Bicyclist and pedestrian crashes in Ontario: Detection and comparison of health outcomes between police-reported collisions and injury health care records

Active transportation modes like walking and bicycling have environmental and health benefits. The COVID-19 pandemic has placed a new focus on active transportation as a "safe" (physically-distanced) travel option. But people walking and bicycling are more vulnerable to road injury. Studies of bicycling and pedestrian injury often rely on police-reported collisions data. However, not all walking and bicycling road injuries are reported to police or entered into collisions records, especially when motor vehicles are not involved or where their involvement is indirect. Police-reported collisions data also contain minimal information on outcomes following injury. Health care records can help detect additional road injuries and the outcomes of these injuries for bicyclists and pedestrians. This project will learn from a linkage between reported collisions and health care records of bicycling and pedestrian injury in Ontario in 3 ways: 1) Ministry of Transportation (police-reported) collision records will be linked to records of health care use (emergency department visits and hospital stays) to compare bicycling and pedestrian collisions reported to police and those found in health care records. We will examine how characteristics that are individual (e.g. gender, age), neighbourhood (socio-economic status), and regional (rurality) affect the chance of being detected in both reported collisions and health care records. 2) We will annually update the linkage as new data become available, including the time period of COVID-19. 3) We will look at what happens to injured pedestrians and bicyclists after crashes, comparing collisions reported to police and those found in health care records, by following their hospital and physician visits after injury. This study will build new partnerships between road safety surveillance and epidemiologists, and form groundwork for prevention of active transportation injury in Canada.