Background: Despite increased investment in infrastructure designed to promote and protect walking, rates of traffic related pedestrian deaths have increased by 87.8% between 2010 and 2022 in the United States. This study aims to investigate how comprehensive measures of built environmental features that encourage walking impact pedestrian risks overall and across levels of urbanicity. Methods: Using data from the Environmental Protection Agency's National Walkability Index (NWI) and National Highway Traffic Safety Administration 2017–2019 Fatality Analysis Reporting System, multilevel negative binomial regression models were used to examine the relationship between walkability score (range 1–20, with higher scores indicating the presence of built environment characteristics that increase the likelihood that people will walk for transportation) and pedestrian death rates by resident population at the census block group level. Results: In adjusted, block group level models, a 5-point higher NWI score was associated with a 29% increase in the rate of pedestrian deaths (IRR: 1.29, 95% CI: 1.27 – 1.32). Models stratified by urbanicity showed a stronger association of NWI in urban block groups (IRR: 1.34, 95% CI: 1.31 – 1.37) and an inverse association of NWI in isolated rural town block groups (IRR: 0.56, 95% CI: 0.43 – 0.72). Conclusion: These results suggest that built environment interventions which promote walking behavior may benefit from additional pedestrian safety improvements. Current nationwide walkability data do not accurately characterize pedestrian safety; however, these data may be used to identify places to be prioritized for pedestrian safety interventions. © 2025

BACKGROUND: The built environments in which we work, live, and play can influence physical activity behaviors, and perceptions of these environments are associated with walking behavior. This study's objective is to compare national-level data on perceptions of the near-home walking environment from the 2015 and 2020 National Health Interview Survey. METHODS: Adults in 2015 (n = 30,811) and 2020 (n = 29,636) reported perceptions of walkable supports (roads, sidewalks, paths, or trails; sidewalks on most streets), destinations (shops, stores, or markets; bus or transit stops; movies, libraries, or churches; places that help you relax, clear your mind, and reduce stress), and barriers to walking (traffic; crime; animals). Age-adjusted prevalence estimates, prevalence differences, and 95% confidence intervals were calculated overall and by demographic characteristics. RESULTS: The reported prevalence of roads, sidewalks, paths, or trails for walking increased overall (85.3% in 2015 to 88.0% in 2020) and for many subgroups. Perceived places to walk to for relaxation, to clear your mind, and to reduce stress increased overall (72.1% in 2015 to 77.1% in 2020) and for all subgroups. Perceptions of crime as a barrier to walking decreased overall (12.5% in 2015 to 11.2% in 2020) and for some subgroups. From 2015 to 2020, the proportion of adults perceiving roads, sidewalks, paths, or trails; places to relax; and crime as a barrier to walking improved. CONCLUSIONS: Continuing to monitor perceptions of the walking environment could contribute to progress toward national walking and walkability goals in the United States.

OBJECTIVES: To determine the prevalence of perceived decreases in three physical activity (PA) behaviors and meeting the PA guideline, by changes in telework. METHODS: U.S. workers (n = 2393) reported teleworking and PA behaviors before and after COVID-19 emergence. Those reporting more and less telework were compared to those reporting stable telework on prevalence of (1) decreasing behaviors and (2) meeting the aerobic guideline (≥150 min/week of moderate-intensity PA). RESULTS: Compared to workers with stable telework, those with increased telework were more likely to report decreases in any PA (by 61%), active transportation (65%), and park use (52%). Workers who deceased telework were also more likely to report decreases in these behaviors. Groups were equally likely to meet the guideline. CONCLUSION: Changes in teleworking status-either more or less-may be associated with decreased participation in PA behaviors.

Commercially-available location-based services (LBS) data derived primarily from mobile devices may provide an alternative to surveys for monitoring physically-active transportation. Using Spearman correlation, we compared county-level metrics of walking and bicycling from StreetLight with metrics of physically-active commuting among U.S. workers from the American Community Survey. Our strongest pair of metrics ranked counties (n = 298) similarly for walking (rho = 0.53 [95% CI: 0.44-0.61]) and bicycling (rho = 0.61 [0.53-0.67]). Correlations were higher for denser and more urban counties. LBS data may offer public health and transportation professionals timely information on walking and bicycling behavior at finer geographic scales than some existing surveys.

Motor vehicle traffic is commonly cited as a barrier to walking, but national level perceptions of traffic characteristics that negatively influence walking and potential traffic mitigation strategies remain unclear. The objectives of this study were to describe perceptions of (1) traffic characteristics that make walking unsafe in the United States and (2) potential mitigation strategies to address these concerns among those who report traffic as a barrier to walking. Data were from FallStyles, a nationwide internet panel survey conducted in October 2019 (n = 3,284 adults). Respondents reported if traffic makes walking unsafe where they live; those who answered yes were then asked about traffic characteristics that make walking unsafe (number of vehicles, speed of vehicles, distracted or impaired driving, types of vehicles, and other reasons) and potential mitigation strategies (new or improved sidewalks, crosswalks, pedestrian signals, street lighting, things that slow vehicles down, separating the sidewalk from the road, fewer vehicle lanes, and other). Prevalence of responses was assessed overall and by select sociodemographic and geographic characteristics, and by walking status. Nearly 25% of US adults reported that traffic is a barrier to walking where they live. Of these, 79% selected vehicle speed as a contributing traffic characteristic, and 57% indicated new or improved sidewalks as a potential mitigation strategy. These top responses were shared across all sociodemographic, geographic, and walking behavior subgroups. Speed reduction efforts and built environment enhancements such as sidewalks may alleviate pedestrian safety concerns. Promotion campaigns may be needed to bring awareness to such changes.