Social Deprivation Index and Pediatric Pedestrian-vs-Automobile Collisions in Ohio

BACKGROUND: Social Deprivation Index (SDI) is a composite measurement of disadvantage in which higher SDI indicates worse social deprivation. Previous studies have suggested a relationship between pedestrian-vs-automobile (PVA) collisions and poverty among adults, but a similar association using state-level pediatric data has not previously been shown. We hypothesize that pediatric PVA collision incidence will differ with SDI and urbanicity across Ohio. METHODS: Coordinates for pediatric PVA collisions between January 2012 through January 2023 from Ohio’s Department of Transportation were spatially joined to zip codes. SDI was merged with 5-year American Community Survey population estimates (0–17 years) at the zip code level. Rural-Urban Commuting Area Codes determined urbanicity. Wilcoxon rank-sum tests compared pediatric PVA collision incidence (number of collisions per 10 000 population members aged <18 years) pairwise among SDI quintiles. Zero-inflated negative binomial regression analysis modeled the odds of a zip code being collision-free. RESULTS: Across 1188 zip codes, 5521 pediatric PVA collisions were identified. Adjusting for population size, PVA incidence was higher in zip codes with very high or high SDI compared with moderate SDI (P < .001), as well as moderate SDI compared with low or very low SDI (P = .02). The odds that a zip code was collision-free decreased by 2% for every unit increase in SDI (P < .001). Rural zip codes had 6.5-times higher odds of being collision-free than urban zip codes (P < .001). CONCLUSIONS: Children in urban zip codes and zip codes with higher SDI are more vulnerable to PVA collisions. Next steps include identifying opportunities for targeted intervention, including traffic calming measures and traffic safety education programs.