摘要：Objectives. To demonstrate an information technology–based approach to assess characteristics of streets and intersections associated with injuries that is less costly and time-consuming than location-based studies of pedestrian injury. Methods. We used imagery captured by Google Street View from 2007 to 2011 to assess 9 characteristics of 532 intersections within New York City. We controlled for estimated pedestrian count and estimated the relation between intersections’ characteristics and frequency of injurious collisions. Results. The count of pedestrian injuries at intersections was associated with the presence of marked crosswalks (80% increase; 95% confidence interval [CI] = 2%, 218%), pedestrian signals (156% increase; 95% CI = 69%, 259%), nearby billboards (42% increase; 95% CI = 7%, 90%), and bus stops (120% increase; 95% CI = 51%, 220%). Injury incidence per pedestrian was lower at intersections with higher estimated pedestrian volumes. Conclusions. Consistent with in-person study observations, the information-technology approach found traffic islands, visual advertising, bus stops, and crosswalk infrastructures to be associated with elevated counts of pedestrian injury in New York City. Virtual site visits for pedestrian injury control studies are a viable and informative methodology. In 2013, an estimated 70 000 pedestrians were injured or killed by motor vehicles in the United States. 1 Pedestrian deaths as a proportion of overall traffic fatalities have grown from 11% to 14% in the past decade nationally, 2 and in New York City more pedestrians than vehicle occupants have been killed by motor vehicles each year since at least 1910. 3 On a trip-by-trip basis, a pedestrian is 50% more likely to be killed than a motor vehicle occupant. 4 Pedestrian safety is not only vital for public health directly through reduced traffic-related morbidity and mortality, but also indirectly as the perception of increased safety from traffic encourages outdoor physical activity, with consequent mental and physical health benefits. 5,6 Investments in pedestrian safety infrastructure may be a particularly cost-effective way to improve population health. 7 Recently, several major cities, including New York City, have developed high-profile plans to improve pedestrian safety citywide. 8 New York City alone has installed 1500 pedestrian signals and reengineered dozens of roads and intersections. 9 Although recent studies have suggested that road and pedestrian environment modifications such as improving lighting, adding speed bumps, or maintaining pavement markings can substantially improve pedestrian safety, 10–13 such studies have not been as widely replicated, in part because of methodological and logistical challenges of conducting pedestrian environment studies. One 2003 systematic review of literature regarding engineering measures designed to reduce pedestrian–motor vehicle crashes that considered both before and after interventions and location-based case–control designs found at most 3 studies per intervention type and only 1 study for most intervention types. 11 The ability to replicate findings is essential to the scientific method and the lack of replication studies undermines weight of evidence and meta-analytical approaches to determining evidence-based best practices. The large burden of injury coupled with the sparse empirical literature justifies more research into risk factors for pedestrian injury and into the effectiveness of interventions. Such studies have, however, typically entailed costly data-collection procedures that require researchers to visit and code every intersection included in the study. Recently, several research teams have validated the use of Google Street View to conduct “virtual” neighborhood audits that obviate the need for field teams to conduct in-person audits. 14–18 However, to the best of our knowledge, such approaches have not been used to assess risk factors for pedestrian injury. In this article, we demonstrate an investigation of environmental contribution to injuries by using information technology rather than site visits.
