BUILT FOR WALKING: SAFE ENVIRONMENTS FOR ACTIVE SCHOOL TRANSPORTATION January 19, 2017 B.C. Injury Research & Prevention Unit

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BUILT FOR WALKING: SAFE ENVIRONMENTS FOR ACTIVE SCHOOL TRANSPORTATION January 19, 2017 B.C. Injury Research & Prevention Unit Linda Rothman, BScOT, PhD, Post-Doctoral Fellow, York University, School of Kinesiology and Health Science, Hospital for Sick Children

THE TEAM Dr. Alison Macpherson- Professor, Epidemiologist, York University Dr. Andrew Howard- Senior Scientist, Orthopaedic Surgeon, Hospital for Sick Children Dr. Ron Buliung- Professor, Geographer, University of Toronto, Mississauga Dr. Colin Macarthur-Associate Chief, Clinical Research, Epidemiologist, Hospital for Sick Children Dr. Sarah Richmond- Post-doctoral Research Fellow, Epidemiologist, York University, Hospital for Sick Children In Collaboration with Richard Christie and Kristen Evers, Toronto District School Board, Sustainability Office 2

OUTLINE 1. Introduction 2. Observational Study of Walking to School and Pedestrian Motor Vehicle Collisions 3. Speed Humps 4. School Crossing Guards 5. Risky Driving Behaviours around Schools 6. Parent Perceptions of Traffic Danger 7. Summary of Results 8. Response to Our Research 9. Knowledge Users/Stakeholders 10.Related Projects 3

# collisions # collisions 3000 2500 National Pedestrian Collisions Resulting In Any Injury (0-14) 1 2719 44% reduction 2000 1500 1196 1000 500 0 45 40 35 30 25 20 15 10 5 0 40 National Pedestrian Fatalities (0-14) 1 17 9 57% reduction 1 Transport Canada, Canadian Motor Vehicle Traffic Collision Statistics: 2013 4

Are there fewer collisions because children walk less? 1 1986: 59% 2011: 45% Only 38% of Canadian children use any active school transportation (2013) 2 1. Metrolinx. School Travel in the City of Toronto, 2015. 2. Active Healthy Kids Canada. Is Canada in the running? 2014. 5

Walking to School Potential Health Benefits Built Environment Design (BE) BALANCE Potential Risk of Pedestrian- Motor Vehicle Collisions (PMVCs)

Safety in numbers? 1 OR Increased walking exposure = increased risk? 2,3,4 1 Jacobsen PL, Inj Prev. 2003;9:205-209. 2 Macpherson, A. Am J Public Health. 1998;88:1840-1843. 3 Rao, Bull N.Y. Acad Med. 1997;74:65-80. 4 Gropp Inj Prev. 2013;19:64-67

Recent increase in pedestrian fatalities in Toronto (all ages) 20 (2011), 30 (2015) fatalities Many collisions involving children occur near schools ~40% during school travel times/months > 1/3 of collisions within 300 m of a school, highest density within 150 m 8

2. OBSERVATIONAL STUDY What proportion of children in JK-Grade 6 walk to school in the City of Toronto? younger versus older students How many child PMVCs occur in the areas surrounding elementary schools? How does the BE relate to children walking to school and child PMVCs? What types of driving and pedestrian behaviours are observed around schools, and how are they related to child PMVCs and the BE? 9

DIRECT OBSERVATIONS 2 data collections, regular program TDSB JK-grade 6 schools 2011 (118): cross-sectional, 2015 (100): case-control Trained observers morning drop off time (May-June) counts of travel mode, excluding school bus (>20,000) kindergarten entrances (50 randomly selected schools) risky driver behaviour checklist school site survey 10

2011-118 Schools 2015-100 Schools 11

Built Environment Density Census Diversity MPAC, City of Toronto Design City of Toronto, Census Field Survey Social Environment TDSB, Census Child population Total population Males, 4 to 12 Mixed land use (entropy) Commercial land use Industrial Institutional Crossing guards Dead end Flashing lights Intersection Road Local road Collector road Major road Minor road School crossing guard Mean speed> 5 km over speed limit Any dangerous crossing Double parking Cars parked blocking School LOI (Social disadvantage) School population Children grades 4-6 at school Males at school Multi-dwelling Residential Vacant land Recreational Park land One way streets Old houses (pre 1946) Sidewalks missing (both, one) Traffic calming Traffic lights Trails Urban Route directness (Inter/inter+dead end) Other TDSB and Catholic schools Cars appear to be driving fast Traffic congestion Any dangerous intersection Dropping opposite side School vehicle volume Below ATLICO by school DA New immigrants at school School age (years) English not first language

