Trends in Pedestrian-related mortality in the United States; 1999-2020, A CDC-WONDER analysis

Objective Pedestrian mortality in the United States has increased seven times faster than the population growth from 2019 to 2023, according to a Governors Highway Safety Association report. This alarming trend highlights the need to study pedestrian mortality patterns, stratified by gender, race/ethnicity, age group, and state-specific characteristics, along with an exploration of contributing factors driving this surge. Methods The Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC-WONDER) database was used to extract pedestrian mortality data from 1999 to 2020. Age-Adjusted Mortality Rates (AAMRs) per 100,000 population and Annual Percentage Changes (APCs) with 95% confidence intervals (CIs) were calculated. Joinpoint regression analysis was employed to assess the trends across various demographic and regional subgroups. Results A total of 140,280 pedestrian deaths occurred in the US between 1999 and 2020. The overall AAMR increased from 2.21 in 1999 to 2.32 in 2020. A steep rise in the APC (3.11) was observed from 2009 to 2020. Men consistently had higher AAMRs than women, while non-Hispanic (NH) American Indians or Alaska Natives had the highest AAMR among races. Individuals aged 35–44 years exhibited the highest APC (6.92) between 2011 and 2020. States in the 90th percentile (Arizona, Florida, New Mexico) had triple AAMRs compared to those in the 10th percentile. Rural areas had the highest APC (3.23) from 2011-2020. Conclusion Pedestrian mortality rates in the United States have been rising for over a decade. Enhanced public safety interventions and efforts to address disparities based on race, age, gender, and geographic location are essential to curb the growing burden of pedestrian deaths. Abstract Figure