Identifying Countermeasure Strategies to Increase Safety of Older Pedestrians

Levi, S.; De Leonardis, D.; Antin, Jon; Angel, L. · 2013 · ROSA P / United States. National Highway Traffic Safety Administration. Office of Behavioral Safety Research

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Summary

This report, commissioned by the National Highway Traffic Safety Administration (NHTSA), addresses the critical need to identify countermeasure strategies to improve the safety of older pedestrians (defined as adults aged 65 and older). The research was motivated by the disproportionate risk faced by this demographic: while older adults are struck less frequently than children, they are significantly more likely to die following a crash due to frailty and physical complications. In 2010, older pedestrians accounted for 19% of all pedestrian fatalities despite comprising only 13% of the U.S. population. With the older population projected to nearly double by 2030, the study aimed to explore effective interventions from transportation, public health, and education fields to mitigate these risks. The methodology involved a comprehensive review of over 130 literature pieces and informal interviews with thirteen experts in fields including geriatric medicine, occupational therapy, ophthalmology, and transportation safety. The researchers analyzed age-related functional declines and reviewed best practices in health communication design to determine how to effectively disseminate safety information to older adults. The study synthesized data to understand the dynamics of older pedestrian crashes, focusing on physical, visual, and cognitive factors, as well as the effectiveness of various communication channels and theoretical models for behavior change. Key findings highlight that age-related declines in strength, balance, visual processing, and cognitive attention significantly impair an older adult’s ability to navigate complex street environments safely. Older pedestrians often experience slower walking speeds, reduced peripheral vision, and difficulty judging vehicle speeds, which increases their exposure time in intersections. Crucially, the report notes that older adults are often unaware of these "hidden" cognitive and visual declines, making them poor candidates for self-correction without external education. The literature review identified that successful health communication campaigns for older adults rely on participatory design, clear and concise messaging, and relatable content. Effective strategies include using large print, avoiding complex information overload, and employing theoretical models like the Transtheoretical Model to address readiness for behavior change. Specific safety advice identified includes avoiding complex intersections, using refuge islands, and increasing conspicuity through reflective materials. The significance of this report lies in its holistic approach to older pedestrian safety, advocating for countermeasures that address both environmental engineering and behavioral education. It concludes that current strategies are insufficient and that future programs must integrate insights from multiple disciplines. By targeting the specific functional limitations of older adults and utilizing proven health communication techniques, stakeholders can develop more effective interventions. The report emphasizes the need for further research to determine which specific countermeasures are most effective in pre-crash scenarios, suggesting that a combination of educational outreach and infrastructure improvements is necessary to reduce the high fatality rates among older pedestrians.

Key finding

Current countermeasures for older pedestrian safety are insufficient and require holistic integration of engineering designs and tailored health communication strategies that address age-related physical, visual, and cognitive declines.

Methodology

review

Provenance

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Summary generated by qwen3.6-27b-prismaquant on 2026-06-10; verification: verified.

Topics

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• pedestrian behavior perception