The real reasons pedestrians die

An urban planner turned internet content provider did a deep dive into why pedestrian deaths in the U.S. rose 72 percent faster than both population growth and the associated increase in vehicle miles traveled in the past 15 years, and one thing Ray Delahanty found is that Anchorage shares several things in common with the pedestrian-deadly cities of the American Southwest.

And it’s not just that both are home to a lot of Athabascans, the Navaho and Apache of the Southwest being immigrants from Alaska who to settled in sun country at about the time Columbus found what Europeans thought was a “new world.”

Almost everyone was a pedestrian in those days, and though horses were to bring increased mobility to the tribes over the centuries to follow, the equines didn’t run down and kill many people on foot.

The random, supposedly ‘accidental’ killing didn’t get started until the arrival of the first motor vehicles, and it only increased in modern times as so-called ‘traffic engineers’ began designing cities for cars and trucks rather than for  for people.

What former urban planner and ‘traffic engineer’ Delahanty found when he dug into this is interesting. Delahanty is one of those citizen journalists of the Internet Age, who operates a podcast known as City Nerd.

When the City Nerd closely examined the data found in the  “Dangerous by Design 2026” report compiled by Smart Growth America and the National Complete Streets Coalition, what he discovered was a profile that defines pedestrian-deadly cities.

They are largely places that:

• Expanded rapidly in the motor-vehicle era with an emphasis on traffic networks geared toward efficiently moving large volumes of vehicles with little thought to human safety.
• Grew around state-owned roadways designed to speed traffic through metro areas, which created kill zones that accounted for 57 percent of pedestrian fatalities in 2024.
• And largely ignored the infrastructure needed to protect the most vulnerable pedestrians, which helped to make those over the age of 65 prime targets for bad drivers. Old folks now make up almost a quarter of pedestrian deaths nationally, although they comprise only 18 percent of the U.S. population.

These factors which make a city dangerous for people on foot almost perfectly describe Anchorage, which set a record for pedestrian deaths in 2024 only to match it in 2025.

Local kill zones

When researchers at the state’s office of Alaska Epidemiology earlier this year took a look at the city’s staggering pedestrian death rate – among the highest in the nation – they found deaths concentrated in Anchorage’s Midtown, a part of the city that expanded rapidly in the 1980s and is filled with wide roads, a limited number of crossings for pedestrians, and a lot of speeding motor vehicles.

State epidemiologists did not look at the ages of the dead, but it is well known that the state’s elder population has boomed in recent years. The Alaska Commission on Aging last year reported that “Alaska’s 65+ population more than doubled between 2010 and 2025” with one of the biggest increases coming in Anchorage.

The 60+ population grew by 74 percent in Anchorage in that period, according to the report, and while the report didn’t identify how many older Alaskans were killed by motor vehicles in the state, it did list “accidental deaths” as the third biggest killer among older Alaskans.

Cancers and heart diseases were the far and away leaders, as they are in the rest of the country, and they also share a connection to motor vehicles.

Lack of physical activity has been linked to the high rates of death from both diseases. A decade ago, medical researchers reported that “physical activity accounts for 22 percent of coronary heart disease, 22 percent of colon cancer, 18 percent of osteoporotic fractures, 12 percent of diabetes and hypertension, and 5 percent of breast cancer.”

This is the real cost of creating a drive-everywhere society. It’s not easy to overlook the 110 to 120 people killed on the country’s roads every year, but the lack of physical activity is disabling millions. It played a key role in the U.S. becoming a leader in Covid-19 deaths among high-income countries, and it is one of the reasons U.S. average lifespans are lagging further and further behind those countries. 

As for the day-to-day health care costs of keeping those with chronic illnesses alive, the cost has exploded in the past decade. It was pegged at approximately $24 billion per year in the 2016 study. That number looks small by comparison to the present.

“Inadequate leisure-time aerobic physical activity accounts for $192 billion in annual healthcare costs among U.S. adults – 12.6 percent of total national health care spending,” the peer-reviewed Journal of American Health Prevention reported last year. 

