Introduction: Outline of an Epidemic

Ignacio Duarte-Rodriguez had just been trying to grab some cigarettes. That Friday night in March 2018, the seventy-seven-year-old grandfather set off from his son’s house on Phoenix’s northwest side. It was a short walk to the market, across North 43rd Avenue.

Two other pedestrians had been killed on that stretch of 43rd Avenue in the three previous years, Rodriguez’s grieving son and grandson would later tell a local news outlet.1 There were, after all, no crosswalks and no traffic light. There were just six lanes of roaring, indifferent traffic.

Nobody knows much about the last moments of Rodriguez’s life. The key witness, the driver of the 2008 or 2009 sedan (a Chevy Malibu?) who struck Rodriguez, fled the scene, leaving him to die in the road.

It was, in conventional respects, just another sad incident. In a city where about one hundred people lose their lives trying to cross the street every year, deaths like Rodriguez’s are treated as a private tragedy at best or a traffic inconvenience at worst.

But they are part of a mounting epidemic. Ten other pedestrians would lose their lives on roads in the greater Phoenix area over the seven-day period in which Rodriguez was killed—people like Denise-Marye Sileci-Caruso, age sixty-six, another hit-and-run victim, who was killed the same day as Rodriguez while walking to her job at a local gym, or Patti and Ronald Doornbos, both sixty, a married couple from Calgary who were killed in the suburb of Fountain Hills a few days later in a horrific quadruple fatality involving a distracted driver and a Ford Explorer.

Had eleven people been shot by a mass shooter in Phoenix, it would have made national news. By contrast, routine pedestrian deaths do not inspire furious press conferences or congressional hearings. Three of that week’s victims were never even identified by name in the press. Nevertheless, their deaths represent an alarming—and until very recently, largely unexplained—trend.

In 2018, more pedestrians were killed in the United States than at any point in a generation. That year—the most recent for which we have official data—6,283 pedestrians died, a number not seen since the mid-1990s.2 (An additional 1,500 were killed in driveways or parking lots and other locations that are considered private property and so are not counted as “traffic fatalities.”3)

In the United States, about 50 percent more people die while walking or using a mobility device today than a decade ago.4 In all but the most unusual circumstances, these kinds of deaths never attract any sustained attention. But the sharp, sustained rise in pedestrian deaths has not been seen in the United States since the 1980s. It represents a reversal of the pattern of gradually improving outcomes seen in traffic safety for more than a generation.

The mounting crisis is so unexpected and unusual that for a long time, experts dismissed it as perhaps an aberration. But year after year now, as the death count has risen, the reality has become harder and harder to ignore.

There is something exceptional and new happening to the most vulnerable travelers in the United States, and the escalation is distinct from what we have seen for other groups. Over the same decade, from 2009 to 2018, by contrast, drivers and passengers have seen their fatality rates mostly unchanged—rising less than 2 percent.5

What has changed? What is killing pedestrians? What can we do about it—and why haven’t we done it already?

We know that pedestrian deaths are not just random occurrences. There is a clear pattern in where they occur: along streets like 43rd Avenue—wide, fast arterial roads, especially in lower-income areas.

There are patterns in who is killed: older people, men, and people of color are disproportionately at risk. We know what kinds of vehicles are most likely to kill: large trucks and SUVs. We know what kinds of neighborhoods (low-income, black, and Latino) and what areas of the country (the Sun Belt) where people are mostly likely to be struck down. Finally, we know what times to day (night) pedestrians are most likely to be struck.

If we analyze these patterns, they tell us very clearly that pedestrian deaths are not just random acts of God or bad luck, nor are they the result of individual decision-making or laziness (although both bad luck and bad decisions often play a role). Pedestrian deaths are part of a systemic problem with systemic causes.

Like gun deaths, pedestrian deaths are influenced a great deal by policy, such as the speeds limits we impose on local roads, local zoning rules, and public budgets. Culture and vehicle design and technology play roles too.

But culprit number one is the way we have designed commercial streets like North 43rd Avenue, where Rodriguez was killed. Six lanes wide, 43rd Avenue separates a residential neighborhood from a modest shopping center across the street. Stores like the ones at 43rd Avenue and West Rose Lane—a Mexican carnicería, a pawnshop—generate a lot of trips.

