Assessing multimodal school travel safety in North Carolina.

School transportation has been the subject of numerous federal and state policies since the early twentieth century-the Safe Routes to School program is the most recent example. However, few recent studies have thoroughly analyzed the risks and costs associated with different modes of transportation to school. Our descriptive study assessed the injury and fatality rates and related safety costs of different modes of school transportation using crash and exposure data from North Carolina, USA from 2005 to 2012. We found that riding with a teen driver is the most dangerous mode on a per trip basis with injury rates 20 times higher and fatality rates 90 times higher than school buses, which had the lowest injury rates. Non-motorized modes had per trip injury rates equivalent to school buses but per trip fatality rates were 15 times higher than for school buses. The economic costs of school travel-related injuries and fatalities for walking, biking, and teen drivers were substantially higher than other modes. This research has important policy implications because it quantified the risks of different school travel modes which allows policymakers to consider how safety investments can reduce risks. Decades of effort by schools, communities, and the government have made school buses a very safe mode and endeavored to reduce risks to teen drivers. This study highlighted the need for these same actors to reduce the risks of injury for walking and bicycling. As more improvements are made to infrastructure around schools, repeated studies of this type will allow practitioners to examine whether the improvements help mitigate the risks.