Study finds Ontario children in low-income areas at higher risk of being hit by cars

Children in lower-income areas are at a higher risk of being injured by motor vehicles than those living in higher-income neighbourhoods in Ontario, according to a new study from the Hospital for Sick Children (SickKids), York University and ICES.

Using emergency department data provided by ICES, the research team studied trends in Ontario pediatric emergency department visits due to pedestrian-motor vehicle collisions from 2008 to 2015. The data was divided into five quintiles from lowest-income areas to highest-income areas. This is the first study to analyze household income and rates of pedestrian-motor vehicle collisions in Ontario.

Alison Macpherson, a professor in the School of Kinesiology & Health Science at York University and a senior adjunct scientist ICES, is the the study’s senior author; Linda Rothman, a senior research associate in child health evaluative sciences at SickKids, is the lead author.

This study, published in the April 2019 edition of Injury Prevention, reveals that despite a focus of Canadian health policy on reducing socioeconomic disparities in health, the number of emergency department visits involving children who were hit by cars differs by income level, and that children in lower-income areas are at greater risk of being hit by motor vehicles.

Alison MacPherson
Alison Macpherson

The data indicates that, across Ontario, the total number of pediatric emergency department visits due to pedestrian-motor vehicle collisions decreased by 18 per cent, from 1,562 visits in 2008 to 1,281 visits in 2015. While rates of pedestrian-motor vehicle collision-related emergency department visits decreased by 22 per cent in high-income neighbourhoods, the rates of visits in low-income neighbourhoods increased by 14 per cent. Overall, children in the highest income level areas had a 48 per cent lower rate of visits than children in the lowest-income level areas.

“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,” said Rothman. “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.”

The study also revealed the following statistics:

  • Teens and pre-teens were at highest risk of pedestrian-motor vehicle collisions. Teens aged 15 to 19 accounted for 51 per cent of emergency department visits due to pedestrian-motor vehicle collisions and pre-teens aged 10 to 14 accounted for 26 per cent of visits.
  • Seventy-three per cent of collisions occurred in cities, and 20 per cent occurred in suburbs.
  • Fifty-four per cent of children who visited the emergency department due to pedestrian-motor vehicle collisions were males.

In earlier research, the team found differences in road safety features in high- versus low-income areas in Toronto. High-income areas had a higher number of low-speed roadways and traffic-calming measures, such as speed humps. These differences in road safety features by area income may explain some of the differences in pedestrian-motor vehicle rates between high- and low-income areas revealed in this study.

“Unfortunately, these province-wide results support our previous research that shows that the traffic environment is less safe in poorer areas,” said Macpherson. “It is time to take steps to make our streets safer for everyone.”

The team’s findings highlight the potential to reduce child pedestrian-motor vehicle rates in lower-income areas by focusing on roadway changes that slow traffic such as the installation of speed humps, road narrowings or fixed objects in the middle of the street. Implementing these traffic changes in lower-income areas could benefit pedestrians of all ages, they say.

The research team is continuing to evaluate the geographic locations and effectiveness of road safety features for the prevention of child pedestrian-motor vehicle collisions in different cities across Canada, based on area income.

This study was supported by the Canadian Institutes of Health Research and SickKids Foundation.