New York data reveal substance use in 44% of pedestrian deaths

In New York state, 44% of pedestrian deaths involved alcohol or drug use by the pedestrian, according to a retrospective analysis published online in the journal Injury Prevention. Pedestrian injuries are the seventh-leading cause of injury-related death in New York state. There are approximately 15,000 pedestrian injuries annually, of which 3,000 require hospitalization.

Most public safety campaigns focus on drinking and driving, whereas pedestrian substance use and impairment are relatively neglected issues.

The researchers analyzed data from the Fatality Analysis Reporting System, a national database covering all motorized vehicle traffic-involved fatalities on a public roadway. This includes deaths that occurred within 30 days of the crash, as well as alcohol and drug test results reported as part of postmortem examinations.

During the three-year study period of 2018 to 2020, there were 771 pedestrian deaths recorded in New York state as a result of a collision with a vehicle. Substance use, defined as the presence of alcohol, drugs or both, was recorded in 338 of the pedestrians who died (44%).

Nearly one in five fatalities (18%) involved drugs alone, while 12% involved both alcohol and drugs. Alcohol use (defined as a blood alcohol concentration of 0.01% or more) was recorded in 14% of the pedestrian deaths.

The researchers, from the Bureau of Occupational Health and Injury Prevention at New York State Department of Health and Columbia University, write: “Alcohol and drug co-use is particularly concerning, as poly-substance use has been linked to more severe impairments in cognitive function and neurocognitive deficits compared with single drug use.”

They say further research is needed to better understand the role of polysubstance use in pedestrian injuries and fatalities.

The number of deaths was highest among men (63%) and those 65 and older (34%).

Hispanic males had the highest proportion of substance-involved deaths (58%). However, a large proportion of pedestrians (57%) did not have their race and ethnicity recorded, which limits interpretation of this finding.

The study found that substance-involved deaths were most likely to occur between 6 p.m. and 6 a.m. Overall, the largest number of pedestrian deaths occurred on Saturday evenings.

Pedestrians who had taken drugs were more likely to be on a road and not on a crosswalk when struck by a vehicle.

Based on their findings, the researchers suggest that substance use may contribute to riskier crossing behaviors and that a reduction in visibility at night may give drivers insufficient time to react and avoid a collision.

A limitation of the study is that the analysis examined only fatalities, and the findings cannot necessarily be extrapolated to nonfatal injuries. Additionally, the researchers coded an individual as negative for alcohol and drugs when testing was not conducted or results were unavailable, which may have underestimated the true prevalence of substance use.

The researchers note that the presence of alcohol or drugs does not necessarily mean that impairment was solely responsible for the fatality or that it directly contributed to the crash.

Nevertheless, they say impairment—including impaired decision-making and walking—may have played a role in the sequence of events leading to a fatal motor vehicle crash. They call for strategies that promote safe drinking practices and encourage safe travel home for anyone who may be impaired from alcohol or drugs.

Who’s behind this story?

Sadie Harley

BSc Life Sciences & Ecology. Microbiology lab background with pharmaceutical news experience in oil, gas, and renewable industries.

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Andrew Zinin

Master’s in physics with research experience. Long-time science news enthusiast. Plays key role in Science X’s editorial success.

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