Ontario children getting hit by cars less frequently, yet children in low-income areas are still at higher risk, study finds

TORONTO – 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 paediatric 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.

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.

The data indicates that, across Ontario, the total number of paediatric 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,” says the study’s lead author, Dr. Linda Rothman, Senior Research Associate in Child Health Evaluative Sciences at SickKids. “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;
• 73 per cent of collisions occurred in cities, and 20 per cent occurred in suburbs;
• 54 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,” says  Dr. Alison Macpherson from the School of Kinesiology and Health Science at York University and a senior adjunct scientist ICES, the study’s senior author. “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. It is an example of how SickKids is making Ontario healthier, wealthier and smarter (www.healthierwealthiersmarter.ca).

About The Hospital for Sick Children (SickKids)

The Hospital for Sick Children (SickKids) is recognized as one of the world’s foremost paediatric health-care institutions and is Canada’s leading centre dedicated to advancing children’s health through the integration of patient care, research and education. Founded in 1875 and affiliated with the University of Toronto, SickKids is one of Canada’s most research-intensive hospitals and has generated discoveries that have helped children globally. Its mission is to provide the best in complex and specialized family-centred care; pioneer scientific and clinical advancements; share expertise; foster an academic environment that nurtures health-care professionals; and champion an accessible, comprehensive and sustainable child health system. SickKids is a founding member of Kids Health Alliance, a network of partners working to create a high quality, consistent and coordinated approach to paediatric health care that is centred around children, youth and their families. SickKids is proud of its vision for Healthier Children. A Better World.

About York University

York University champions new ways of thinking that drive teaching and research excellence. Our students receive the education they need to create big ideas that make an impact on the world. Meaningful and sometimes unexpected careers result from cross-disciplinary programming, innovative course design and diverse experiential learning opportunities. York students and graduates push limits, achieve goals and find solutions to the world’s most pressing social challenges, empowered by a strong community that opens minds. York U is an internationally recognized research university – our 11 faculties and 25 research centres have partnerships with 200+ leading universities worldwide. Located in Toronto, York is the third largest university in Canada, with a strong community of 53,000 students, 7,000 faculty and administrative staff, and more than 300,000 alumni. York U's fully bilingual Glendon Campus is home to Southern Ontario's Centre of Excellence for French Language and Bilingual Postsecondary Education.

About ICES

ICES is an independent, non-profit research institute that uses population-based health information to produce knowledge on a broad range of health care issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting health care needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. In October 2018, the institute formerly known as the Institute for Clinical Evaluative Sciences formally adopted the initialism ICES as its official name. For the latest ICES news, follow us on Twitter: @ICESOntario

Media contacts

Vanessa Blanchard
The Hospital for Sick Children (SickKids)
416-813-7654 ext. 228728
vanessa.blanchard@sickkids.ca

Anjum Nayyar
York University Media Relations
416-736-2100 ext. 44543
anayyar@yorku.ca