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Reid Ewing, PhD, Richard A. Schieber, MD, MPH and Charles V. Zegeer, MS

Reid Ewing is with the Alan M. Voorhees Transportation Center, Edward J. Bloustein School of Planning and Public Policy, Rutgers, The State University of New Jersey, New Brunswick, NJ; Richard A. Schieber is with the Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, US Public Health Service, Atlanta, Ga; and Charles V. Zegeer is with the University of North Carolina, Chapel Hill, Highway Safety Research Center, Chapel Hill.

Correspondence: Requests for reprints should be sent to Reid Ewing, PhD, National Center for Smart Growth, Preimkert Field House, University of Maryland, College Park, MD 20742.

Objectives. We sought to determine the association between urban sprawl and traffic fatalities.

Methods. We created a sprawl index by applying principal components analysis to data for 448 US counties in the largest 101 metropolitan areas. Regression analysis was used to determine associations between the index and traffic fatalities.

Results. For every 1% increase in the index (i.e., more compact, less sprawl), all-mode traffic fatality rates fell by 1.49% (P < .001) and pedestrian fatality rates fell by 1.47% to 3.56%, after adjustment for pedestrian exposure (P < .001).

Conclusions. Urban sprawl was directly related to traffic fatalities and pedestrian fatalities. Subsequent studies should investigate relationships at a finer geographic scale and should strive to improve on the measure of exposure used to adjust pedestrian fatality rates.

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