P3A293: Characterizing Pediatric Pedestrian versus Motor Vehicle Accidents in Norfolk, Virginia to Inform Crash Prevention

Background: Motor vehicle crash (MVC) injuries are a leading cause of death for children worldwide and in the United States. Prior studies have suggested certain racial and socioeconomic groups are disproportionately affected by MVC versus pedestrian (MVC-P) and MVC versus pedal cycle (MVC-PC). Children who survive MVC-P and MVC-PC may suffer physical and mental comorbidities. We analyzed accident location and characteristics of MVC-P and MVC-PC patients treated at Children’s Hospital of the King’s Daughters (CHKD) emergency department (ED) to inform future advocacy and prevention efforts.

Methods: Inclusion criteria were pediatric ( < 18 years old) CHKD ED MVC-P and MVC-PC accidents that occurred in Norfolk between January 1st, 2016 to December 31st, 2020. The patients' sex, race, age, severity, and outcome as well as crash location, date, and time of day were analyzed. Severity was determined using the injury severity score (ISS), with 0-2 classified as minor-moderate, 2-30 as serious-severe, and 30-100 as critical-fatal. Location of events was confirmed through cross-referencing patient chart data with the DMV Crash Location Map by Jurisdiction feature.

Results: Forty-nine patients (65% male) met inclusion criteria: 39 MVC-P and 10 MVC-PC. Included patients were African American (76%), Caucasian (20%), Hispanic/Latino (2%), or Asian/Pacific Islander (2%). 25 crashes were classified as minor-moderate, 20 as serious-severe, and 4 as critical-fatal. Mean patient age was 9.4 (standard deviation 3.9). The exact event location for 45 patients was known. Events on average occurred 2.1 (standard deviation 2.7) miles from home. 51% occurred less than 0.5 miles from the patient’s home. 61% of patients had a median household income between $20,001-$60,000. 66% of crashes occurred in neighborhoods where median household income is between $20,001-$60,000 and 70.5% occurred in neighborhoods where most residents are Black. Injuries most frequently happened between 4-8 pm (51%) and were most common between the months of April-July (55%). Of all patients for whom outcomes were reported, 38 fully recovered, 8 recovered with disability, and 1 was declared dead on arrival.

Conclusion: Most crashes occurred close to the patient’s home during the late afternoon to early evening hours. Crashes most commonly involved young, Black male patients. Future efforts will generate heat maps of geographic areas that have frequent crashes and use our lessons learned to advocate for increased safety measures for these locations.