• Charles DiMaggio, Spiros Frangos, and Guohua Li.
• Department of Surgery, New York University School of Medicine, New York; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York. Electronic address: Charles.DiMaggio@nyumc.org.
• Ann Epidemiol. 2016 Jun 1; 26 (6): 412-7.

PurposeSafe Routes to School (SRTS) was a federally funded transportation program for facilitating physically active commuting to and from school in children through improvements of the built environment. There is evidence that SRTS programs increase walking and bicycling in school-age children, but their impact on pedestrian and bicyclist safety has not been adequately examined. We investigate the impact and effects of the SRTS program on school-age pedestrian and bicyclist injuries in a nationwide sample in the United States.MethodsData were crash records for school-age children (5-19 years) and adults (30-64 years), in 18 U.S. states for a 16-year period (1995-2010). Multilevel negative binomial models were used to examine the association between SRTS intervention and the risk of pedestrian and bicyclist injury in children aged 5-19 years.ResultsSRTS was associated with an approximately 23% reduction (incidence rate ratio = 0.77, 95% confidence interval = 0.65-0.92) in pedestrian/bicyclist injury risk and a 20% reduction in pedestrian/bicyclist fatality risk (incidence rate ratio = 0.80, 95% confidence interval = 0.68-0.94) in school-age children compared to adults aged 30-64 years.ConclusionsImplementation of the SRTS program appears to have contributed to improving traffic safety for school-age children in the United States.Copyright © 2016 Elsevier Inc. All rights reserved.

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