MAPPING Police-reported child PMVCs 2002-2011, 4-12 years School attendance boundaries: Unit of analysis Rates of collisions per child population 13

Proportion of children observed walking to study schools by school boundary (2011) Average walking = 67%, wide variability Kindergarten children walked significantly less than older children (56% vs 69%) 14

What was related to more walking to school? Population density Traffic lights Intersections Pedestrian crossovers (crossing controls) Children who s first language wasn t English School crossing guards (14% more walking) Where there were school crossing guards, nothing else was important 15

Average =7.4/10,000 children/year, wide variability 16

CHILD PMVCs, 2002-2011 (10 years) 481 collisions within 105 school boundaries* No collisions in 13 school boundaries No Injury: 24 (5%) Minimal Injury: 191 (40%) Minor Injury (seen in ED): 236 (49%) Major Injury (admitted): 30 (6%) Fatality: 1 (<1%) 214 (44%) were school travel time collisions 17

Collision Rate/10,000\year Collision Rate and Proportion Walking to School 30 25 20 15 10 5 0 0 10 20 30 40 50 60 70 80 90 100 Proportion Walking 13% increase in collision rate with every 10% increase walking HOWEVER, once we controlled for the influence of BE features, this relationship disappeared 18

What is related to a safer traffic environment? Higher population/residential density Lower school disadvantage Fewer one way streets Fewer traffic lights (i.e. road crossings)? Speed humps? School crossing guards Walking to school is unrelated to child PMVCs if environment is safe 19

13 schools with no collisions Higher school social disadvantage Lower density of higher speed roads Lower density of one way streets 20

PROBLEMS WITH CROSS- SECTIONAL STUDIES Associated with higher collision rates?? Traffic calming School crossing guards 2002 2005 2007 2011 Collision Traffic calming implemented Traffic Calming Collision Traffic calming may have not been present when collision occurred Pre-post studies 2 1

3. SPEED HUMPS: PRE-POST STUDY 1,344 collisions along speed hump roadways, 2000-2011 Central City of Toronto Installation associated with a 22% decrease overall (296 PMVCs prevented) 45% decrease in child PMVCs

4. SCHOOL CROSSING GUARDS PRE-POST STUDY 58 newly implemented guards 260 PMVCs within 50m Central City of Toronto Collision rates unchanged after implementation Simple roadway modification to that may be related to more walking without detrimental safety effects

SCHOOL CROSSING GUARDS 568 existing guards city-wide 2,573 PMVCs, 2000-2011 Most child PMVCs occurred outside of school travel times (62%) Most school travel time PMVCs occurred in locations without crossing guards (86%) More permanent interventions needed to address high burden of child PMVCS happening outside of school travel times and away from guard locations

5. TOP 3 OBSERVED RISKY DRIVING BEHAVIOURS (2011) Drop-offs opposite side of road from school 70% Cars blocking view of motorists and pedestrians 62% Double parking 46% 0% 10% 20% 30% 40% 50% 60% 70% 80% % of schools (n = 118) 25

Each additional riskydriving behaviour was associated with a 45% increase child PMVC rates within 200m of a school during school travel times Higher school social disadvantage and higher speed roadways were associated with higher collision rates 26

DRIVING BEHAVIOURS Dropping children opposite side 79% 2015 Drivers parking blocking vision U-Turns Backing up dangerously 64% 67% 72% Double parking 46% Drivers disobeying traffic controls 28% Parking blocking crossing controls Texting while driving Talking on phone while driving 15% 15% 19% PEDESTRIAN BEHAVIOURS Uncontrolled midblock crossing 0% 20% 40% 60% 80% 100% 85% 82% Crossing between parked cars 61% 57% Using cell phones/electronic devices 4% 25% Children Disobeying crossing controls 8% 14% Adults Disobeying crossing guards 2% 2% 0% 20% 40% 60% 80% 100%

Traffic congestion risk: double parking parking blocking vision parking blocked crossing controls dangerous reversing crossing unsafely between cars Designated drop off areas protective: parked blocking controls dangerous reversing dangerous midblock crossings crossing unsafely between cars but increased talking on phone School crossing guards protective: texting while driving potentially parking blocking controls 28

