On a Sunday afternoon in May 2021, Patsy Ellison left her Knoxville, Tenn., apartment in her motorized wheelchair and started to cross a nearby street, as she often did. She never made it.

Even though there was a stop sign, a Dodge Ram pickup truck turning into the intersection struck and killed Ellison, who was 62. The driver told police he didn’t see her in the roadway.

“We were just devastated. She was such a good person. It’s still hard,” her great-niece Destiny Dozard said in an interview with Stateline. “I have a 5-year-old, and he talks about it every day. He’s still traumatized.”

Dozard said her great-aunt, who used the wheelchair because of knee problems that made it hard for her to walk more than a few steps, had a beloved dog named Spartacus and was well known in the neighborhood, where she regularly visited a convenience store to buy Hot Cheetos and Slim Jims.

“She’s someone we could go to when we couldn’t go to anyone else to talk to,” Dozard recalled. “She helped her neighbors if they didn’t have any food and gave them money. She was a sweetheart. It’s crazy that something like this happened to her.”

The streets can be dangerous for people in wheelchairs. Some are forced to roll along the street because the sidewalk is broken, uneven or nonexistent. Some have to cross busy roads with multiple lanes. Motorists, particularly those in SUVs and large pickup trucks, may not see them because they sit low.

Disability rights and highway safety advocates say some of the funding from the new $1.2 trillion federal infrastructure law, which includes $11 billion for transportation safety programs, should be spent on curb ramps, more accessible sidewalks and roads engineered to slow down traffic and provide safe crossings for people with disabilities.

The law includes the “Safe Streets and Roads for All” initiative, which will provide $5 billion in grants to local governments over five years to support projects and strategies to reduce crashes and fatalities.

The law also boosted funding for the Federal Highway Administration’s state-administered highway safety improvement program. It added a provision aimed at improving safety for “vulnerable road users” such as older adults, people with disabilities and bicyclists. If those users comprise 15% or more of the total number of annual fatalities in a state, it will have to dedicate at least 15% of those funds the next year to improve those road users’ safety.

“The disability community has not always been at the forefront of thought when we’re doing our mobility planning,” said Jane Terry, a vice president at the National Safety Council, an Itasca, Ill.-based organization focused on eliminating preventable deaths. “We can and we must do better.”

Some state and local governments already are trying to figure out how to improve safety for people with disabilities, according to Carol Tyson, government affairs liaison for the Disability Rights Education and Defense Fund, a civil rights law and policy center based in Berkeley, Calif.

Tyson pointed to a 2019 Massachusetts Department of Transportation survey of state sidewalks and curb ramps that noted, for example, that 31% of the 7,600 bus stops in the Boston area lacked adjacent crosswalks.

In the Chicago area, the Metropolitan Planning Council and the University of Illinois Chicago issued a report last year that focused on whether 200 municipalities had inventoried physical barriers to access on streets and sidewalks and created plans to remove them, as required by the federal Americans with Disabilities Act. Only 22 were able to show they had a plan.

Dangerous Streets

A 2015 Georgetown University study found that pedestrian wheelchair users were more than a third more likely to be killed in crashes than non-wheelchair users. Nearly half the deaths occurred at intersections. And in more than three-quarters of fatalities, the driver used no “crash avoidance maneuver,” such as braking or steering.

Pedestrian fatalities overall have spiked during the COVID-19 pandemic, as speeding and aggressive, impaired and distracted driving have proliferated.

Last month, an analysis by the Governors Highway Safety Association, a nonprofit that represents state highway safety offices, found that an estimated 7,485 pedestrians in the United States were struck and killed by drivers in 2021, the largest number in four decades.

Data involving pedestrians in wheelchairs, however, is sparse. The federal government collects fatality data from law enforcement crash reports, but police don’t always identify whether a pedestrian was using a wheelchair, walker or crutches.

