Equity Approaches for Vision Zero: San Francisco

Challenge

Every year in San Francisco, approximately 30 people lose their lives and more than 500 are severely1

injured while traveling on city streets. Seventy-five percent (75%) of these severe and fatal traffic crashes occur 

on only 13 percent of San Francisco streets, which comprise the City’s High-Injury Network.

2 According to San 

Francisco’s Vision Zero 2021 End of Year Report:

3

 

• Fifty-nine percent (59%) of all fatal and severe injury crashes occur in Equity Priority Neighborhoods,

4

which San Francisco defines as areas with high concentrations of households with low incomes, 

people of color, seniors, and other vulnerable populations. Equity Priority Neighborhoods are almost 

twice as likely to be on the High-Injury Network, even though they contain only a third of city 

streets.

• 59 percent of traffic fatalities occurred on the Vision Zero High-Injury Network.

• 15 percent of all traffic fatalities occurred among people experiencing homelessness5 even 

though people experiencing homelessness only make up 1 percent of the city population.

6

 

• 22 percent of traffic fatalities were Black individuals, even though Black people only make up 

5 percent of the population.

San Francisco is committed to prioritizing roadway safety and reaching zero deaths by adopting the Safe 

System Approach’s principle that fatalities and severe injuries on city streets are unacceptable and 

preventable as detailed in their 2021 Vision Zero San Francisco Action Strategy:

7

1 Severe is the preferred term used by San Francisco. “Serious” is the term utilized by the U.S. Department of 

Transportation

2 Link to High-Injury Network: 

https://sfgov.maps.arcgis.com/apps/webappviewer/index.html?id=fa37f1274b4446f1bdddd7bdf9e708ff

3 Link to San Francisco Vision Zero 2021 End of Year Report: https://www.sfcta.org/sites/default/files/2022-

06/SFCTA_Board_VisionZeroTrafficFatalities2021EndofYearREPORT_2022-06-07.pdf 4 Equity Priority Neighborhood is the preferred term used by San Francisco. “Underserved communities” is the 

term most often utilized by U.S. Department of Transportation. 

5 San Francisco defines homelessness as persons with no fixed address.

6 Link to San Francisco City Performance Scorecard on Homeless population: https://sfgov.org/scorecards/safetynet/homeless-population 7 Link to 2021 Vision Zero SF Action Strategy: https://www.visionzerosf.org/wpcontent/uploads/2021/11/VZSF_AS_111021_spreads-FINAL.pdf 

High Injury Network

Based on both hospital and police data, 13 percent of San Francisco streets 

account for 75 percent of the City’s severe and fatal traffic crashes. Half of 

this High-Injury Network is located in Equity Priority Neighborhoods.
Vision Zero

To meet their ambitious goal of zero deaths by 2024, the City adopted a Vision Zero policy in 2014 that 

reflectsthe City’s commitment to prioritize street safety and eliminate traffic deaths, particularly for the 

most vulnerable populations.

8

A Vision Zero Task Force was established to provide input to key decision-making. This Task Force is cochaired by the San Francisco Municipal Transportation Agency (SFMTA) and the San Francisco 

Department of Public Health (SFDPH).

9 The inclusion of SFDPH is notable because it reflects the City’s 

view that traffic injuries and fatalities are a public health crisis. In addition to city and county agencies, 

the Task Force includes 40 community members who represent communities across the City to address 

roadway safety. The Task Force meets quarterly to advance projects, programs, and policy changes for 

Vision Zero, and they report on the progress of this citywide initiative. 

In addition, a community-led Vision Zero Coalition comprised of more than 30 organizations and led by

WalkSF,

10 regularly engages with both the Task Force and city agencies to advance Vision Zero and hold

the city accountable to its commitments for safe streets. 

8 Link to the current San Francisco Vision Zero Action Plan: https://www.visionzerosf.org/wpcontent/uploads/2021/11/VZSF_AS_111021_spreads-FINAL.pdf 9 Link to Vision Zero Task Force: https://www.visionzerosf.org/whos-involved/vision-zero-sf-taskforce/ 10 Link to Walk San Francisco: https://walksf.org/ 
Equity in Vision Zero

San Francisco recognizes that vulnerable communities are disproportionately impacted by traffic 

fatalities and severe injuries, and it prioritizes and monitors safety improvements throughout its Vision 

Zero Action Strategy and programs. Currently, the City is engaged in the following activities: 

• Maps Equity Priority Neighborhoods,11 which include locations with a concentration of 

individuals who are experiencing homelessness, individuals with low-income, people of color, 

seniors, people with disabilities, and communities with limited English proficiency. 

