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Objective To examine the relationship between the numbers of people walking or bicycling and the frequency of collisions between motorists and walkers or bicyclists. The common wisdom holds that the number of collisions varies directly with the amount of walking and bicycling. However, three published analyses of collision rates at specific intersections found a non-linear relationship, such that collisions rates declined with increases in the numbers of people walking or bicycling. Data This paper uses five additional data sets (three population level and two time series) to compare the amount of walking or bicycling and the injuries incurring in collisions with motor vehicles. Results The likelihood that a given person walking or bicycling will be struck by a motorist varies inversely with the amount of walking or bicycling. This pattern is consistent across communities of varying size, from specific intersections to cities and countries, and across time periods. Discussion This result is unexpected. Since it is unlikely that the people walking and bicycling become more cautious if their numbers are larger, it indicates that the behavior of motorists controls the likelihood of collisions with people walking and bicycling. It appears that motorists adjust their behavior in the presence of people walking and bicycling. There is an urgent need for further exploration of the human factors controlling motorist behavior in the presence of people walking and bicycling. Conclusion A motorist is less likely to collide with a person walking and bicycling if more people walk or bicycle. Policies that increase the numbers of people walking and bicycling appear to be an effective route to improving the safety of people walking and bicycling. [ABSTRACT FROM AUTHOR]

Background: Priority setting, identification of unmet and changing healthcare needs, service and policy planning, and the capacity to evaluate the impact of health interventions requires valid and reliable methods for quantifying disease and injury burden. The methodology developed for the Global Burden of Disease (GBD) studies has been adopted to estimate the burden of disease in national, regional and global projects. However, there has been little validation of the methods for estimating injury burden using empirical data. Objective: To provide valid estimates of the burden of non-fatal injury using empirical data. Setting: Data from prospective cohort studies of injury outcomes undertaken in the UK, USA, Australia, New Zealand and The Netherlands. Design and participants: Meta-analysis of deidentified, patient-level data from over 40 000 injured participants in six prospective cohort studies: Victorian State Trauma Registry, Victorian Orthopaedic Trauma Outcomes Registry, UK Burden of Injury study, Prospective Outcomes of Injury study, National Study on Costs and Outcomes of Trauma and the Dutch Injury Patient Survey. Analysis: Data will be systematically analysed to evaluate and refine injury classification, development of disability weights, establishing the duration of disability and handling of cases with more than one injury in burden estimates. Developed methods will be applied to incidence data to compare and contrast various methods for estimating non-fatal injury burden. Contribution to the field: The findings of this international collaboration have the capacity to drive how injury burden is measured for future GBD estimates and for individual country or region-specific studies. [ABSTRACT FROM AUTHOR]