Traffic safety decisions are based predominantly on information from police collision reports. However, a number of studies suggest that such reports tend to underrepresent bicycle and pedestrian collisions. Underreporting could lead to inaccurate evaluation of crash rates and may under- or overestimate the effects of road safety countermeasures. This review examined ten studies that used data linkage to explore potential underreporting of pedestrian and/or bicyclist injury in police collision reports. Due to variations in definitions of reporting level, periods of study, and study locations, it was difficult to directly compare the studies. Even among the six studies using the hospital link definition, estimates of reporting levels ranged from 44 to 75 percent for pedestrian crashes, and from 7 to 46 percent for bicycle crashes, suggesting a severe underreporting problem. However, few of the studies provided estimates of the error around their reporting level estimates, and as a result, it is difficult to determine the true level of underreporting. It may be that bicycle and pedestrian crashes appear in both police and hospital datasets but are less likely to be linked. Due to linkage error, link rate can only be used to estimate reporting level. Without the variance of that estimate, the effect of underreporting on traffic safety analyses cannot be accurately determined. Future studies should include estimates of the error present in their data linkage process for greater accuracy of the underreporting in police data. Datasets should be designed for easier linkage with hospital data and other datasets.

A significant proportion of fatalities from motor vehicle collisions (MVC) could be prevented through better emergency medical service (EMS) care. Despite a lack of conclusive research, there is a consensus that prehospital time (the time between the MVC and the patient’s arrival at the hospital) must be reduced as much as possible. Many studies use response time (the time between EMS dispatch and arrival at the scene) as an indicator of overall prehospital time and a metric of EMS performance. However, there are other components of prehospital time that may be equally important, including the discovery time between the collision and EMS notification, the on-scene time, and the transport time from the scene to the hospital. In rural MVCs, the discovery time can be substantial if there are no witnesses or survivors capable of calling emergency services. Technologies that automatically detect MVCs can shorten discovery times in such circumstances. Transport times depend on the distance between the crash scene and the hospital; this time could be reduced by increasing access to trauma centers, especially in rural areas. On scene time is a component of the total time, however there is a trade-off between minimizing scene time to reduce total time and providing optimal on-scene care. Increasing capacity of EMS personnel and/or utilizing technology such as telemedicine should be considered as part of this trade-off. Future research is needed to determine the relative benefits and costs of reducing any of these segments of prehospital time.

This study examines data from the California EMS Information System (CEMSIS) to identify factors that influence prehospital time for EMS events related to motor vehicle collisions (MVCs). While only 19 percent of the United States population resides in rural areas, over half of all traffic fatalities involve rural motor vehicle collisions. Rural and urban MVCs result in similar injury severities, however relative inaccessibility of trauma centers and prehospital EMS time (activation, response, and transport time) likely contribute to the generally higher mortality rate in rural areas. For the present study, 24 CEMSIS data variables were requested, many of which involved missing data, which severely restricted the potential analysis of the impact of EMS response times. However, the findings did show that average overall EMS time (including response, scene and transport time) were approximately twice as long for collisions in rural zip codes compared with urban zip codes. Several limitations influence the interpretation of these results. Data on prehospital EMS times is missing for much of the state—even for zip codes with records of EMS events, data is likely incomplete. In addition, zip code level location data is insufficient for adequate study of the effects of the built environment and road network on prehospital time. Furthermore, according to the National EMS Information System (NEMSIS) User Manual, the national dataset suffers from selection and information bias, which are likely also present in the CEMSIS data. Although the present study cannot analyze the effect of longer prehospital times on patient outcome, other research has found that longer prehospital times may negatively impact patient health. Recommendations for reducing time from injury to appropriate medical care in rural areas include improving cell phone coverage, compliance of rural 911 center with FCC wireless, use of GPS technology, and integration of automatic vehicle location and computer aided navigation technologies into all computer-aided dispatch systems. In addition, CEMSIS should improve the coverage of their dataset and ensure that all EMS activities are recorded. To expand the type of analyses that can be conducted using CEMSIS data, EMS records must include fields that allow them to be linked to hospital and police datasets. When such data becomes available, research must be conducted to determine whether prehospital time is significantly related to patient outcome following motor vehicle collisions.

Meeting the mobility needs of an aging population is one of the most substantial challenges facing California in the coming decades. The number of residents age 60 and above will grow to 13.9 million by 2050, representing over 25% of the state population. Meanwhile, the number of residents age 85 and above is expected to increase by over 70% between 2010 and 2030. In 2018, the Safe Transportation Research and Education Center (SafeTREC) at UC Berkeley conducted a survey on transportation mobility issues among older adults in Contra Costa County in California. Results indicated, among other findings, that a majority of seniors are car dependent, that some older adults miss important activities due to mobility limitations, and that most older adults want to “age in place.” A follow-up survey of 302 Contra Costa County seniors ages 60 and above was conducted in June 2020, just as the COVID-19 pandemic changed life for all residents. The follow-up survey assessed the mobility needs and changes during the Shelter-in-Place order as well as how COVID-19 was impacting other areas of their lives, such as their economic situation, views of government regulatory efforts, feelings of social isolation, and work/employment status. This brief presents findings from the follow-up survey.

