Anyone who lives in Baltimore knows this is a city of jaywalkers.
It's a violation committed by people of all races, ethnicities and classes in all parts of the city.
But if you happen to get hit by a car why you're jaywalking, new research by Johns Hopkins suggests your risk of death is significantly higher if you are a minority and don't have insurance.
This is true even if the injuries sustained are similar to a white pedestrian who is hit.
The study, to be published in the August issue of the journal Surgery, also found that minority pedestrians are far more likely than white pedestrians to be struck by motor vehicles, making the issue even more troubling.
"It's a double whammy," Adil H. Haider, an assistant professor of surgery at the Johns Hopkins University School of Medicine and the study's senior author, said in a statement. "Minorities are much more likely to get injured by this mechanism and much more likely to die by this mechanism."
Haider and colleague Rubie Sue Maybury reviewed National Trauma Data Bank information on 26,404 patients hit by vehicles between 2002 and 2006.
African-American patients had a 22 percent greater risk of death and Hispanic patients a 33 percent greater risk of death than white patients involved in similar crashes. Uninsured patients had a 77 percent greater risk of death than those who were insured.
The researchers aren't sure what is leading to the disparities. Previous studies have shown that insurance status and race may increase mortality risk because of treatment delay or differences in services provided.
Minorities also have higher rates of diseases such as obesity, diabetes or hypertension, which could raise their risk of death if involved in a crash.
Since the underlying causes of the disparities can't be easily answered, Haider believes policy makers need to focus in the short term on better pedestrian injury-prevention programs.
This is particularly important in the inner city, where many of these deadly crashes occur, he said. He points to successes in getting people to use seat belts and in getting parents to put their children in safety seats - two innovations that have saved many lives.