Linking Transportation and Population Health to Reduce Racial and Ethnic Disparities in Transportation Injury: Implications for Policy and Practice

Key takeaway:

• Globally, people with lower incomes and people of color are disproportionately at risk of being injured or killed in motor vehicle crashes, especially as pedestrians. However, most studies of transportation injury lack data on people’s race and ethnicity, and/or only focus on motor vehicle occupants. This study fills a fundamental gap at the intersection of safety, travel behavior, race, and ethnicity by advancing a combined transportation–population health framework to understand disparate impacts of road safety across populations and travel modes. Such a framework enables decision-makers to better prioritize equity in transportation safety.

Results:

• Most data on sex and race/ethnicity in transportation injury only covers motor vehicle crashes, revealing that white males have the highest rates of motor vehicle crashes. However, there needs to be more sex and race/ethnicity data collection on transportation injury from other modes of travel (i.e., walking and bicycling) in order to more holistically address transportation inequities.

Sex, Race/Ethnicity, and Modal Share

• There are notable differences in bicycle and pedestrian travel by race and ethnicity:
  • Across races and ethnicities, men make more bicycle trips than women.
  • Black men made over twice as many trips on foot (as pedestrians) than black women.
  • Compared to Hispanic men, Hispanic women made over twice as many trips on foot (as pedestrians).
  • Most trips in Wisconsin were made by motor vehicle with significant differences in motor vehicle use by race and ethnicity (based on data from 2001):
    • Compared to white women, black women made half as many car trips. Similarly, black men made half as many car trips as white men.
    • Hispanic, Asian/Pacific Islander, and American Indian women made more car trips than men of the same racial group (Hispanic: 40%, Asian/Pacific Islander: 47%, American Indian: 30%).
    • White women and white men made similar numbers of car trips.

Sex, Race/Ethnicity, and Transportation Injury

• Black female pedestrians and motor vehicle occupants have higher risks of nonfatal injury than women of other races/ethnicities traveling by car or by foot.
• Black and American Indian male motor vehicle occupants have higher risks of nonfatal injury than men of other races/ethnicities traveling by car.
• Black women are the only demographic group with a higher risk of fatal injury as pedestrians than as motor vehicle occupants. Black women face nearly three times the risk of dying and almost twice the risk of nonfatal injury as pedestrians than they do as motor vehicle occupants.
• Black and Hispanic men face higher injury risk of pedestrian travel versus motor vehicle travel, while white men have an equal injury risk if they walk or drive.
• Bicycle travel has the highest rate of fatalities and injuries compared to motor vehicle travel. However, bicycle injury rates should be interpreted cautiously due to the small number of injuries and limited information about the race/ethnicity of bicyclists.

Implications:

• The researchers recommend using quantitative road safety targets (i.e., Vision Zero) to reduce disparities in fatalities and injury rates based on race/ethnicity and modal share. International research on the efficacy of quantitative road safety targets has found that they are useful, especially when they are ambitious. However, without high-quality data for all groups of travelers (across race/ethnicity and across travel modes), quantitative road safety targets and other interventions will not be as effective.
• To improve data collection, large-scale surveys, like the National Household Travel Survey, should reflect concerns about transportation equity and health equity. People of color, smaller populations, and non-motorized travelers could be oversampled to compensate for the bias in prior survey design and data collection that privilege motorized travelers.
• To meaningfully translate road safety equity research into policy and practice, we need more data, a better understanding of the underlying reasons behind road safety disparities, and political will.

Methods:

• The researchers used the state of Wisconsin as the study area and analyzed two transportation injury outcomes—fatalities and nonfatal injuries requiring a hospital stay—against data on travel mode from the 2001 Wisconsin Add-On to the National Household Travel Survey. Data on fatalities (2001 – 2009) was from the national database, Fatality Analysis Reporting System, which includes a 90 percent reporting rate for race and ethnicity. Data on nonfatal injuries was from hospital in-patient discharge records, 97 percent of which include information about people’s race and ethnicity. To determine transportation injury risk, the researchers calculated the average annual travel mode, sex, and race/ethnicity-specific injury rates per 100 million person-trips.

McAndrews, C.; Beyer, K.; Guse, C.; and Layde, P. (2017). Linking Transportation and Population Health to Reduce Racial and Ethnic Disparities in Transportation Injury: Implications for Policy and Practice. International Journal of Sustainable Transportation, 11(3).