The only way to absolutely prevent all drivers from going around lowered gates at level rail-highway crossings is to make it physically impossible, or at least very difficult, for them to do so. While there are various options to accomplish this (constructing a separation of grade, closing the crossing, or deploying an impenetrable concrete barrier), most have high monetary or social costs. Alternative approaches—such as channelization devices and long-arm gates—while not 100 percent effective, can be used to prevent deaths and injuries while remaining economically feasible. Research has shown that the addition of channelization devices can dramatically reduce the number of violations at level rail-highway crossings. While long-arm gates appear to be effective, additional study is needed to determine their suitability for individual locations. Unfortunately, even when overall rail crash totals for the country or for a given state are high, crashes at specific crossings are relatively rare events, making it extremely difficult to show that the addition of a safety treatment at a particular site prevented a crash. However, based on the efficacy of channelization devices—75 percent—in addition to the experiences of various transportation agencies, these devices appear to be a viable, low cost safety upgrade for at-grade crossings.

Road deaths are forecast to double by 2020, with the burden falling most heavily on low- and middle-income countries and, within those countries, on the most vulnerable and poorest road users. Half of the 1.2 million people killed and 50 million injured in road crashes each year are pedestrians, motorcyclists, bicyclists, and users of unsafe public transport; and more than 90 percent are from low- and middle-income countries. Because these are the areas where rapid motorization is taking place, the issue of safety in increasingly multi-modal environments is now of critical importance, particularly for pedestrians and bicyclists, since as vulnerable road users (VRU), they comprise a large proportion of injuries and deaths, and similar strategies for prevention of injuries and fatalities for these two groups are available. Although a great deal of additional research is needed to determine the costs and benefits of various proposed solutions, some basic principles can be identified to guide roadway and infrastructure design for improved pedestrian and bicyclist safety. The three broad but separate strategies for reducing the probability of an injury or fatality are: (i) reducing exposure, (ii) reducing the probability of a collision given exposure, and (iii) reducing the probability of injury given a collision. The purpose of this paper is to describe and illustrate these principles, discuss issues related to each one, and discuss the benefits—indeed, imperativeness—of the application of these principles by planners and traffic engineers.

The mobility needs of an aging population is one of the most substantial challenges facing California in the coming decades. The number of residents age 65 and older is expected to double between 2012 and 2050, and the number age 85 and above is expected to increase by over 70% between 2010 and 2030. Declines in physical function related to age may reduce mobility options dramatically. A survey of 510 residents age 55 and older in Contra Costa County was conducted to determine mobility patterns and limitations related to age and other factors. Results of the survey indicate that a majority of seniors are car dependent. However, some older adults miss important activities due to mobility limitations associated with increasing age, poorer health, living alone, not having a licensed driver in the household, and having a disability. Mobility options are also limited in some geographic areas and demographic groups. Importantly, older adults want to “age in place.” Based on these findings and those in related studies, the travel options and the quality of life for older adults, now and in the future, can be greatly enhanced if efforts are made to develop mobility solutions beyond use of private vehicles. The findings support the recommendations of recent regional plans such as the Coordinated Public Transit–Human Services Transportation Plan (2018), adopted by the Metropolitan Transportation Commission (MTC) of the San Francisco Bay Area, which recommends supporting a range of mobility options centered around shared mobility and accessibility for populations at risk for limited mobility.

There is a disproportional risk of motor vehicle death and injury among American Indian/Alaska Native (AI/AN) populations in the United States. As home to the nation’s largest population of AI individuals, it is vital that California develop a better understanding of the factors contributing to this risk to guide the development and implementation of interventions to improve traffic safety for this population on the nearly 100 Rancherias and reservations in the state. However, there is very little data about the numbers and types of collisions, and driver and environmental factors contributing to the collisions that occur on tribal lands. As a first step toward better understanding the scope of the risk disparity, and the shortcomings in data collection, SafeTREC conducted a literature review and crash analysis using data from the Statewide Integrated Traffic Record System (SWITRS) and tribal area base maps targeting these communities. As a result of presentations and discussions at a California Tribal Safety conference where these analyses were presented, a number of procedural and institutional challenges were identified. Addressing these issues will not only help policymakers identify interventions to improve traffic safety on tribal lands, but it will give tribal jurisdictions tools to compete for scarce safety funding through the use of data documenting the need for safety improvements. Future research efforts should be aimed at refining these and other initiatives to address both the dire conditions of traffic safety on California’s tribal lands, and the limitations of the data.

In 2018, SafeTREC conducted a survey on transportation mobility issues among older adults in California. A follow-up survey planned for 2020, just as the COVID-19 pandemic changed life for all residents, was redesigned to assess mobility needs and changes during the Shelter-in-Place order and focused on COVID-19 impacts. Results indicate that the COVID-19 pandemic and subsequent Shelter-in-Place order have had a major impact on senior mobility. Communications for many were restricted to phone, email, texts, social media and video chats. Among those with a medical problem, just over 60% called a doctor or nurse line or went to a doctor’s office, while 11.2% went to an emergency room, and 8.6% did nothing. A total of 8% of respondents said they had run out of food or other important items during the Shelter-in-Place order. Rates of exercise outside the home dropped 20% between January and June 2020, and while over 60% sought outside entertainment in January 2020, by June 2020, nearly 70% accessed their entertainment online at home. Almost 80% of working respondents feared spreading or contracting COVID-19 because of their work or related transportation. Almost 20% felt a lack of companionship or closeness sometimes or often. Over 30% were worried about their current or long-term finances. A total of 84.5% strongly agreed or agreed that the Shelter-in-Place order was necessary. None of the respondents to the follow-up survey were diagnosed with COVID-19, and 88.2% were not concerned about risk of exposure from any member of their household.