Alison Macpherson

URBAN/RURAL VARIATION IN CHILDREN'S BICYCLE-RELATED INJURIES

The objective of this study was to examine bicycle-related injury rates for children living in urban and rural areas. Data on all Canadian children hospitalised because of bicycling-related injuries (1994-1998) were obtained from the Canadian Institute for Health Information (CIHI). Injured children were classified as residing in urban, mixed urban, mixed rural or rural areas. Incidence rates for bicycle-related head injuries and other bicycle-related injuries were calculated. Logistic regression was used to estimate the odds of head injury, controlling for age, sex, socio-economic status (SES), collision with a motor vehicle, and the presence of provincial helmet legislation. In total, 9367 children were hospitalised for a bicycling-related injury over the 4-year-study period. Of these, 21% occurred in rural areas, 18% in mixed rural, 17% in mixed urban, while the remaining 44% occurred in urban areas. The average annual incidence rate for bicycle-related head injuries in children was 18.49 per 100000 for children living in rural areas compared with 10.93 per 100000 for those living in urban areas, 15.49 for children in mixed urban areas and 17.38 for children living in mixed rural areas. This variation may be explained by differences in bicycling exposure, helmet use, hospital admission criteria, or road environments across geographic areas.

PW 0373 Evaluation of the vision zero school safety zones program in the city of toronto- policy makers and researchers working together

The City of Toronto adopted its Vision Zero Road Safety Plan in July 2016, with its focus on eliminating motor vehicle collisions that result in death and serious injuries. The safety plan emphasizes a collaborative and integrative approach, involving multiple stakeholders. One of the Plan’s six areas of emphasis is on school children. Stakeholders from public health, the public school board, the police, a not-for- profit organization and academic researchers have worked with the City of Toronto’s Transportation Services Division to identify a package of interventions to create School Safety Zones. New interventions include physical environment changes, enforcement activities, education and support from a school traffic management facilitator. The Plan is intended to be evidence-based and data-driven. Therefore, it is essential that policy makers and researchers work together to develop appropriate evaluation strategies. Several challenges to policy makers and researchers working together exist; most of which can be overcome using a collaborative process. For example, funding cycles and priorities of granting agencies to fund academic research may not match the timelines and priorities of policy makers. Researchers prefer evidence-based priority setting and random selection to enhance scientific validity, whereas policy makers also consider political priorities and community interests. Although researchers would ideally like to maximize sample size, policy makers often have fiscal restraints. The definition of meaningful and valid outcome measurements is a challenge. Fatal and severe collisions are relatively rare, so proxy measures must be agreed upon prior to the evaluation. Regular meetings of stakeholders will help ensure evaluation that is meaningful to policy makers and scientifically sound. This process will lead to a strategy to be used by City of Toronto, Transportation Services to evaluate the effectiveness of their school zone safety interventions and can provide a model for future evaluations of Vision Zero Road Safety Plan interventions.

PW 0318 Child pedestrian risk and social equity: spatial distribution of roadway safety features in toronto, canada

Investments in road design features are made to improve pedestrian safety in urban areas. Pedestrian motor vehicle collisions (PMVC); however, remain common, and occur at higher frequency in lower income neighborhoods. The objective of this study was to compare child PMVC rates and the distribution of roadway environment features related to child pedestrian safety in low versus high income clusters, in Toronto, Canada. Spatial cluster detection by census tract identified low and high income clusters using Canadian census data. Police-reported data of 2185 PMVCs involving children ages 5–14 from 2001–2010 were mapped with speed humps, crossing guards, missing sidewalks, one-way streets and local roads. Relationships between roadway features and low versus high income clusters were examined using multiple logistic regression. Of 524 census tracts, fifty eight (11%) were in high and 44 (8%) were in low income clusters. Collision rates were almost 6 times higher in low income clusters. For every km/10 km road increase of speed humps there was a 65% lower odds, for every km/10 km road increase in local roads there was a 38% lower odds and for every additional crossing guard/10 km road there was a 43% greater odds of being in a lower income cluster. Fewer lower speed local roads and speed humps in lower income areas may put children at increased risk. The inequity in spatial distribution of speed humps may due to process of request which is initiated by the community and may favour higher income communities. More school crossing guards may reflect more children walking in lower income areas, as well as attempts to ameliorate more dangerous road environments with higher PMVC rates. Policy implications relate to the equitable distribution of roadway features to provide safe pedestrian environments.

PW 1782 An environmental scan of road safety policies in toronto, canada

Background Toronto introduced a Vision Zero Road Safety Plan (RSP) in 2017 with a goal of eliminating road traffic fatalities and serious injuries by 2021. A series of policies were published alongside the RSP with a focus on pedestrians, school children, and cyclists. While these documents provide insight into plans for future interventions targeted at vulnerable road users, little is known about the types of interventions that are most frequently recommended by policymakers and whether they are effective at reducing injuries. Objective The purpose of this study was to identify and categorize the types of interventions outlined in city plans and/or policies directly related to traffic safety in Toronto, Canada. Methods We performed an environmental scan of policies/plans that outline interventions such as regulatory changes and awareness campaigns with a focus on road traffic safety. Results Our search yielded 26 policies with a purpose/objective statement on topics including the built environment, urban design, and active school transportation. Almost half (46%) were identified as being directly related to road traffic safety and were further summarized by intervention type, target population, cost, and whether the intervention was outlined in Toronto’s Vision Zero RSP. A total of 107 interventions were identified in policy documents in Toronto. Forty three percent of interventions recommended modifications to the built environment (e.g. traffic calming measures). Interventions requiring a reduced speed limit from 50 km/h to 40 or 30 km/h were mentioned in 58% of policy documents in Toronto. Conclusions Most interventions outlined in road safety policy documents in Toronto align with Vision Zero. Having identified the policies/plans that are recommended most often for implementation, these results will be used to prioritize naturalistic (quasi-experimental) research studies that demonstrate the effectiveness of specific interventions (e.g. speed limit reductions). Future studies will examine inter-municipal policy comparisons between Canadian provinces.