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April 2025 — When 73-year-old Meredith Melville crossed a marked crosswalk in Oakland, California, two years ago, she never expected a Toyota sedan to launch her airborne. “She should have seen me,” Melville recalls of the driver. “All of a sudden she was there, and I didn’t have any way to get out of her way.”
Melville survived, but with a replaced hip, a repaired elbow, and a lingering fear of walking. She’s one of the lucky ones. Across the U.S., older pedestrians like her are not necessarily hit more often — but when they are, the consequences are far deadlier.
According to the latest 2023 data from the National Highway Traffic Safety Administration (NHTSA), pedestrians aged 65 and older accounted for over 1,500 deaths and nearly 8,200 injuries in crashes — though underreporting likely masks the true scale. While their injury rate is similar to younger adults, their death rate is significantly higher and has remained stubbornly flat for nearly two decades, even as overall pedestrian fatalities fell after 1975.
The reasons are both physical and environmental. “Older adults move through intersections at a slower pace,” explains Andrew Rundle, an epidemiologist at Columbia University. Impaired hearing or vision makes it harder to spot approaching vehicles, and slower reaction times reduce their ability to dodge a turning or speeding car.
Physically, seniors have greater frailty, loss of muscle mass, and fragile bones. “A hip fracture in a 45-year-old is unfortunate. In a 75-year-old, it’s tragic,” says Charles DiMaggio, an injury epidemiologist at NYU Grossman School of Medicine. The frailty factor means that even a low-speed collision can be fatal.
One critical factor that has worsened the situation is the proliferation of large SUVs and trucks. Andrew Rundle points out that these vehicles have taller hoods and larger blind zones, making them more lethal to pedestrians. A 2024 New York Times investigation documented how these design trends directly correlate with rising pedestrian fatalities.
But a newer threat is emerging: e-bikes and e-motos. The industry calls them “micromobility,” but the numbers are alarming. An analysis of emergency room data published in the American Journal of Public Health showed a nearly 300% increase in e-bike injuries from 2019 to 2022. While cars still cause the vast majority of pedestrian deaths (105 of 112 in New York City last year), trauma teams are sounding the alarm. “Clinical colleagues are saying we need to pay more attention,” says DiMaggio.
Another blind spot is alcohol. Among adult pedestrians killed in nighttime crashes, about a third had blood alcohol levels indicating intoxication. Even during the day, 20% were drunk. Public health officials have noted that older adults are drinking more frequently. “We talk about drunk drivers a lot, but less about inebriated pedestrians,” says Rundle.
Despite these trends, crashes are preventable. Laura Sandt, co-director of the Highway Safety Research Center at the University of North Carolina, emphasizes that policies have evolved since the era when pedestrian deaths were seen as inevitable. More than 200 municipalities have adopted the Vision Zero approach, focusing on engineering, education, and enforcement.
Key changes that save lives include:
A recent study by Stephen Mooney at the University of Washington found that older pedestrians are at higher risk near hospitals, pharmacies, and senior centers. Targeting those neighborhoods with traffic-calming measures could mirror the success of school zone safety programs.
“Our job is to make the system safer for all ages and capacities,” Mooney says. “It shouldn’t rely on a pedestrian’s noticing a car coming and jumping out of the way.”
In early 2025, the U.S. Department of Transportation announced a new round of grants under the Safe Streets and Roads for All program, specifically prioritizing projects that address older pedestrian safety. The funding will support street redesigns in communities with high senior populations. This marks a shift from earlier years when such targeted funding was rare.
Back in Oakland, Melville has recovered enough to walk without a cane, but she still deals with chronic pain and has given up hiking. “It could have been a lot worse,” she says. But she insists that traffic safety cannot depend on each pedestrian’s vigilance. “I was in a crosswalk, with the light. The driver just didn’t see me.”
As the U.S. population ages and walking becomes more popular for health, the need for safer streets grows urgent. The data is clear: older pedestrians are not expendable. With smart design, enforcement, and public awareness, their lives can be saved.
