented in the study, which found teens and pre-teens at the highest risk of being hit in traffic in the period examined, accounting for 51 and 26 percent of ER visits respectively. Additionally, the bulk -- 73 percent of incidents -- took place in cities, while the suburbs accounted for 20 percent.

"Children who are the most disadvantaged ... often live in families that don’t have a car."
"They don’t have a choice about how they get to school, how they get to go grocery shopping, etc." "They have to take care of transit and they have to walk."
Dr. Alison Macpherson, professor, York University’s School of Kinesiology and Health Sciences