The National Highway Traffic Safety Administration conducted an analysis for Stateline and found that at least 301 people in wheelchairs and 225 who used a cane or crutches died in pedestrian crashes from 2010 through 2020.

Those fatalities continue to mount.

• In April, a 65-year-old man in a wheelchair attempting to cross a street in Salt Lake City was killed after being struck by a car.

• In January, a 58-year-old woman in a wheelchair and her dog were killed in a hit-and-run crash as she was trying to get across a street in Tucson, Ariz.

• In early April 2021, a 37-year-old mother of five in a wheelchair died while crossing a street in San Jose, Calif., after being struck by a hit-and-run driver. Just weeks later, a woman using a walker was hit and killed at the same intersection.

“Think about how many communities have a bus stop on one side of the street and a shopping center on the other side and five or six lanes of traffic and no light or crosswalk there,” said the National Safety Council’s Terry. “The crossing point might be blocks away. In a wheelchair, they’re going to cross where they get off the bus.”

A 2020 University of Illinois Chicago study found that people with disabilities encountered barriers including “broken or uneven sidewalks, intersections that have poor walking signals, crosswalks that are unsafe to cross, curb ramps that are too steep, and fast moving traffic being too close.”

Those findings are similar to what Disability Rights Washington, a statewide advocacy group based in Seattle, found when it surveyed 200 people with disabilities who do not drive in the state over the past two years.

“People feel scared to walk or roll around their communities because of inadequate infrastructure,” said Anna Zivarts, who directs the group’s mobility program.

Some intersections have no signal at all, Zivarts said. “You have to trust that the driver is going to stop and see you. It’s like a game of chicken.”

Another obstacle for wheelchair users: scooters and e-bikes left in the middle of sidewalks, which can make them not only dangerous but also impassible.

Tanisha Sepulveda, 31, a Seattle architectural drafter who has used a motorized wheelchair for more than a decade after a spinal cord injury left her with quadriplegia, wanted the public to know how bad sidewalk conditions were, so she participated in a video last year showing how she maneuvers city streets.

“Sometimes the sidewalks have ended, or the concrete has broken up, or there is no curb cut, and you’re forced to be on the road,” she told Stateline. “I’ve had people who’ve yelled and cussed at me for being in the street. They say, ‘Get back on the sidewalk.’ And I think, ‘Where do you see a curb cut, buddy?’ It’s ridiculous.”

Heidi Case, a Washington, D.C., resident who uses a wheelchair because she has multiple sclerosis, knows about those perils well.

One of the biggest problems in her city is that many sidewalks aren’t smooth, and streets often have potholes, making them difficult to cross, she said. Some curb cuts are so steep that she has fallen off her chair, face first into the street.

Case, 61, said she has been hit twice crossing the street: once by a city bus and another time by a car. The car crash threw her 10 feet out of her wheelchair, and she wound up in the hospital, and then a rehab facility.

With the influx of new federal infrastructure dollars, Case, who also chairs two city government transportation-related accessibility groups, predicted that bicycle and pedestrian advocacy groups are going to be pushing hard for money to be targeted to help their members.

“Everyone wants those dollars to be spent on them, and the disability community has to fight to get in there,” she said. “We have made good partnerships with them, but bike groups have lobbying and funds and are a huge powerhouse. We’ve got a lack of lobbying pull. Without our voices and getting a seat at the table, accessibility will get short shrift.”

Even if disability groups get what they’re asking for, the infrastructure money won’t be enough, said Zivarts, of Disability Rights Washington. She noted that her state did an analysis last year that found it needed more than $5 billion just to make state roads safer for pedestrians and cyclists. That’s the total amount of the Safe Streets program’s funding nationwide.

“The infrastructure funding is a drop in the bucket,” Zivarts said. “It’s not nearly enough to address how dangerous and disconnected our pedestrian networks are. We’re going to need a whole lot more.”

Stateline is a nonpartisan, nonprofit news service of the Pew Charitable Trusts that provides daily reporting and analysis on trends in state policy.