Pedestrian fatalities among the elderly: Controlling for exposure

Purpose: Older adults have the highest pedestrian mortality rates of any

age group, including young children. In New Jersey, the average rate of

older pedestrian mortality in 1999-2004 was higher than the national

average. We examined incidents in which older adults (65+) were fatally

struck by a motor vehicle in New Jersey in 1999-2004. Our objective is to

determine whether demographic characteristics and population density and exposure are

associated with risk.

Methods: Demographic information was obtained from the National Center for

Health Statistics' (NCHS) Multiple Cause of Death files, and New Jersey

death certificates. Demographic data were compared to state-wide

proportions. Population figures were obtained from the 2000 Census.

Counties were combined into three categories based on population density and standardized mortality ratios were adjusted for exposure, as measured with data on walking behavior from the 2000 Census.

Results: Results show significant association between risk of injury and

age, gender, and marital status. After adjusting for exposure, SMRs increased in low density counties and decreased in high density counties, suggesting that the pedestrian fatality rate among the elderly is in part a function of walking behavior.

Conclusions: Older victims of pedestrian fatalities are disproportionately

likely to be unmarried males who are 75 years old or older. Differences in fatality rates by density appear to in part to reflect differences in exposure.