• Creates and maintains TransBASE,12 an online public database and analyticaltool that makes data 

available to communities, so people are able to understand health impacts of transportation systems, 

including safety, access, physical activity, air and noise quality, and health disparities. 

• Engages with community leaders and local stakeholders to ensure that strategic actions reduce 

injury inequities and do not exacerbate existing inequities. For example: 

o The City identifies and builds relationships with community organizations and members 

of the public and encourages them to become traffic safety champions. One of the ways 

this is accomplished is through the “Left Turn Calming Project” where drivers are guided 

through a behavior change educational campaign to grow their understanding and 

knowledge about the dangers posed by left-hand turns, and once this knowledge and 

understanding is achieved, become champions for safety within their communities on 

making safe left-hand turns. 

o The City further invests in community engagement and education to promote a culture 

prioritizing traffic safety, including multilingual marketing campaigns and direct 

outreach in the most widely spoken non-English languages. 

o The City manages several key programs, such as the Safe Streets for Older Adults and 

People with Disabilities Program and SFDPH grants,

13 which help analyze neighborhood 

safety conditions; provide educational outreach and community engagement, including 

assistance with translation and culturally appropriate communications; and engage with 

city decision-makers about proven streetscape solutions for safer streets. 

11 Link to SFCTSA map of Equity Priority Neighborhood: https://www.sfcta.org/policies/equity-prioritycommunities 12 Link to TransBASE: https://transbase.sfgov.org/transbase/ 13 Link to Walk San Francisco page on Safe Routes for Seniors and People with Disabilities: https://walksf.org/ourwork/safe-routes-for-all/safe-streets-for-seniors-and-people-with-disabilities/ 

Equity is a Core Principle of Vision Zero

San Francisco operates under the principle that a transportation system 

should be safe for all road users, for all modes of transportation, in all 

communities and for people of all incomes, races and ethnicities, 

languages, ages, abilities, and housing status. 
• Develops and institutionalizes an injury surveillance system to ensure that injury crash data is 

accurate, publicly available, and includes analysis of vulnerable populations (see below). 

• Implements data-driven, culturally competent, multilingual education, engagement, and 

enforcement campaigns targeted in impacted areas. 

• Ensures Vision Zero strategic actions identify and address potential unintended consequences 

on vulnerable populations, including the impact of fines and fees on low-income residents.

• Prioritizes and monitors improvements on the High-Injury Network, in Communities of Concern, 

and where there are concentrations of fatal and serious injury crashes to seniors and people 

with disabilities and other vulnerable populations to address historic differences in resource 

allocation.

Collaboration with Public Health

Interagency coordination is a key component of San Francisco’s Vision Zero effort. The collaboration 

with SFDPH has been instrumental in elevating equity discussions, particularly around data collection 

and analysis to establish consistent crash fatality reporting and develop an accurate, publicly available 

injury surveillance system that includes an analysis of vulnerable populations. 

Consistent Crash Fatality Reporting

To ensure consistency in the measurement and reporting of traffic fatalities across city agencies, San

Francisco leverages a traffic fatality protocol14 to create a standardized case definition of a Vision Zero 

traffic fatality. 

Each month, the Office of the Medical Examiner (OME) sends a Motor Vehicle Monthly Death Report to 

a group of stakeholders, including SFDPH epidemiologists, law enforcement, and transportation officials. 

Together, they determine if the fatality meets their shared definition of a traffic fatality: 

• Person(s) killed in or outside of a vehicle (bus, truck, car, motorcycle, moped, bicycle, standup 

powered device, light rail vehicle, etc.) involved in a crash or impact with a vehicle or road 

structure.

• Occurs within the public right of way in the City or County of San Francisco.

• Death takes place within 30 days of the public roadway incident as a result of the injury.

