Social inequalities in child pedestrian collisions: The role of the built environment

Background: Important inequities in child pedestrian-motor vehicle collisions (PMVC) have been observed. The mechanism through which social dimensions influence child PMVC is not well understood, nor is the role of the roadway-built environment.Methods: The relationship between area-level social dimensions (material deprivation, proportion recent immigrants, proportion visible minority) and police-reported child PMVC between 2010 and 2018 in Toronto, Canada was examined using multivariable negative binomial regression models, controlling for built environment covariates.Results: All social dimensions were significantly associated with child PMVC, including material deprivation (Incidence Rate Ratio (IRR-adjusted): 1.31, 95 % Confidence Interval (CI): 1.22-1.40), recent immigrant proportion (IRR adjusted: 1.58, 95 %CI: 1.30-1.92, per 10 % increase), and visible minority proportion (IRR adjusted: 1.09, 95 %CI: 1.05-1.12, per 10 % increase). Built environment features did not attenuate these associations.Conclusion: This study provides evidence of social inequalities in child PMVC, suggesting a need to target traffic safety interventions towards the most socially marginalized areas.