Most of these trips, especially in a place like Phoenix, are made by car. But in this part of Phoenix and neighboring Glendale (43rd Avenue is the boundary between the two cities) is a moderate-income Latino neighborhood where many people rely on walking and transit. The public right-of-way—the avenue and the narrow sidewalk that borders it—does not reflect it, however. The marked speed limit on 43rd Avenue is 40 miles per hour—a speed at which being struck by a car is, statistically speaking, a death sentence for a majority of pedestrians and especially so for an older person like Rodriguez.

Even though there were no painted stripes on the roadway, the intersection where Rodriguez was struck is, legally speaking, a crosswalk. Pedestrian right-of-way laws are commonly misunderstood. But in most states, almost every intersection is considered an unmarked crosswalk, meaning that pedestrians have the legal right to cross there, even if there are no stripes on the road.

If Rodriguez had wanted to avoid dodging speeding cars, he would have had to travel about five blocks in either direction to the nearest marked crosswalk. In other words, for the option of maybe twelve seconds of “Walk” signal, the seventy-seven-year-old would have had to make a two-thirds of a mile detour—twice. Almost every pedestrian put in this position will make the decision to chance it rather than make the hike, which may itself be dangerous.

This kind of scenario is not unusual in the sprawling Sun Belt city of Phoenix. For Rodriguez, the cigarettes were across six lanes of high-speed traffic, each more than fourteen feet wide. It is a perilous journey of roughly eighty-six total feet—about the same length as the distance from home plate to first base.

People without cars in cities like Phoenix, in situations like Rodriguez’s, are playing a high-stakes game in which they bet their life that they can make it to first base before the ball is caught, before the wall of traffic closes in. And a small but growing number of them are losing that bet.

About every ninety minutes, one person is being killed walking on a street somewhere in the United States. The circumstances are always different, and many factors are at work in almost every fatality. But Rodriguez’s case is typical in many ways, from the demographic profile of the victim to the setting. He was a person with vulnerabilities in a high-risk setting who was failed by the infrastructure.

Confronting this pedestrian death crisis will require a commitment to protecting people like him. But that has not been the priority in the United States, especially in cities like Phoenix.

Following his father’s death, Rodriguez’s son, Felipe Duarte, pleaded with the city for something that could give meaning to his loss. “They have to do something with this intersection,” he told Fox 10 Phoenix. “If his dad would be the last of this, I think that would be something that he would be proud of,” said Constantino Escarcega, a family member.6

More than two years later, however, the intersection of Rose and 43rd was unchanged.

The lack of urgency around the problem may, in part, reflect the relatively low status of those being killed. Walking deaths fall disproportionately on those who are poor, black and brown, elderly, disabled, low-income, or some combination thereof—marginalized people with fewer political resources to demand reforms. Their experiences and viewpoints are often lost in a system in which few influential people from politics, media, or business are forced to, for example, rely on the bus in hostile environments like outer Phoenix. Among people privileged enough to avoid these kinds of situations—a category that includes most Americans—many view pedestrians as an annoyance or irritation, a potential obstacle on their journey.

That lack of sympathy frequently colors the way these deaths are portrayed. Pedestrians are almost always tacitly blamed for their deaths: for not wearing bright enough clothing, for texting, for wearing headphones, for not making eye contact, and most commonly, for “jaywalking.” For example, even though the driver fled the scene and was still at large, original reporting on the Rodriguez case stated that Rodriguez “was not in the crosswalk when he was hit” but failed to mention two facts: that, legally speaking, he was in an unmarked crosswalk and that there was no safe crossing anywhere nearby.7

Pedestrian victims also contend with an American culture of complacency around traffic deaths more generally. The general acceptance of these deaths as tragic but inevitable has headed off the necessary work of recognizing solutions and finding the will to implement them, even as the numbers have soared.

Understanding the systemic causes is the first step to saving lives. Given the right level of public commitment and resources, pedestrian deaths are preventable.

Some leading US cities have begun to demonstrate how these kinds of deaths can be gradually eliminated. New York City, for example, is one of more than forty US cities that is modeling its safety policies on a concept pioneered in Sweden, called Vision Zero, that seeks to entirely end traffic deaths over the long term. The city has retimed more than a thousand traffic signals and overhauled the design of hundreds of road elements in pursuit of that goal. Between 2013 and 2017 alone, for example, pedestrian deaths dropped 45 percent in New York City, reaching the lowest level since 1910. In New York City, for example, total traffic fatalities are about one-seventh of what they were in the 1990s, although the city’s progress has reversed somewhat since 2017.