Much of this spending and many of these deaths are tied to the U.S. having become such a motor-vehicle-dominated society that some people are now afraid to walk or ride a bike in their neighborhood for fear of being run down by a motor vehicle.

“Nearly one in four U.S. adults reported traffic as a barrier to walking where they live,” researchers publishing in the peer-reviewed journal Preventive Medicine Reports wrote in 2022. “Among these adults, vehicle speed was the most commonly perceived traffic characteristic of concern (78.8 percent), and this was notably consistent across all subgroups.”

Anchorage is a poster child for the latter problem. To begin with, it is a city lacking in sidewalks. But where they do exist, many have been rendered useless by traffic roaring by at 45 or 50 mph, if not more, only a curb-edge away.

The Preventive Medicine report noted that “speed reduction and improved sidewalk infrastructure may be important interventions for improving perceptions of walkability among U.S. adults,” which would, in turn, help make people healthier.

Anchorage’s political leaders, and even more so those in charge of state roads cutting through the city, have, however, been loath to lower speed limits, or even enforce the existing and almost always exceeded speed limits now in place becuase of fear of pushback from drivers in a hurry.

And in the deadliest parts of the city, sidewalks are now cemented in place directly adjacent to the roads, making costly any sort of safety separation other than concrete safety barriers or roadside bollards. Other cities have tried installing such barriers to protect pedestrians and/or cyclists, only to run into opposition from motorists who fear they might clip the barriers with their car or truck.

Some cities have gone so far as to remove barriers because American driving skills are now so bad that people keep can’t seem to avoid running into them.

When Anchorage experimented with a temporary, protected downtown bike lane in 2024 to encourage summer tourism, motorists were outraged. The bike lane never returned.

The political lack of will to create safe streets for non-motorists has left 54 percent of Americans afraid to ride a bike near a street, according to a survey conducted by the Breakaway Research Group.  Sadly, too, there is some basis for their fears, especially along high-speed urban roads.

Deadly inattention

“A majority of bicycling fatalities occur at non-intersection locations and speed is frequently a factor in these fatalities,” according to the National Highway Traffic Safety Administration (NHTSA). “Motorist overtaking crashes (cyclists being run down from behind) are the most common fatal crash type for bicyclists in both urban and rural areas.”

Laws mandating safe passing distances are intended to help eliminate such crashes, but these laws are rarely enforced. Anchorage has a three-foot passing law, but there are no records indicating the Anchorage Police Department has ever ticketed a motorist for a dangerous close pass of a cyclist in the municipality.

The NHTSA has also noted the Age of the Internet has brought new and unique problems to the nation’s roadways with collision risks for pedestrians and cyclists rising “due to inattention or distraction, by either the cyclist or driver. While impaired driving and riding have been an ongoing challenge, emerging problems include the use of cell phones, media players, or other electronic devices while riding or driving.”

“Driver distraction, which includes eating, drinking, grooming, daydreaming, talking and texting on handheld devices and many other actions that take a motorist’s eyes and mind off the road, is a contributing factor in many crashes despite many instances going unreported,” according to the Governors Highway Safety Association. “In 2024, 3,208 people died and another 315,167 were injured in distraction-related crashes….

“The true numbers are likely much higher than that, as distraction is difficult to prove at the scene of a crash.”

Displays of distracted driving are, however, pretty easy to find on the internet. Drivers regularly post illustrations of themselves paying more attention to their daily monologue (or some other activity) or filming other people’s collisions with their phone rather than paying attention to their driving.

U.S. law enforcement has done a lousy job of keeping up with the growth in distracted driving and has proven itself even worse at taking advantage of the internet to solicit the assistance of everyday citizens in policing bad behavior.

The United Kingdom has done much better. It has a “National Dash Cam Safety Portal” that allows people to upload dash-cam or action-cam footage of dangerous driving that is then referred to local police departments for examination. 

