Structural Racism and Pedestrian Safety: Measuring the Association Between Historical Redlining and Contemporary Pedestrian Fatalities Across the United States, 2010‒2019.

Objectives. To examine the association between historical redlining and contemporary pedestrian fatalities across the United States. Methods. We analyzed 2010-2019 traffic fatality data, obtained from the Fatality Analysis Reporting System, for all US pedestrian fatalities linked by location of crash to 1930s Home Owners' Loan Corporation (HOLC) grades and current sociodemographic factors at the census tract level. We applied generalized estimating equation models to assess the relationship between the count of pedestrian fatalities and redlining. Results. In an adjusted multivariable analysis, tracts graded D ("Hazardous") had a 2.60 (95% confidence interval = 2.26, 2.99) incidence rate ratio (per residential population) of pedestrian fatalities compared with tracts graded A ("Best"). We found a significant dose‒response relationship: as grades worsened from A to D, rates of pedestrian fatalities increased. Conclusions. Historical redlining policy, initiated in the 1930s, has an impact on present-day transportation inequities in the United States. Public Health Implications. To reduce transportation inequities, understanding how structurally racist policies, past and present, have an impact on community-level investments in transportation and health is crucial. (Am J Public Health. 2023;113(4):420-428. https://doi.org/10.2105/AJPH.2022.307192).

A national landscape: Injury and violence prevention health equity scan findings and implications for the field of practice.

INTRODUCTION: Many federal and national partners have a renewed commitment to addressing health equity and racial equity as a public health issue of concern. These are especially important issues in addressing many injury and violence prevention (IVP) topic areas. In developing and updating approaches to address injury and violence-related health and racial equity challenges, CDC and Safe States Alliance wanted to better understand how partners in the field are already approaching these issues. An environmental scan was conducted to explore how IVP professionals advance health equity and racial equity in their programmatic work. METHODS: Data collection occurred from multiple sources including focus groups and surveys. Health equity and racial equity-related questions were added to the Safe States Member Survey: Evaluating the Impact of COVID-19 on the IVP Workforce and Assessing Equity Initiative (COVID Impact and Equity Survey). An analysis of secondary data sources was conducted through ongoing evaluation initiatives at Safe States Alliance (the COVID Impact Evaluation and Connections Lab Evaluation Focus Groups). CONCLUSIONS: Successes and challenges were identified through the environmental scan that primarily fell into three categories: (1) Injury and Violence Prevention Strategies and Programs, (2) Using IVP Data to Inform Equity Approaches, (3) Equity Approaches in IVP Infrastructure. Practical Applications: Practical applications were identified that can be supported at the local, state, and federal/national level and are specific to the areas of IVP strategies and programs, IVP data and surveillance, and IVP organizational infrastructure. A few examples include: (1) Ensuring decision-making power and ownership of programs is shared between community partners and funders; (2) Working with national/federal surveillance system partners to ensure demographic fields/variables are improved to identify disparities and inequities; (3) Development of an "Injury and Violence Prevention Equity Institute" to better prepare IVP professionals to address health and racial equity challenges.

Law Accommodating Nonmotorized Road Users and Pedestrian Fatalities in Florida, 1975 to 2013.

OBJECTIVES: To examine the effect of Florida's adoption of Statute 335.065-a law requiring the routine accommodation of nonmotorized road users (i.e., a "Complete Streets" policy)-on pedestrian fatalities and to identify factors influencing its implementation. METHODS: We used a multimethod design (interrupted time-series quasi-experiment and interviews) to calculate Florida's pedestrian fatality rates from 1975 to 2013-39 quarters before and 117 quarters after adoption of the law. Using statistical models, we compared Florida with regional and national comparison groups. Semistructured interviews were conducted with 10 current and former Florida transportation professionals in 2015. RESULTS: Florida's pedestrian fatality rates decreased significantly-by at least 0.500% more each quarter-after Statute 335.065 was adopted, resulting in more than 3500 lives saved across 29 years. Interviewees described supports and challenges associated with implementing the law. CONCLUSIONS: Florida Statute 335.065 is associated with a 3-decade decrease in pedestrian fatalities. The study also reveals factors that influenced the implementation and effectiveness of the law. Public Health Implications. Transportation policies-particularly Complete Streets policies-can have significant, quantifiable impacts on population health. Multimethod designs are valuable approaches to policy evaluations.