The goal of eliminating traffic deaths entirely might seem far-fetched, but some global leaders are already closing in on that goal. In 2019, Oslo, Norway, the capital city of the world’s leader on traffic safety, nearly succeeded in doing so. That city of 673,000 had just one traffic death, and a total of zero pedestrians or children were killed on its roads.8

Meanwhile, many of the United States’ international peers have seen their safety records continue to improve as the US pedestrian safety record has deteriorated over the last decade. (For comparison, over that same period, pedestrian death rates dropped 36 percent in Europe.)9

So why is the United States falling dangerously behind? What explains that 50 percent increase in pedestrian deaths in the United States since 2009?

American street design (as discussed), car culture, and sprawl all contribute. But a handful of recent trends have made the problem a lot worse.

Low Gas Prices, Strong Economy

An obvious explanation for skyrocketing pedestrian deaths is that Americans are simply driving more. In fact, they are driving about 280 billion more miles a year than they did in 2012 following the severe economic downturn.10 Whenever the country emerges from a recession, the pattern has been more driving. And when more people drive, more people get killed in crashes.

But there has been only a 10 percent increase in total driving miles by Americans since the depths of the recession in 2009—not nearly enough to explain the 50 percent increase in pedestrian deaths.11 Even when adjusted for miles driven, pedestrian deaths today are at their highest point since 1998.

In some ways, however, the economic recovery after the 2008 financial crisis may have been especially dangerous. For one, gas has been very cheap. In 2015, on an inflation-adjusted basis, US gas prices were lower than they were in 1947.12 And when gas is cheap, more marginal drivers—like teenagers—get out on the roads and cause wrecks.

Auto lending has also been increasingly lax. Since 2009, auto debt held by Americans increased 75 percent, inspiring comparisons to the subprime mortgage crisis.13 Although that trend has created concerns about predatory lending, it has allowed more lower-income people to purchase cars and has contributed to a decline in public transit use nationwide. (Public transit ridership in cities is very closely associated with lower traffic deaths14 because transit eliminates car trips and helps provide an alternative for the riskiest drivers, such as drunk drivers and those with bad driving records.)

SUVs

Americans are driving more than they used to. But more importantly, they have been doing that driving in bigger vehicles. In a May 2018 study, the Insurance Institute for Highway Safety analyzed all the factors in crashes involving pedestrians, hoping to tease out what was causing the increase. The group found that between 2010 and 2016, the number of pedestrian fatalities involving SUVs increased 80 percent.15

The growing preference for SUVs among American car buyers is a long-running trend, with fits and starts dating to the 1990s. But it is still a relatively new phenomenon. In 1983, for example, SUVs were practically nonexistent, accounting for just 3 percent of the vehicles sold in the United States.16 In the mid-2010s, however, SUVs began dominating car sales in ways never seen before, overtaking sedans as the most popular vehicle type. By 2018, SUVs were 48 percent of sales, with sedans (cars) accounting for just over 30 percent of sales and pickup trucks accounting for most of the remainder.17

Today, more pedestrians are getting hit by big heavy trucks than ever, and owing to the heft of these larger vehicles, pedestrian crashes are becoming more deadly when they do occur. Between 2010 and 2016, the odds of a pedestrian crash being fatal increased 29 percent.18

The news of the connection between SUVs’ roaring sales and soaring pedestrian deaths came as a surprise to many traffic safety observers and people in the media, but it should not have. Studies dating to the late 1990s have shown that SUVs are much more dangerous for pedestrians than regular cars. That information had simply been forgotten, ignored, or even intentionally buried.

The National Highway Traffic Safety Administration (NHTSA), for example, has known about the connection between rising pedestrian deaths and SUVs since at least 2015. That year, the agency quietly issued a report finding that SUVs are two to three times more likely to kill pedestrians when they strike them and four times more likely to kill child pedestrians.19

Demographic Change

Americans are driving more and are driving cars that are more deadly, and yet a third factor puts people in harm’s way: because of certain demographic trends, more Americans are walking in the most dangerous places today than they did in 2009. In addition, more Americans today have physical vulnerabilities that make them more likely to be killed when they are hit.

