ArticleJournal of urban health : bulletin of the New York Academy of Medicine2026
Improving the Denominator of Safety Rankings for Bicyclist and Pedestrian Safety.
Article in Journal of urban health : bulletin of the New York Academy of Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
3 authors.
Funding
Abstract
Active transportation increases physical activity and improves health, yet rising pedestrian and bicyclist deaths are a growing public health concern. In North America, regional agencies allocate transportation investments to support safe walking and bicycling. While comparing crash statistic across regions is standard, accurate safety assessment requires exposure data, or the volume of active transportation users, to determine crash rates. Calculating spatial variation in crash rates is difficult given the lack of spatially detailed, regionally extensive exposure data. Our goal is to develop a method to compare bicycling and pedestrian safety between cities, to inform decisions on where investments are most needed to reduce injury and death. We measured exposure as miles walked or biked in California's 15 largest cities, using a validated model and data from the US Census, National Household Travel Survey, OpenStreetMap, and a statewide crash database. We performed linear regression with exposure and crashes, ranking cities by safety based on residuals. Higher positive residuals indicated less safe cities for active transportation. Including exposure shifted which cities had the highest safety risks for bicyclists and pedestrians. Safety differences were greatest in cities with high percentages of Hispanic residents, where crash-to-volume ratios showed unsafe conditions. Our method enables robust regional assessment of bike and pedestrian safety, allowing health departments and planners to identify where infrastructure investments can effectively prevent injuries and deaths, reduce health disparities, and create environments supporting active living. Our approach is scalable to major population centers nationwide, supporting evidence-based decisions that protect public health.
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