Shedding light on the pedestrian safety crisis: An analysis across the injury severity spectrum by lighting condition

Objective Pedestrian fatalities in the United States increased 51% from 2009 to 2019. During that time, pedestrian fatalities occurring at night increased by 63.7%, compared to a 17.6% increase for pedestrian fatalities occurring during daylight conditions. Have there also been increases in serious, minor, and possible pedestrian injuries (i.e., have all pedestrian collisions been occurring more frequently)? Have pedestrian collisions been getting more severe (i.e., are there now higher proportions of more severe injuries)? Have trends differed between night and day? What role does street lighting play in the nighttime trends? Methods We analyzed pedestrian fatalities, serious injuries, minor injuries, and possible injuries that occurred in California, North Carolina, and Texas from 2010 to 2019 using linear regressions to explore the strength and statistical significance of trends. We then parsed these trends by lighting condition, exploring outcomes during the day and night and with and without street lighting. Results Findings suggest that increases in daytime minor (7.9%) and possible (7.5%) injuries closely mirrored increases in population (9.8%). Increases in daytime fatal/serious injuries were significantly higher (43.1% and 35.1%, respectively), suggesting worsening severities during the day. Increases in nighttime minor/possible injuries (31.9% and 27.6%, respectively) were significantly larger than those during the day, suggesting that pedestrian collisions are occurring more frequently at night. Substantial increases in nighttime fatal/serious injuries (78.0% and 74.7%, respectively) likely reflect a combination of worsening severity (seen throughout the day) and increasing frequency (seen particularly at night). A pedestrian injured in the dark was found to be 5.0 times more likely to be killed than a pedestrian injured during the day. While a lack of street lighting does not seem to be the cause of the disproportionate increase in pedestrian injuries at night, pedestrians struck without a street light were 2.4 times more likely to be killed than those struck in the presence of a street light. Conclusions As we find ourselves in the midst of a pedestrian safety crisis, understanding that severities have increased throughout the entire day and frequencies have increased particularly at night helps illuminate a path forward.