Dying to Walk (4/8/13)
Is walking dangerous to your health?
Sometimes. Particularly when you march through city streets.
A recent media friendly study looked at emergency patients hit by cars and trucks who entered Bellevue Hospital in New York. Some salient “facts”:
1. 44% were hit while in crosswalks while the light was signaling a safe time to walk. About 5% of the time they were on the sidewalk.
2. Heavier pedestrians received lighter injuries.
3. 40% of cyclists were hit by taxis; 25% of pedestrians.
4. Of cyclists aged 7-17, 30% were using cellphones or music players.
Yet many of these results are misleading.
Naturalistic Versus Population Studies
I like Bellevue. I trained there for three years. It’s a slice of New York Life unlike any other.
Which is one reason what happens there may not generalize much to other populations. And as Emily Badger in Atlantic Cities and others have pointed out, there are many flaws in the study, including:
1. No interviews with the dead. The most directly affected pedestrians did not get into the study.
2. No statement about how many taxis, private cars, cyclists, were actually on the road. A 2010 study by New York City found its famed fleet taxis were proportionately less likely to hit pedestrians than were private cars.
3. The “fact” that 40% of cyclists were hit by taxis is less impressive when you realize that 40% or more of the miles traveled at those times were driven by taxis.
4. Approximately 15% of pedestrians hit “had drunk alchol ” prior to being hit. But there’s no idea of what the overall prevalence of drinking in the population at the same time.
What Does This Mean?
It’s clear headline writers prefer personal stories to “dry” national statistics. This study is another example. Talking about patients, one of whom might be you, is a lot more interesting to TV commentators breathlessly reading 30-60 second “news stories” than explaining general population death rates.
Yet some facts do come out even from this foray.
The most impressive – there is no way to completely avoid risk when walking. Or pretty much any form of transport except flying commercial (see below).
If you look at even the Bellevue study’s less than perfect numbers, fully half of people hit were walking on the sidewalk or in the crosswalk with the light clearly marked.
Most sidewalk walkers do not expect to be hit by careening cars.
And news reports on what happens to the drivers who hit pedestrians are notably lacking – or whether they were texting or using cellphones. And enforcement? We just don’t see those stories.
The Bigger Picture
The public is not good at assessing risk. We prefer the illusion of control to actual safety.
One example – the results of transportation after 9/11.
Many people have been put off by TSA. It’s not fun taking the extra time to fly knowing you’ll enter a prison type environment before you reach the plane. It’s no fun getting patted down. It’s not pleasurable finding your bag has been moved about, even sometimes ransacked. It’s not enticing to take off your belt and shoes, ram your shaving cream and skin protecting lotions into rapidly disappearing plastic buckets, then find yourself irradiated with your hands over your head, your feet spread apart, and your pants falling down..
It’s so not fun many people, particularly the elderly with their new metal hips beloved of xray screeners, refuse to fly.
But flying is a lot safer than driving. Flying deaths on commercial aircraft are now amazingly rare.
The result of our “security” policy – one Cornell study claims our new transport formats – by encouraging driving, for example – kill an extra 2500 people a year. That’s pretty close to 9/11 levels of death.
And if we want to prevent heart disease in America, we need to walk. The “walkability” of New York City is often cited as a major reason New Yorkers live 2.4 years longer than the average American (personally I doubt it’s the ball teams or the low level of daily stress that accounts for that difference.)
If we want to prevent Alzheimer’s Disease, we need to walk. Dementia treatment and care are now more expensive than heart disease. Those costs will soon get asymmetrically worse.
We need to walk to get to know our neighbors. To improve the mobility of our joints. To understand and enjoy the community. To get fresh air, such as it is, and the natural settings that make people feel so much better.
What Is To Be Done?
It’s fairly simple. People should be encouraged to walk – inside and outside.
And to move outside, walking needs to be safe.
So cities can get creative. They can create pedestrian zones, where walking is the preferred form of transportation. They can create special “walking lanes” in high use zones – in places like hospitals.
They should also enforce pedestrian laws.
Motorists rule the roads. They know it. Pedestrians are supposed to get out of the way.
They do – if they’re fast enough, are constantly watching the road and sidewalk, and pay complete attention to what’s going on around them.
Unlike many motorists. In recent simulations, drivers making left hand turns did not even bother looking for pedestrians 4-9% of the time.
And those folks were sitting in nice labs, not texting, or making cellphone chat.
In sum – to help save the planet from global warming and improve planetary health, we need to enforce pedestrian laws.
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