The Sun Belt region of the United States is by far the most dangerous for pedestrians (for reasons, see chapter 2). On this issue, the region is a complete outlier. According to an analysis by Smart Growth America, nineteen out of twenty of the most dangerous metropolitan areas in the United States for pedestrians are in the Sun Belt.20 Arizona, for example, has three times the pedestrian fatality rate of New York and Colorado and six times that of Minnesota.21

These Sun Belt metro areas—the most dangerous ones—are almost without exception the fastest-growing places in the United States. The twenty-two large metro areas in the Sun Belt have captured almost half the US population growth since 2010, according to the Kinder Institute for Urban Research at Rice University. And some of the most deadly metro areas—like Houston and Dallas, which each have added a million people since 2010—led the pack.22

Maricopa County, where Phoenix is located, for example, added almost six hundred thousand people between 2010 and 2018. In other words, it grew more than ten times as fast as the comparatively much safer Philadelphia County, Pennsylvania.23

Within metro areas, migration trends are also putting more people in harm’s way. The geography of poverty has shifted considerably in this century. Between 2010 and 2015, about half the growth in poverty took place in US suburbs, according to the Institute for Research on Poverty at the University of Wisconsin–Madison. In the United States today, more than three million more people are living in poverty in suburbs than in cities.24

Suburbs are a dangerous place to be poor. Suburban areas like Cobb County, Georgia, and Oakland County, Michigan, that were once homogenous and wealthy have become progressively more racially and economically diverse since the early 1990s. These places and their streets, almost without exception, were not designed to accommodate people walking or relying on transit.

In addition, gentrification in major US cities may also be contributing to the problem. Demographic groups that are less likely to own cars—black and Hispanic people—are being pushed into more hostile environments on the suburban fringes, places that lack sidewalks and streetlights. This problem is especially pervasive in expensive coastal metros like Seattle that offer some of the best conditions for pedestrians—at least for those who can afford to live within urban neighborhoods.

Finally, as a nation, we are aging, and older adults are particularly vulnerable to pedestrian crashes. Those over age sixty-five account for about one in five pedestrian fatalities, and people over seventy-five, like Rodriguez, die at about twice the rate of the population at large.25 As the US population ages, the demographic that is most at risk is swelling.

Driver Distraction

What about smartphones? Everyone’s favorite theory about what is killing pedestrians is distraction. Unfortunately, it is difficult to say how big a problem distraction is because we do not have very good data about it.

The US Centers for Disease Control and Prevention, for example, estimated that 3,450 people were killed—out of some 40,000 total traffic deaths—by crashes involving distraction of any kind, not just cell phone distraction, in 2016.26 The NHTSA estimated that just 562 of those deaths were either bicyclists or pedestrians. Perhaps more difficult to believe, however, is that the agency reported that the proportion of people dying as a result of distraction remained relatively unchanged from 2012 to 2015.27

That is almost certainly an undercounting. Traffic safety officials rely on police reports to identify and correctly report instances of distraction—and many police departments’ crash reports still do not contain a standard reporting mechanism for cell phone distraction. In addition, correctly identifying cell phone distraction after a crash may require a level of investigation that police departments typically do not undertake following traffic crashes.

We do know, however, that people who have smartphones are distracted by them—a lot. Some of the best information we have comes from the tech company Zendrive, which was able to track actual cell phone use from three million drivers through censor technology embedded in their phones.

Zendrive found that practically everyone who owns a smartphone is distracted by it an alarming portion of the time while driving. Owners of smartphones use them on eighty-eight out of one hundred trips, the data showed, and average about 3.5 minutes of use on a one-hour trip. More worryingly, this study only counted physical manipulation of the phone with the hands, not voice commands.28 Zendrive estimates that at any given moment, about three-quarters of a million drivers are using hand-held cell phones.29

We also know that this practice is extremely dangerous. Taking your eyes away from the road for as long as two seconds increases the chances of crashing as much as twenty-four times, studies have shown.30 Using mobile technology—even the kind that is now standard in the dash-mounted entertainment systems of most new cars—is surprisingly mentally taxing and interferes with a driver’s ability to perform more complex driving tasks, such as making left turns.

That being said, we know that the ubiquity of smartphones does not in itself guarantee escalating pedestrian carnage. Smartphones have penetrated European and Canadian markets at similar rates, and yet Europe and Canada have seen pedestrian fatalities decline over the same period (dramatically, in the case of Europe, although it has ticked up moderately in some wealthy countries like the United Kingdom).31 So although we know that distracted driving is likely worsening the problem, it is difficult to say exactly how much.