Greater School Social Disadvantage Greater proportions of children walking Higher collision rates Higher density multifamily housing Fewer crossing guards Higher speed roadways Less traffic calming More traffic congestion 29

6. PARENT PERCEPTIONS OF TRAFFIC DANGER Objective 1 To determine if parent perceptions of traffic danger en route to school and/or at the school site during morning drop-off are related to walking to school Objective 2 To examine the relationship between features of the built environment and parent-perceived traffic danger Parent questionnaire in 20 schools, grades 4-6, participated in the observational study (2011), 733 surveys returned

How dangerous is the traffic for your child 1. Between your home and your child s school? (ROUTE) 2. Around the school during drop-off time? (SITE) How often does your child walk to school (frequent = 4-5x/weekly) High route danger perception was related to: Less frequent walking Dangerous midblock crossing Higher speed roadways But not actual collision rates To influence walking, the safety of the route must be considered, however, must also address safety directly around school sites 31

7. SUMMARY What is related to a safer traffic environment? 1. Higher population/residential density 2. Lower school disadvantage 3. Fewer one way streets 4. Fewer traffic lights (i.e. road crossings) 5. More speed humps 6.? School crossing guards 7. Less dangerous driving/pedestrian behaviour less traffic congestion controlled midblock crossings designated car drop offs school crossing guards 32

8. SCHOOLS RESPONSE. Knowledge users: Parent council Caretaker School staff School superintendent School advisory council Caring and safe schools committee Crossing guard Toronto Police Services Community liaise officer School newsletter Toronto public health Actions taken: Developed a pedestrian/parking safety committee New crosswalk installed Used info for establishment of Kiss N Ride Used for proposal to City of Toronto for new crossing guard Walking school bus implemented Contacted police re: excessive speeding Assigned more staff to monitor drop off No stopping, buses only signs posted along curb Started Walking Wednesdays New lines painted on driveway Purchased bike rack Planned 3 walk to school days Registered on the Safe Routes to School website Changed bus loading, legal parking and drop-off zones Investigated changes to speed limit and signage (e.g. curve ahead) Invited Manager of Traffic Operations for City of Toronto to do student talk about traffic safety Traffic safety incorporated into health class discussions 33 Established walking goals for school

MEDIA S RESPONSE 34

35

9.KNOWLEDGE USERS/STAKEHOLDERS School Zone Safety Working Group, City of Toronto Vision Zero Metrolinx GTHA Active and Sustainable School Transportation Regional Hub, Advisory Committee Toronto District School Board, Sustainability Office, EcoSchools Program Parachute Green Communities Toronto Police Services CAA Presentations, Webinars Ministry of Transportation Active and Safe Routes to School, York and Peel Region CAPHC, Ontario Traffic Council City Hall-City-School Boards Advisory Committee TDSB: Health and Wellness, Program, Environmental Sustainability Committees Local/National/International Conferences 36

10. RELATED PROJECTS National CIHR Team Grant, Environments Health Child and youth pedestrian and cycling injury School observations and the built environment Other designs case crossover Pre-post analysis of built environment features Spatial Distribution of PMVC before and after installation of countdown timers Other BE interventions (speed humps, bike lanes) Equity Child pedestrian safety as an equity issue in urban neighbourhoods, comparing Montreal and Toronto Traffic safety design features 37

Safety must be considered with the promotion of walking to school Built environment influence on PMVC is more important than walking rates To influence AST, route safety must be considered; in addition to school site safety We need to get the built environment right! 38

ACKNOWLEDGEMENTS City of Toronto, Transportation Services Toronto Police Services TDSB, Sustainability Office Funding Hospital for Sick Children Restracomp Research Training Award Ontario Neurotrauma Foundation (ONF) Summer Internship Program in Injury Prevention CIHR Doctoral Research Award Strategic Teams in Applied Injury Research (STAIR) Traffic and Road Injury Prevention Program (Dr Andrew Howard, Dr. Anne Snowdon) Child and Youth Injury Prevention (Dr. Ian Pike, Dr. Alison Macpherson) CIHR Chair in Child and Youth Health Services and Policy Research (Dr. Alison Macpherson) 39

Last day of observations Friday, June 19/15 40

Further questions. Linda Rothman BScOT, PhD Senior Research Associate Hospital for Sick Children Linda.rothman@sickkids.ca 41