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Estimating the effects of a studded footwear subsidy program on pedestrian falls among older adults in Gothenburg, Sweden

Journal article
Authors Carl Bonander
R. Holmberg
Published in Accident Analysis and Prevention
Volume 132
ISSN 0001-4575
Publication year 2019
Published at Institute of Medicine, Department of Public Health and Community Medicine, Health Metrics
Language en
Keywords Vulnerable road users, Falls prevention, Elderly, Road safety, Evaluation, Quasi-experimental, time, mortality, surface, walking, devices, Engineering, Public, Environmental & Occupational Health
Subject categories Health Sciences


We study the effects of a studded footwear subsidy program in Gothenburg, Sweden, where a free pair of anti-slip devices was distributed to all residents aged over 65 years as a pedestrian falls prevention measure. Using a difference-in-differences approach with internal age-based controls, we find evidence of a short-term effect on emergency department visits due to slips on snow and ice during the first year of the intervention ( -45% [95% CI: - 54, - 9] in 2013), which equates to 21.8 injuries prevented (95% CI: 3.34, 39.4). A cost-benefit analysis based on this result suggests that the short-term benefits outweigh the total costs of the intervention (benefit-cost ratio: 6.9 [95% CI: 1.05-12.46]), indicating that this type of subsidy program may be an important tool for the prevention of pedestrian falls among older adults during icy weather conditions. However, replication at other sites is recommended before drawing any strong and general conclusions.

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