The Governors Highway Safety Association has issued a report aimed at reducing pedestrian fatalities, saying these deaths have increased in recent years due to factors ranging from speed to distraction.

In a report entitled "Everyone Walks: Understanding and Addressing Pedestrian Safety," the GHSA says pedestrian fatalities have increased by 15 percent since 2009. In 2013, the most recent year where data is available, 4,735 pedestrians were killed in motor vehicle accidents.

The report offers 21 suggestions for reducing the frequency of pedestrian deaths or injuries. These strategies include education on issues such as safely passing a disabled vehicle or stopped emergency responder, expanding efforts against distracted driving to include distracted walking, better speed enforcement, and allowing communities to lower speed limits in areas where pedestrians are more common.

"States are developing and implementing programs to ensure the safety of all roadway users," said Jonathan Adkins, executive director of GHSA. "But clearly more can be done to make travel on foot as safe as possible. Taking a comprehensive approach that includes education, engineering, and enforcement is the best way to maximize limited resources and get results."

Several factors can increase the likelihood of a pedestrian becoming involved in a motor vehicle collision. Vehicle breakdowns often lead to motorists becoming "unintended pedestrians" after they pull over to the side of the road. Emergency responders, highway workers, and tow truck drivers are also vulnerable to collisions when they are outside their vehicle.

The GHSA says 515 pedestrians were killed on average each year between 1993 and 2012 when they were struck by a vehicle on a highway. These deaths accounted for 10 percent of all pedestrian deaths and 11.6 percent of all interstate highway traffic fatalities.

The report says drivers who experience a vehicle breakdown can stay safe by pulling over as far as possible, turning on their emergency flashers, and remaining in the vehicle until help arrives. The report says drivers should also be more aware of the need to change lanes for a disabled vehicle or stopped emergency responder, or to slow down if a lane change is not possible.

"It's incumbent upon states and their partners to educate motorists about how to stay safe in the event of a vehicle breakdown or roadside stop to minimize risk," said Adkins. "That, coupled with a strong Move Over Law that explains what to do if they encounter a first responder on the side of the road, are critical."

The GHSA says distraction has become a significantly more dangerous factor among both drivers and pedestrians. According to the National Highway Traffic Safety Administration, 12 percent of the people killed in 2,910 distracted driving crashes in 2013 were pedestrians. Meanwhile, the share of pedestrians killed while using a cell phone increased from less than 1 percent in 2004 to 3.6 percent in 2010. The report also says it has been estimated that as many as 2 million pedestrians were injured while using a cell phone in 2010.

A previous study by the Georgia Department of Transportation, cited in the GHSA report, says that half of the pedestrians observed at 20 high risk locations were engaged in some distracting behavior. These actions included talking to a companion, wearing headphones, texting, or talking on a cell phone. A similar study by the University of Washington found that one-third of pedestrians were distracted while crossing the street.

In both studies, distracted pedestrians were more likely to take longer to cross a street and engage in unsafe behaviors such as not looking both ways before crossing. However, pedestrians who were not distracted were less likely to use a crosswalk or obey a traffic signal, possibly due to a perception that they had a lower risk due to their attention.

The report says teenagers are especially likely to be distracted pedestrians. Observations by Safe Kids Worldwide determined that one out of five high school students and one out of eight middle school students crossed a street while distracted, usually by texting, wearing headphones, or talking on a cell phone. A survey by this organization found that 40 percent of teenage respondents said they have been hit by a car, bicycle, or motorcycle while walking or had a close call with a motor vehicle.

Alcohol has also played a significant role in accidents involving a pedestrian and vehicle, according to the report. Thirty-six percent of pedestrians over the age of 16 who were involved in a fatal crash had a blood-alcohol level above the legal driving limit of .08 in 2013, along with 15 percent of drivers.

"It's time to expand the focus on the dangers of impairment and distraction to include walking," said Adkins. "States and their law enforcement partners are encouraged to conduct high visibility enforcement in areas where there's the potential to reach intoxicated pedestrians such as entertainment districts, sports venues and colleges and universities. Messaging about both unsafe behaviors should target pedestrians as well as motorists."

Speed is another significant factor contributing to collisions between vehicles and pedestrians. The report states that while the risk of serious injury to a pedestrian is only 10 percent when a vehicle is traveling at 17 miles per hour, it increases to 50 percent at 33 miles per hour and 90 percent at 48 miles per hour.

However, pedestrian fatalities are also more likely to occur in urban areas with lower speed limits. In 2013, nearly one in five fatalities occurred on roads with speed limits under 35 miles per hour, while 28 percent occurred on roads with speed limits between 35 and 40 miles per hour.

"A key finding in the report is that communities should be allowed to reduce speed limits to establish slow speed zones in areas with a history of pedestrian-motor vehicle crashes as well as in neighborhoods with schools, parks, day care, and senior centers," said Pam Fischer, a traffic safety expert who authored the GHSA report.

The GHSA says male pedestrians are more likely to be killed in motor vehicle accidents, accounting for 70 percent of these fatalities. Men also accounted for 80 percent of pedestrian fatalities that occurred on interstates.

Deaths among pedestrians between the ages of 20 and 69 have increased by 28 percent since 1975, while those for pedestrians ages 70 and older have dropped from 9.3 percent to 2.2 percent in the same period. Pedestrian deaths involving children under the age of 12 have dropped from 21 percent in 1975 to 4 percent. The average age of a pedestrian injured in an accident increased from 31 in 2004 to 36 in 2013.

Pedestrians are most likely to be killed in accidents that occur in the evening or late at night, with these time periods accounting for 72 percent of all fatal accidents in 2013. Seventy-three percent of these fatalities occurred in urban areas, and 69 percent occurred at non-intersection locations. Pedestrian fatalities were more likely in the second half of the year, especially late autumn and winter.

Ninety-two percent of pedestrian deaths involve a collision with a single vehicle. One out of every five pedestrian fatalities in 2013 involved a hit-and-run driver.

A Connecticut safety program was one of 13 state initiatives highlighted in the GHSA report. A "Street Smarts" program established in New Haven is an integrated education effort encouraging pedestrians, bicyclists, and drivers to be attentive at all times. The report also notes that the city has taken steps such as targeted enforcement at areas with high crash rates, new crosswalk signals, and traffic calming measures such as speed bumps and roundabouts.