Qualitative Field Observation of Pedestrian Injury Hotspots: A Mixed-Methods Approach for Developing Built- and Socioeconomic-Environmental Risk Signatures

Abstract

Road traffic injuries constitute a significant global health burden; the World Health Organization estimates that they result in 1.35 million deaths annually. While most pedestrian injury studies rely predominantly on statistical modelling, this paper argues for a mixed-methods approach combining spatial analysis, environmental scans, and local knowledge for assessing environmental risk factors. Using data from the Nova Scotia Trauma Registry, severe pedestrian injury cases and ten corresponding hotspots were mapped across the Halifax Regional Municipality. Using qualitative observation, quantitative environmental scans, and a socioeconomic deprivation index, we assessed hotspots over three years to identify key social- and built-environmental correlates. Injuries occurred in a range of settings; however, clear patterns were not observed based on land use, age, or socio-economic status (SES) alone. Three hotspots revealed an association between elevated pedestrian injury and a pattern of geographic, environmental, and socio-economic factors: low- to middle-SES housing separated from a roadside attraction by several lanes of traffic, and blind hills/bends. An additional generalized scenario was constructed representing common risk factors across all hotspots. This study is unique in that it moves beyond individual measures (e.g., statistical, environmental scans, or geographic information systems (GIS) mapping) to combine all three methods toward identifying environmental features associated with pedestrian motor vehicle crashes (PMVC).

Keywords: geographic information systems; hotspots; mapping; mixed methods; pedestrian injury; socio-economic status.

Figure 1

Methods for the study including framework for assessing risk profiles for pedestrian motor vehicle crashes (PMVC).

Figure 2

A visual representation of the environmental artifacts included in the survey instrument used during our environmental scans. Each of these environmental elements was selected based on a thorough literature review in which we examined the chief (known) correlates with pedestrian motor vehicle crashes.

Figure 3

Map of the top ten pedestrian injury hotspot locations showing a range of specific as well as contextual risk correlates. Clear patterns are not observed based on socioeconomic status (SES), age, and land use alone. This indicates the need for further field examination of the individual hotspots in order to understand patterns associated with the built urban environment. Note that this map shows only the top 10 hotspots representing 64 injuries.

Figure 4

Examples of images that were taken throughout the qualitative scans. The image on the left depicts an industrial area frequented by large trucks, while the image on the right illustrates the low-income house found at one hotspot in an area with blind bends and hills. These factors were associated with increased pedestrian injury risk at three of the hotspots that were surveyed.

Figure 5

Frequently observed configurations of geographical, socio-economic, and environmental factors present in pedestrian injury hotspots in urban Halifax. The number of hotspots where each factor was observed is listed within parentheses.