Cost effective ways to make walking safer for children and adolescents.

One thing that makes road accidents particularly abhorrent is that so many young people are killed and injured.' In England and Wales in 1992 a quarter of all deaths in the age group 10-14 years were due to road accidents and 57% of these were pedestrians. As well as the suffering caused by the injuries inflicted, fear of accidents means that people go out less than they otherwise would. It is especially important that children be able to play outside in safety. The National Playing Fields Association report, Mean Streets, stresses the importance for children of safe play areas near their homes,2 and the Department of the Environment report, Children at Play, states that 'The child who has not had the opportunity to meet his fellows, take part in their games, or explore his environment is deprived and therefore at a disadvantage'.3 In areas where houses have no gardens, and there is no safe play space nearby, the children may well be, as Colin Ward puts it, 'kept under house arrest'.4 Children's freedom to go out alone, and play with their friends, has been severely restricted during the past 20 years. In 1971, as Hillman et al have shown,5 63% of primary schoolchildren were allowed out alone in their leisure time; in 1990 only 37% were allowed to go out alone. In order to decide which measures should be used to reduce the number of pedestrians killed and injured it is important to consider where the accidents occur, which groups are most vulnerable, what the children were doing at the time of the accident, and what safety measures have been shown to be useful in Great Britain and in other countries. Vulnerable groups People in the Registrar General's social classes IV and V semiskilled and unskilled manual workers suffer higher death rates, from most causes, than those in social class I professional people,9 10 but one of the highest social class gradients is seen in deaths due to pedestrian accidents." Figures for child pedestrian deaths are given in table 2.12