396 - Assessing Crash Severity of Pediatric Active Commuters and Social Vulnerability in a Large American City

Maisie D. Nievera, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, United States; Mary Li, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, United States; Zoabe Hafeez, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, United States

Background: Active transportation, or non-motorized modes such as walking and bicycling, is frequently used by people who have limited access to transportation. This population includes children, who often use active transportation as means to get to school, and people who are of lower socioeconomic backgrounds. With urbanization and automobile usage on a constant rise, children are at a higher risk of injury and fatality from car accidents. Further investigation into the severity of a child's injuries and its connection to their community’s social vulnerabilities is essential for effective injury prevention.

Objective: The purpose of this study is to evaluate the relationship between active transportation-related injuries among children in Harris County and social vulnerability on a census tract level. We aim to determine whether the CDC Social Vulnerability Index (SVI) is associated with the frequency and severity of injuries within this population of child pedestrians and cyclists.

Design/Methods: We collected data from 2021 through July 2024 from the Texas Department of Transportation's Crash Records Information System and mapped child active transportation crashes alongside the 2022 SVI using ArcGIS Pro. Demographic information was analyzed using descriptive statistics. Mann-Whitney tests were conducted to determine significant associations (p < 0.05) between crash severity and SVI themes.

Results: Out of 1,021 children involved in reported crashes, 690 were male and 330 were female. Analysis revealed that the majority of children identified as Hispanic (n= 375, 37%) and Black (n= 362, 35%). From all four SVI domains, socioeconomic status had a significant association with more severe injuries from a crash (p=0.04), notably when the community was below 150% federal poverty level (p=0.01). There was no statistically significant association between ethnicity or age and crash severity. Women were less likely to be injured, accounting for 32% of injuries, but they were more likely to have serious injuries when injured (p=0.02). Additionally, pedestrians had more serious and fatal injuries than bicyclists (p=0.00) with fewer minor injuries.

Conclusion(s): Our results suggest that critical injuries tend to occur amongst socially vulnerable individuals such as females and those living in poverty. These findings foster greater discussion about the overlooked lack of surveillance and necessary safety measures to protect child active transporters in lower socioeconomic locations. Stakeholders such as policymakers and advocacy groups may use this information to improve preventative measures for active transportation safety.

Crash Severity Overlaid on Socioeconomic Status (SVI Theme 1) Percentile Ranking in Harris County
Map of Harris County with pediatric injuries overlaid on Socioeconomic Status theme from 2022 Social Vulnerability Index expressed as a percentile compared to national level census tract data.

P-values of Crash Severity and SVI themes
P-value <0.05 used to determine significance.