By Leslie Vasquez Guzman
Pedestrian deaths are rising faster in the U.S. than in any other high-income country. A decade-long surge, up 50%, has made the U.S. the most dangerous place to walk among 27 peer nations. Many experts view these deaths not as random accidents but as preventable tragedies that reflect deeper policy failures in transportation, infrastructure, and public safety.
A recent study from the Centers for Disease Control and Prevention (CDC) comparing traffic fatalities across 28 high-income countries from 2013 to 2022 found that the U.S. had by far the worst overall traffic fatality rate—three times the median of other nations. While many countries saw significant reductions, traffic fatalities in the U.S.—including vehicle occupants, pedestrians, cyclists, and other road users—rose by 22.5% over the decade with older adults disproportionately affected.
Another study, published in JAMA Internal Medicine in 2025, revealed a broader pattern of failure. It found that avoidable mortality from preventable and treatable causes, including traffic-related deaths, increased in every U.S. state between 2009 and 2021. Nearly all other peer countries, by contrast, experienced steady declines. The study emphasizes that these outcomes were exacerbated during the COVID-19 pandemic and were particularly severe in states that already faced high mortality rates.
What sets the U.S. apart is not just worse statistics—it’s the absence of effective systemic responses. Despite spending more on health care than any other country, the U.S. still sees worse outcomes—pointing to failures in policy, not resources.
Countries that improved pedestrian safety adopted the Safe System approach, a people-first strategy that focuses on designing transportation systems to reduce the risk and severity of crashes through collective responsibility. The U.S. federal government adopted this framework in 2022 through its National Roadways Safety Strategy, and researchers note that greater application of this strategy could help reduce fatalities.
They explain:
“Increased adoption of evidence-based strategies to reduce these deaths, such as the Safe System approach which focuses on structural and policy changes, such as protected walkways and safe crossings, consistent street lighting, and speed management policies, might help reduce traffic deaths.”
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