What About Distracted Walking?

Smartphones are hugely distracting, and pedestrians are certainly not immune. For example, we know that people are falling a lot more when walking, even when inside their own houses, thanks to smartphone-related distraction. A 2013 study using Consumer Product Safety Commission information estimated that smartphones caused an additional fifteen hundred walking injuries in 2010 and that the number of injuries was rising at a rate of about two hundred a year—and the researchers believe that the figure was an undercounting.32

But even if the rate had been undercounted by a factor of two or three, it would still represent only a small share of the 137,000 pedestrian injuries treated in hospitals annually33 (and that study includes non-traffic-related injuries—like a pedestrian who walked into a pole).

Although pedestrian distraction may be a minor factor, we can be confident that distraction is not what has increased deaths 50 percent in a decade. Here’s why:

1. Most pedestrian fatalities occur at night. About 75 percent of pedestrian fatalities occur at night. It is not impossible that people are staring at their phones while walking around at night, but it is somewhat less likely. Having a glowing phone lit at night might even improve visibility for pedestrians, which is a major factor in these crashes.
2. Most pedestrian fatalities occur outside crosswalks. About three-quarters of pedestrian fatalities (73 percent) occur outside of intersections—meaning that the pedestrian is not in a crosswalk, marked or unmarked, when struck.34 People could still be distracted by cell phones when they are running across a road midblock or walking along a road with no sidewalks, but many of the situations in which pedestrians get killed are not the kind of relaxing crossings that would make checking one’s phone tempting.
3. Low-income and elderly people are killed disproportionately. The kinds of people being killed while walking are not the stereotypical smartphone addicts. Rather, older people are overrepresented in the statistics. We also know that low-income people are disproportionately likely to be killed. Those living in neighborhoods where the median per capita income is less than $21,000 are killed while walking at twice the rate of those in neighborhoods where people earn more than $31,000 per capita.35 Many older people and many lower-income people own smartphones. In general, however, the groups most likely to be killed while walking are some of those who we would expect to be the least wired.

Are Americans Simply Walking More?

What about the so-called return-to-cities movement? Are more pedestrians being killed simply because a lot more Americans have been inspired to ditch their cars?

Walking and cycling for transportation have become much more celebrated recently. And there is some good evidence—real estate demand, for example—that more and more people want access to neighborhoods that offer at least some destinations within reach of a stroll.

But some of the best data we have show not much change or even a decline in walking since 2009. We do not have great information about how many people are walking and how far they are walking. The most comprehensive study of American’s travel habits, however, showed a 9 percent reduction in walking trips of all kinds between 2009 and 2017.36

The Response

As these factors have culminated to produce a crisis that is killing thousands of Americans, the public response has been muted. State and federal transportation programs have simply not been oriented around prioritizing pedestrian safety and, in many cases, make things worse. That is especially true in the areas where safety reforms are most desperately needed.

To begin, the scale of resources dedicated to solving the problem is wildly out of scale with the costs. Twenty-two US states have amended their constitutions to forbid any gasoline tax revenues at all from being spent on sidewalks.37 Many of these laws were passed in the 1960s with the financial backing of highway construction lobbyists.38

At the federal level, bicyclists and pedestrians now represent about one in five traffic deaths, but they receive less than 1.5 percent of all federal infrastructure funding.39 Increasing political polarization may also play a role. Just as the pedestrian death crisis was beginning to present itself in 2012, and in an era of loud and renewed interest in active transportation, the Republican-led US Congress substantially reduced federal funding support for walking and biking programs. In addition, following the election of Donald Trump in 2016, the newly regulation-averse US Department of Transportation slow-walked reforms that could have, for the first time, made automakers more accountable for their design impacts on pedestrian safety.

Cities Take the Lead

There is hopeful work taking place, however, at the city level, where sensibilities about traffic safety have been undergoing a sea change. Seattle is one of a growing number of US cities that has made a commitment to try to end traffic deaths altogether. Seattle is using a variety of policy and design approaches—lower speed limits, bicycle lanes, retimed traffic signals, to name a few—to save lives.

In December 2019, as she announced a series of reforms—including funding for intersection upgrades—Seattle Mayor Jenny Durkan made a statement that helped affirm this new vision: “We must make our sidewalks and roads safe for everyone—too many of our residents have lost their lives in traffic incidents, often the most vulnerable,” she said. “That is unacceptable.”40