Childhood pedestrian mortality in Johannesburg, South Africa : magnitude, determinants and neighbourhood characteristics

Abstract

Child pedestrian injury and mortality is an issue of significant public health concern in the city of Johannesburg, Gauteng, in South Africa. Since there is a paucity of studies in the last decade or more on fatal childhood traffic and non-traffic injuries in Johannesburg, this study aspires to address the disproportion in this domain of research, and provide more recent, and comprehensive empirical evidence over a ten-year period. The overarching aim of this study was to describe and examine the magnitude, circumstances, and neighbourhood characteristics of fatal pedestrian injuries among children (0-14 years) in Johannesburg for the period from 2001 to 2010. More specifically, the objectives of the study were: firstly, to provide a comprehensive epidemiological description of the magnitude, trends and occurrence of pedestrian mortality among children; secondly, to describe and examine the epidemiology of child pedestrian mortality in relation to children as motor vehicle passengers; thirdly, to describe and examine child pedestrian mortality in relation to non-traffic injuries, in particular, burns and drowning; and fourthly, to assess the influence of neighbourhood characteristics on child pedestrian mortality. The study conceptualised pedestrian road safety within an ecological systems framework. The study used quantitative descriptive, and multivariate logistic regression methods of analysis to examine child pedestrian mortality data. The study drew on data from the National Injury Mortality Surveillance System (NIMSS) and the Census 2001. The main findings indicated that black, male children aged 5 to 9 years (11.02/100 000) are the most vulnerable, and that mortality occurred predominantly during the afternoons and early evenings (12h00-16h00 and 16h00-21h00), over weekends, during school holidays, and to a lesser extent, during non-holiday months. In addition, neighbourhood characteristics that reflected concentrations of disadvantage, single female-headed households and residentially stable areas were associated with child pedestrian mortality. The study findings highlight the need for critical action in terms of investment in child pedestrian safety research, and appropriate prevention initiatives guided by stringent evidenced-based studies, and the design of safe pedestrian, vehicular and urban environments.