Mortality Risk Associated with Leaving Home: Recognizing the Relevance of the Built Environment”. American Journal of Public Health, 93, 9, pp 1564 - 1569

Objectives. I analyzed traffic fatalities and homicides related to leaving home for rou-tine activities, and considered connections between these fatalities and the built envi-ronment. Methods. I analyzed city, county, state, and federal data for traffic fatalities and homi-cides by strangers for 15 metropolitan areas, and classified deaths as occurring in the central city, in inner suburbs, or in outer suburbs (exurbs). Results. Traffic fatality rates were highest in exurban areas. Combined traffic fatality and homicide-by-stranger rates were higher in some or all outer counties than in cen-tral cities or inner suburbs in all of the metropolitan areas studied. Conclusions. Traffic fatalities are largely unrecognized as a danger to be factored into residential location decisions. Land use controls that deter sprawl along narrow exur-ban roads can reduce the mortality risks associated with leaving home. (Am J Public Health. 2003;93:1564–1569) considered the circumstances under which these mortality risks are encountered in cities, inner suburban counties that border central cities, and outer suburban (exurban) counties that touch nonmetropolitan counties.5 These findings have implications for citizens decid-ing where to live, developers deciding where to build, and public officials deciding which patterns of development to encourage and discourage. METHODS I studied the danger of leaving home, as represented by traffic fatalities and homi-cides by strangers, in 8 large metropolitan areas encompassing 60 counties and 9 cen-tral cities for varying periods from 1997 through 2000, and in 7 medium to small metropolitan areas in Virginia for 3 seg