Attachment C <br />14 <br />is addressing pedestrian safetv necessa <br />. Children from the highest household income quartile were significantly less likely <br />to sustain pedestrian road traffic injuries in Hyderabad, India (3S). <br />. Low income and poverty were associated with the largest numbers of child <br />pedestrian crashes in the city of Memphis, United States (36). <br />1.2.4 Where do pedestrian collisions occur? <br />Overall, there is wide variation in locations of pedestrian collisions from one country <br />to another. While pedestrian collisions occur more in urban areas than rural settings <br />in high-income countries, the opposite is true in some low- and middle-income <br />countries. For example, about 70% of all pedestrian fatalities in the European Union <br />and 76% in the United States occur in urban areas (25,37). In the United Kingdom, <br />young pedestrians from urban areas were involved in crashes five times more <br />frequently than those in rural areas, and their death rate was twice as high (39). This <br />is in contrast to a Chinese study, which found that pedestrians who commute in rural <br />areas were more likely to suffer injuries than pedestrians who commuted in urban <br />areas (39). A study of university students in Cairo, Egypt, found that participants <br />who resided in rural areas were significantly more likely to suffer pedestrian injuries <br />than those who resided in urban areas (40). <br />Most pedestrian collisions occur when pedestrians are crossing the road (41). For <br />example, a study in Ghana found that 68% of the pedestrians killed were knocked <br />down by a vehicle when they were in the middle of the roadway (42). Information <br />provided by 73 pedestrians in a study in Kenya showed that 53 (71.6%) were <br />injured when crossing the road, 8 (11%) when standing by the road, 6 (8.2,0/.) while <br />Attachment B <br />Page 159 <br />