A new analysis of pedestrian deaths in New York State finds that nearly half of the people struck and killed by vehicles while walking may have had impaired awareness due to alcohol or drug use at the time of the crash.

Researchers from the New York State Department of Health’s Bureau of Occupational Health and Injury Prevention, working with Columbia University, conducted a retrospective analysis of 771 pedestrian deaths involving motor vehicles in New York State between 2018 and 2020, drawing on data from the federal Fatality Analysis Reporting System (FARS).

The analysis found that 44%, or 338 of the 771 deaths, involved alcohol or drugs. Of those, 18% involved drugs alone, 12% involved both alcohol and drugs, and 14% involved alcohol alone.

Who was affected

Pedestrian deaths in the study were highest among men, who accounted for 63% of fatalities, and among people aged 65 and older, who made up 34% of deaths. Among racial and ethnic groups with available data, Hispanic men had the highest proportion of substance-involved deaths, at 58%. However, the researchers caution that 57% of records lacked race or ethnicity data altogether, limiting the strength of conclusions that can be drawn about disparities between groups.

When and where deaths occurred

Substance-involved pedestrian deaths were most common between 6pm and 6am, while pedestrian deaths overall, regardless of substance involvement, were most common on Saturday evenings. Pedestrians who were impaired by drugs were also more likely to be struck while walking outside of a marked crosswalk compared to pedestrians who were not using substances.

Study limitations

The researchers note several limitations to the analysis. The study examined only fatalities and did not include non-fatal pedestrian injuries, so its findings may not generalize to pedestrian crashes overall. Additionally, pedestrians who were not tested for alcohol or drugs were coded as substance-negative in the data, meaning the true prevalence of substance involvement among the pedestrians studied is likely undercounted.

Despite these limitations, the researchers say the findings point to substance use as a significant and underappreciated factor in pedestrian fatalities, and suggest that prevention efforts aimed at reducing pedestrian deaths should account for the role of alcohol and drug impairment, particularly during nighttime hours.

Journal: Injury Prevention
DOI: 10.1136/ip-2025-045980
Article Title: Substance use among fatally-injured pedestrians in New York State, USA: a retrospective analysis
Publication Date: 13-Jul-2026
Funding: National Center for Injury Prevention and Control of the CDC; NY State Governor’s Traffic Safety Committee grants; CDC

Source: EurekAlert