“Dangerous drivers are being caught on camera and shopped to the police in increasing numbers, with other drivers and the general public having sent more than 100,000 video reports to UK police forces,” The Guardian newspaper reported in 2023.

“The number of reports filed in 2023 increased by 30 percent compared with the previous year, with more than 33,500 videos submitted to police via the National Dash Cam Safety Portal until the end of November. About 70 percent of the submissions lead to police action, ranging from warning letters to penalty points and prosecution.”

The UK is among the countries – the far north country of Finland among them – that have managed improve public health and push down deaths among pedestrians and cyclists by gaining control of traffic.

The deaths of pedestrians fell by 17 percent from 2015 to 2024, according to the UK’ government website, while the deaths of cyclists declined by 15 percent in that same period. Deaths of both did tick up every so slightly in 2025, but that was apparently due to the UK’s promotion of “active travel” encouraging far more people to make trips on foot or by bike than to automatically hop in a motor vehicle.

The government now reports 81 to 84 percent of trips of under a mile are made on foot, and cycling has exploded in parts of the country.  Transport for London last year reported daily cycling journeys in that city were up by 43 per cent since 2019.

An overwhelming number of Americans, on the other hand, appear reluctant to cycle, and most won’t walk even a half mile.

According to the Centers for Disease Control, which surveyed Americans on the subject of walking, 79 percent identified at least one reason for not walking to places within 10 minutes of their home.

With the average walking speed in the U.S. now down under 3 mph, 10 minutes is less than half a mile from someones home, but the CDC found that’s more than three-quarters of Americans can handle.

“Commonly reported reasons (for not walking) were hot and humid conditions (36.0 percent), no places to walk within 10 minutes (24.9 percent), a preference for driving (22.1 percent), and inconvenience (21.5 percent),” the agency reported.

The report also contained one alarming sentence: “Our findings yielded somewhat surprising results by age group, with younger adults reporting more reasons for not walking near home versus older adults.”

The authors were at a loss to explain this, given that national transportation data reports walking is less prevalent among older adults while other studies have concluded that younger adults have “more positive attitudes” toward walking.

“Yet, we found older adults less likely to report that they did not like walking than younger adults,” they wrote.

There might be a simple explanation for this. America is now home to a whole generation of younger adults who were driven everywhere as children because their parents were afraid to let them ride a bike or walk because of dangerous roads.

They were driven to day care. They were driven to school. They were driven to sports activities of all sorts. They were driven to the homes of their friends. They were driven to the story. They were, in general, conditioned to believe that the way one gets around in this country is in a motor vehicle, and as a result, walking or cycling is foreign to them.

Some of which might help explain the growth in chronic diseases among younger Americans in this country. The CDC now reports 60 percent of Americans between the ages of 35 and 64 suffer from at least one chronic condition.

United Health Care in March highlighted news that “younger generations are getting sick earlier in life.” Millennials and Gen Z still have lower health care claims than older generations, the insurance group said, but the rate of growth in the health claims they filed from 2023 and 2025 “was nearly double that of Baby Boomers. The data shows these younger groups are developing chronic conditions, like diabetes and obesity, earlier in life.”

Diabetes and obesity, diseases linked to a lack of fitness, are also precursors to even bigger health problems, and United Health cited data showing that “major health events that exceed $100,000 annually are now about twice as common as they were five years ago. Average monthly claims for these events, such as heart attacks, strokes, complex surgeries or high-cost conditions like cancer or genetic disorders, have jumped nearly 40 percent since 2020.”

The University of Tennessee Health Center has reported these conditions concentrating in a “Chronic Disease Belt” in the Mid-South. This just happens to be the part of the country where people walk the least.

The CDC’s report on walking noted that  “adults living in the South more commonly reported several reasons for not walking near home than adults in other U.S. regions. Transportation walking is less common in the South than in other US regions , and rates of physical inactivity are highest.”

The South is also home to the five fattest and most out-of-shape states in the nation, with a whole lot of them suffering from chronic dieseases. 

Correlation is not necessarily causation, but….