14 Link to traffic fatality protocol: 

https://www.sfdph.org/dph/files/EHSdocs/PHES/VisionZero/Vision_Zero_Traffic_Fatality_Protocol.pdf 

Traffic Fatality Protocol 

The process of creating a standardized case definition of a traffic fatality 

ensures consistency and improves fatal crash data collection, analysis, and 

evaluation across city agencies, including transportation, law enforcement, 

and public health. 
The cases are then classified on the resulting incident report as: pedestrian, driver, passenger inside a 

motor or transit vehicle, passenger outside a motor or transit vehicle, motorcyclist, cyclist, moped rider, 

or standup powered device rider. Each of these classifications has a clear definition. 

Additionally, the traffic fatality protocol outlines which fatalities are excluded from the analysis and 

provides an explanation as to why those numbers are not included in the count. Once confirmed, the 

SFDPH publishes a final monthly fatality report15 and an end of year report.

16 

A key benefit of this collaborative analytical approach is the integration of the OME and San Francisco 

Police Department (SFPD) data. Table 1 outlines the types of data collected from each report. This 

integration provides a more complete and clear picture of the crash―specifically, who is killed in the 

crash, if they are a vulnerable road user, where the crash took place, and the roadway conditions of the 

crash. 

Table 1. Types of data collected from OME and SFPD reports. 

 

Closing Data Gaps

In San Francisco, the county owns and operates the only Level I Trauma Center in the city―the 

Zuckerberg San Francisco General Hospital (ZSFGH)―which allows access to a single source of medical 

data relating to severe and fatal crashes. The SFDPH Center for Data Science conducts additional 

analysis, including comparing police crash reports with the ZSFGH medical data for traffic crashes. 

15 Link to traffic fatality scorecard: https://sfgov.org/scorecards/transportation/traffic-fatalities 16 Link to 2021 San Francisco End of Year Report: https://www.sfcta.org/sites/default/files/2022-

06/SFCTA_Board_VisionZeroTrafficFatalities2021EndofYearREPORT_2022-06-07.pdf

Office of the Medical Examiner Data: San Francisco Police Department Data:

• Name

• Age

• Gender

• Race (verified through family, medical 

records, driver’s license, etc. when 

possible)

• Address type (e.g., no fixed address)

• Location of the incident

• Circumstances of fatality

• Date and time of death

• Investigating agency

• Person data (e.g., name, date of birth, 

sex, injury status, driver’s license 

information, speeding or other traffic 

violations, restraint/helmet use, etc.)

• Crash data (e.g., location, date, time, 

severity, light, weather, etc.)

• Vehicle data (e.g., body type, make, 

model, year, license plate number, etc.)

• Roadway data (e.g., lighting)

• Circumstances of the crash if applicable 

(e.g., if there was a fatality, size of 

vehicle, hazardous materials, nonmotorist involvement, etc.) 
Examining both sets of data side by side provides a better understanding of injury trends. This analysis17

supports San Francisco’s collective effort to provide a more complete and more equitable summary of 

severe crashes and to better inform decision making on prioritizing investment. Preliminary results from 

this analysis reveal that severe injuries are underreported in police crash data due to a number of 

factors, including the following:

• Police are not trained to assess medical conditions, so severe injuries were higher in hospital 

data than those reflected in the police database.

• Certain types of crashes (e.g., those involving bicyclists) are less likely to be reported to the 

police. 

• Crashes in areas with a greater density of people of color are less likely to be reported to the 

police.

Summary 

To promote equity in the Vision Zero program, San Francisco has created a strong partnership between 

traditional transportation stakeholders, public health experts, and the community. The city is using 

public health methods to ensure accurate and transparent collection and analysis of roadway crash 

fatalities and injuries to create more complete data. This comprehensive, data-driven analysis allows the 

City to prioritize safety improvements on roadways on the High-Injury Network located in Equity Priority 

Neighborhoods, where these investments will make the most progress toward reaching the City’s goal 

of zero deaths. 

For more information, contact: VisionZeroSF@sfmta.com 

17 Publication of results is currently pending.

Lessons Learned

• Collaborate with the public health community to create more 

complete, accurate, and transparent fatal and severe injury 

data, particularly for vulnerable populations.

• Identify Equity Priority Neighborhoods and overlay that 

information with the High-Injury Network.

• Engage meaningfully with vulnerable populations and build 

relationships to support development of traffic safety 

champions in these communities.

• Prioritize safety investments and improvements on roadways 

on the High-Injury Network located in Equity Priority 

Neighborhoods.