Identifying alcohol-related and built environment factors that can be modified to prevent pedestrian road traffic death

确定可以修改的与酒精相关的和建筑环境因素，以防止行人道路交通死亡

• 批准号: 10602550
• 负责人: Andrew G Rundle
• 金额: $ 65.96万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-06-15 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10602550
• 关键词: Address; Alcohol consumption; Alcohols; Automobiles; Businesses; Case/Control Studies; Censuses; Cessation of life; Characteristics; Cities; City Planning; Complex; Computer Assisted; Consumption; Data; Development; Development Plans; Economic Development; Economics; Environment; Geography; Health; Homeless persons; Homelessness; Image; Individual; Infrastructure; Injury; Intoxication; Licensing; Location; Maps; Measures; Modification; Municipalities; Neighborhoods; Neon; Online Systems; Public Policy; Reporting; Research; Research Project Grants; Research Support; Restaurants; Risk; Risk Factors; Role; Safety; Sales; Sampling; Services; Shelter facility; Social Environment; Structure; System; Technology; Testing; Time; Travel; United States; Urban Developments; Visual; Visualization; Walking; alcohol involvement; alcohol risk; annotation system; application programming interface; billboard; built environment; case control; design; distilled alcoholic beverage; distraction; injured; innovation; interest; land use; method development; modifiable risk; pedestrian injury; prevent; statistics; tool; trend; urban planning; virtual; walkability

Every year in the United States automobiles kill about 6,000 pedestrians and injure another 70,000, a significant health burden, especially for cities where pedestrian deaths and injuries are most common. Over 35% of all fatally struck pedestrians are under the influence of alcohol at the time they are killed. Many cities are developing and promoting nightlife districts, prominently featuring alcohol-serving establishments, as part of economic development plans to revitalize urban spaces. By clustering alcohol outlets, these urban initiatives may also cluster intoxicated pedestrians near intoxicated or distracted drivers. Currently, research and public policies focused on preventing pedestrian fatalities fail to account for the built environments pedestrians walk into when they leave alcohol-serving establishments, despite the risks these environments pose for pedestrian injuries and fatalities. In addition, emerging evidence suggests that homeless individuals are at particular risk for pedestrian injury, and they make up a significant percentage (~25%) of the pedestrians killed while under the influence of alcohol. Cities across the U.S. are developing plans to prevent all pedestrian fatalities, yet none of these city plans even mention the role of alcohol use by pedestrians or have action items to address this modifiable risk factor. The broad objective of this proposal is to conduct a nationwide geographic case-control study of pedestrian fatalities to identify modifiable retail, built, economic and social environment risk factors within cities, especially risk factors related to alcohol sales and consumption. Case locations will be urban street segments or intersections where pedestrians were fatally struck from 2017-2018 and two control locations, street segments or intersections where fatalities did not occur, will be matched to the case locations. The presence of alcohol retail establishments (e.g. bars, clubs, liquor stores), nightlife districts, services for the homeless and encampments and informal sheltering locations (e.g. bridges and overpasses) will serve as the key independent variables of interest. We hypothesize that alcohol-involved pedestrian fatalities are a distinct subtype of pedestrian fatality and have different built environment risk factor profiles from pedestrian fatalities that do not involve alcohol. Neighborhood-, street- and intersection-level features for case and control locations will be measured via GIS analyses and via neighborhood audits conducted using Google Street View and our online research tool, the Computer Assisted Neighborhood Visual Assessment System (CANVAS). As part of this proposal we will expand the capabilities of CANVAS for conducting nationwide virtual neighborhood audits via Google Street View. We will also test whether proximity to retail alcohol outlets, nightlife districts or services for the homeless increases risk for pedestrian fatality and whether this risk is heightened by built environments that: encourage pedestrian activity; place pedestrians near road traffic; or cause distractions to pedestrians or drivers. This project will be highly innovative as the first national study to identify modifiable environmental characteristics related to alcohol as potential solutions to reduce pedestrian injury risk within cities.

在美国，汽车每年造成约 6,000 名行人死亡，另有 70,000 人受伤，这是一个重大的数字。 健康负担，特别是对于行人死亡和受伤最常见的城市。超过全部的35% 被撞致死亡的行人在被杀时处于酒精的影响下。很多城市都在发展 推广夜生活区，以提供酒精饮料的场所为特色，作为经济发展的一部分 振兴城市空间的发展计划。通过聚集酒类商店，这些城市举措也可能 将醉酒的行人聚集在醉酒或分心的司机附近。目前，研究和公共政策 专注于防止行人死亡，却没有考虑到行人在以下情况下走进的建筑环境 尽管这些环境存在造成行人受伤的风险，但他们还是离开了提供酒精饮料的场所 死亡人数。此外，新出现的证据表明，无家可归者尤其面临行人伤害的风险。 伤害，并且在受伤害影响而死亡的行人中，他们占很大比例（~25%） 酒精。美国各地的城市正在制定计划以防止所有行人死亡，但这些城市都没有 计划甚至提到了行人饮酒的作用，或者有行动项目来解决这种可改变的风险 因素。该提案的总体目标是开展全国范围内的地理病例对照研究 行人死亡，以确定城市内可改变的零售、建筑、经济和社会环境风险因素， 尤其是与酒类销售和消费相关的风险因素。案例地点将是城市街道段或 2017 年至 2018 年行人被撞致死亡的十字路口以及两个控制地点、街道路段 或未发生死亡事件的交叉路口将与病例位置相匹配。酒精的存在 零售场所（例如酒吧、俱乐部、酒类商店）、夜生活区、为无家可归者提供的服务 营地和非正式庇护场所（例如桥梁和立交桥）将作为关键的独立庇护所 感兴趣的变量。我们假设与酒精有关的行人死亡是一种独特的亚型 行人死亡事件与不存在的行人死亡事件具有不同的建筑环境风险因素概况 涉及酒精。病例和控制地点的社区、街道和交叉口级别的特征将 通过 GIS 分析以及使用 Google 街景和我们的在线服务进行的社区审计进行测量 研究工具，计算机辅助邻里视觉评估系统（CANVAS）。作为本次活动的一部分 建议我们将扩展 CANVAS 的能力，通过以下方式进行全国范围内的虚拟社区审计 谷歌街景。我们还将测试是否靠近零售酒类商店、夜生活区或服务设施 无家可归者会增加行人死亡的风险，以及这种风险是否因以下建筑环境而加剧： 鼓励行人活动；将行人置于道路交通附近；或导致行人或司机分心。 作为第一个确定可改变环境特征的国家研究，该项目将具有高度创新性 与酒精作为减少城市内行人伤害风险的潜在解决方案有关。