How does America protect public health?  A clear example can be seen in national pedestrian deaths, up twenty percent from 2009 to 2014.  Presently five thousand walkers  a year are mowed down by motor vehicles, with tens of thousands seriously injured, and hundreds of thousands maimed. In a recent study by Smart Growth America, a group dedicated to the health and economic benefits of walking, eight out of the top ten lethal municipalities are in Florida.  The one where I live, Sarasota-Bradenton, ranks tenth in the nation.

Medical colleagues routinely tell me I am “taking my life in my hands” by walking from my office to the  regional hospital.  You heard right – they regard it as life threatening to cross the street to the main local hospital, something patients, their families and workers need do every day.  Our inability to even consider public health thus kills people twice.  The obvious body count is through pedestrian, bicyclists, and driver deaths.  Yet the second,  making people fearful to walk, blocks what may be the easiest means for decreasing overall deaths in America.  Recent international studies show cardiovascular deaths down 40% with moderate exercise, primarily walking, and cancer deaths down about 20%. Collectively that’s tens of millions of lives.

Yes, this is crazy.  And it can get fixed, on both a local and personal level.

Why Is Florida Lethal?

Florida’s status as an outlier in pedestrian deaths is longstanding and  compelling – the figures are even worse when relative numbers of walkers in the population are compared.  There are many reasons for this high death rate.  Certainly Florida is a car culture, with rudimentary public transport systems in many cities.  The population is also older than most states.  In a car culture, people are very, very reluctant to give up the main form of transportation.  Additionally, there are cultural elements that rarely get considered.  Many motorists do not believe pedestrians have rights that measure up to their own.  Last week I was berated by one driver, using many choice epithets, for walking across a semi-major thoroughfare with a very obvious white blinking walk sign.  He told me how much he wanted to mow me down, and was thoroughly unimpressed when I pointed out the other sign declaring motorists yield to pedestrians.

Perhaps he was correct to remain unimpressed.  Having routinely walked around town for decades, I have not once seen any action by law enforcement against motorists who drive through walk zones with pedestrians inside them.  Not once.  If the authorities do not enforce the law, why should anyone care?

Then there is the issue of cellphones, whose use distract motorists and pedestrians alike, with many fatal consequences.  In Florida, use of cellphones to text while driving is illegal.  It can be punished by a $30 fine.  I have yet to hear of anyone receiving such a fine.

The implication is obvious.  Violation of pedestrian laws may, possibly, get  investigated after you are killed or maimed.

Walking As a Luxury Activity

A comment on Bloomberg about the Smart Growth America study noted that in cities like Seattle, where walking is regarded more as a “luxury activity,” pedestrian rules are defined and enforced much more regularly than in cities where the “only” people walking are poor.  Walking is regarded politically and socially very differently depending on whether it is seen as a leisure activity – or a work activity.  One of the unheralded results of social inequality may be increased pedestrian deaths.  The culture ramifications can sometimes prove curious – many locals have commented to me “I saw you walking” with the same incredulity they might describe a public sex act.

This points a way forward.

What To Do

Defining walking and pedestrian safety as a health issue does not seem to have gotten us far.   Politicians and indeed the public are highly focused on medical care rather than health.  They appear to possess little appetite for measures that would save millions of lives.  That walking improves mood, improves work productivity, aids social cohesion, cuts out heart attack and cancer deaths, just does not impress.

So it makes more sense for pedestrians to define walking as a luxury activity, preferred by those who desire to increase their daily pleasure and lifespan.  Pedestrian safety can then be sold to local populaces and politicians as encouraging tourism, improving retail and sales environments, enhancing local ambience and economics  for tourists and locals, while increasing social connection for neighborhoods.  If rich people like to walk – and they do, especially in entertaining urban environments – then it should be good for the rest of us.

In the meantime, pedestrians are advised to wear gear that makes their presence extremely obvious to heavily distracted motorists, like skin cancer preventing hats and coruscating lights for night-time promenades.  On occasion they may also wish to point out to police and local authorities events when motorists regarded them as invisible,  potential roadkill.

Thus may the public health be advanced.