Photograph courtesy Ray Sherman

To the Editor: I read with interest the entry in "In other Journals" entitled "Beware the zebra".1 It described a study in the United States (reported in JAMA)2 which found that elderly people were more likely to be struck by a motor vehicle when crossing at a marked crossing than at an unmarked site! Personal observation after a year of living and working in the States has led me to be no longer surprised by such a report.

There is what I believe to be a culturally different attitude to road safety here. There seems to be a general belief by pedestrians that cars will stop if they walk out on to the road — often without looking. This is more so at marked crossings, where I can attest to the findings of the article that "nearly 40% of pedestrians incorrectly believed that traffic must stop for a pedestrian who is on the curb waiting to cross at a marked crosswalk."

I believe that this perception may have been ingrained from an early age — US school buses have stop signs which appear when the bus stops, so that traffic behind the bus, alongside and in the opposing lanes has to stop while children are getting on or off the bus and then crossing the road. There is little attempt by the schoolchildren to "look both ways", as we were taught when growing up. This, I think, leads to a misperception that traffic will stop for all pedestrians, who may feel even more entitled at a marked crossing to cross without looking.

Since the report may have horrified some readers, I thought it might be worth providing a little local experience on the subject!