National Safe Routes to School Program and Risk of School-Age Pedestrian and Bicycle Injury

In this study, the Safe Routes to School program was associated with an approximately 23 percent percent reduction in pedestrian/bicyclist injury risk and a 20 percent reduction in pedestrian/bicyclist fatality risk in school-age children (5-19 years) compared to adults (30-64 years). 


  • When comparing school-age children to adults in the pre- and post-Safe Routes to School intervention periods, the study found an approximately 23 percent greater decrease in all-hour injury risk and an approximately 16 percent greater decrease in school-hour injury risk for children compared to adults after the SRTS intervention.
  • The Safe Routes to School intervention was associated with a statistically significant decrease in the risk of school-age school-travel pedestrian/bicyclist injury in four states (Florida, Maryland, New York, and South Carolina).
  • Consistent with previous studies, this study found that the Safe Routes to School program was associated with a 14 percent to 16 percent decline in pedestrian and bicyclist injury risk and a 13 percent decline in pedestrian and bicyclist fatality risk in all 18 U.S. states.


  • Individual-level pedestrian and bicyclist injury data for school-aged children (5-19 years) and adults (30-64 years) over a 16-year period (1995-2010) were obtained from the U.S. Department of Transportation National Highway and Traffic Administration State Data System for 18 states across the country, as were funding allocations for SRTS programs, data on number of roadway miles categorized as rural versus urban, and population data from a variety of state and federal sources. Eleven multi-level 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.

DiMaggio, C., Frangos, S., and Guohua Li (2016). National Safe Routes to School program and risk of school-age pedestrian and bicycle injury (2016). Annals of Epidemiology, 26: 412-417.

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