Each year close to 80,000 pedestrians are hit by motor vehicles in the United States, and 5,000 of these people die. One-fifth of these deaths are among adults over age 65—higher than any other age group. Research has revealed that collisions involving older pedestrians are more likely to occur at intersections and during daylight hours, leading many to wonder whether crosswalk markings might help to prevent pedestrian-motor vehicle collisions.

Findings have been mixed on whether marked crosswalks actually improve pedestrian safety. New research published in the November 6, 2002 issue of the Journal of the American Medical Association (JAMA) expanded on past studies by paying particular attention to the types of crosswalk marking patterns, the condition of the markings, and other environmental characteristics. The findings support the idea that crosswalk markings at urban intersections are associated with an increased risk of injury to older pedestrians.

About the Study

Over a five-year period, researchers from the University of Washington (Seattle, Washington), the Centers for Disease Control and Prevention (Atlanta, GA), and the University of California (Los Angeles, CA) studied 846 crosswalks in six cities in Washington and California. Crosswalks where a pedestrian aged 65 years or older was struck by a motor vehicle (as indicated on a police report) were compared to crosswalks where a pedestrian over age 65 had not been hit.

Streets in these cities were classified into one of four categories based on the number of lanes, daily traffic volume, and speed limit. The streets where people had been hit in a crosswalk were matched—based on the neighborhood and the classifications of roadways meeting at the intersection—to two streets where people had not been hit ("control crosswalks"). The US Census block group (an area of about 12 city blocks) was used to randomly select the control crosswalks.

At each crosswalk site, trained field workers collected information on environmental factors like the layout of the intersection, the presence of crosswalk markings (including descriptive details), and the presence of traffic signals or stop signs. A portable radar gun was used to measure vehicle speed, and a video was used to record, and later calculate, car flow over a 10-minute period and pedestrian flow over a 30-minute periods. All measurements on the control crosswalks were made at the same time of the day and the same day of the week as when the victim had been struck at the matched case sites.

The Findings

A total of 282 collisions (20 fatal) involving an older pedestrian were identified during the study period. The researchers found that older pedestrians were more than two times as likely to be hit by a vehicle when using a marked crosswalk than when using an unmarked crosswalk. Most of this excess risk was due to the fact that when no traffic signal or stop sign was present to control traffic flow, marked crosswalks were associated with a 3.6-fold increase in risk of being hit.

At intersections with a stop sign or traffic signal, there was virtually no association between the presence of crosswalk markings and pedestrian-motor vehicle collision risk. When researchers adjusted these findings for traffic and pedestrian flow, the length of the crosswalk, and other environmental characteristics, the risk was less though still significantly increased.

Although these results suggest that marked crosswalks may be more risky to older pedestrians than unmarked crosswalks, there are a number of limitations to this study. First, there may have been other unmeasured site characteristics that could have influenced the outcome. The weather, for instance, could be different and affect individual sites differently. There could have been measurement errors in determining the motor vehicle and pedestrian volume at certain sites – especially given that observations were made during a limited time interval on the same weekday and time of day as the pedestrian-motor vehicle collision.

A second limitation is that the study findings may not apply to other urban areas or age groups since only collisions involving individuals over age 65 in these 6 cities were assessed. Finally, there were not enough crosswalks analyzed to assess whether differences in the crosswalk marking patterns were significant. (i.e., did more accidents happen in those crosswalks that were harder for drivers to see?)

How Does This Affect You?

This study suggests that older pedestrians should be especially cautious when crossing the street at high-risk locations, since it appears that crosswalk markings alone may offer little protection against getting struck by cars. It is possible that marked crosswalks give older pedestrians a false sense of security. Crossing where stop signs and lights are located increases the chance that traffic will stop and allow them to cross safely. Toning muscles and keeping up balance and strength could also help to minimize the chance of being caught in an intersection. Here are some additional suggestions for pedestrian safety.

Tips for crossing the street safely

  • Cross where stop signs or stop lights are present
  • Follow prompts to stop or walk
  • Leave yourself enough time to cross the street
  • Look both ways even when you have a green light or walk symbol
  • When possible, wait to make sure traffic has stopped before you cross
  • Ask for assistance in crossing the street
  • Wear a sturdy pair of walking shoes