The neglect of pedestrian and bicycling safety in the United States has made these modes dangerous ways of getting around. Pedestrian fatalities are 36 times higher than auto occupant fatalities per km traveled, and bicycling fatalities are 11 times higher than auto occupant fatalities per km. Walking and bicycling can be made quite safe, however, as clearly shown by the much lower fatality rates in The Netherlands and Germany. Pedestrian fatalities per billion km walked are less than a tenth as high as in the United States, and bicyclist fatalities per billion km cycled are only a fourth as high. Moreover, the safety gap has been widening. Over the past two decades, pedestrian deaths fell by 72% in The Netherlands and by 79% in Germany, but by only 31% in the United States. Bicyclist fatalities fell by 57% in The Netherlands and by 66% in Germany, but by only 24% in the United States.

What has the United States been doing wrong, and what have The Netherlands and Germany been doing right? All levels of government in the United States have focused their subsidies, regulations, technological developments, and planning efforts on the safety of auto occupants. Perhaps because walking and bicycling account for such a small percentage of trips in the United States, they have been treated as insignificant modes, and their safety has been woefully neglected, thus further discouraging their use. Federal and state departments of transportation have made a few half-hearted attempts to improve pedestrian and cyclist safety, but all measures stop far short of anything that would cost much money or inconvenience motorists in any way. Those restrictions virtually guarantee little if any progress.

In sharp contrast, The Netherlands and Germany have long recognized the importance of pedestrian and bicyclist safety and have undertaken a wide range of measures in a serious attempt to help pedestrians and bicyclists. These measures can be grouped into six categories:
  More and better facilities for walking and bicycling
  Urban design oriented toward people and not cars
  Traffic calming of residential neighborhoods