Traffic accidents claim a terrible toll. In 2010, 4,280 pedestrians were killed in traffic accidents in the United States. This month, the National Highway Traffic Safety Administration (NHTSA) released its latest traffic fatality figures, showing a nearly 5% increase in the number of pedestrian fatalities from traffic accidents in 2010 compared to 2009. In some states, the rate of pedestrian fatalities rose substantially. Now, state traffic safety boards are scrambling to try to address this problem.

Read: The Most Dangerous States for Pedestrians

The national death rate of pedestrians per 100,000 people was 1.38 in 2010, up from 1.33 the year before. In 10 states, the rate of pedestrian fatalities was at least 1.65 per 100,000 people, well above the national rate. Based on independent analysis of the NHTSA report, 24/7 Wall St. identified the states with the highest rates of pedestrian fatalities.

Between 2008 and 2010 the rate of pedestrian fatalities increased in six states by more than 50%, including in Oklahoma, one of the most dangerous states for pedestrians, where the rate more than doubled. In Delaware, which had 2.45 pedestrian fatalities per 100,000 people in 2010 — the second worst in the country — the rate increased 31.5% from the previous year. In other states, the pedestrian fatality situation improved dramatically. In Nebraska, the rate fell by more than 20% to just 0.44 deaths per 100,000 people, the lowest in the country.

To determine why pedestrian safety poses a far greater challenge in some states than others, 24/7 Wall St. spoke to several traffic and pedestrian safety experts, including Trenda McPherson, Florida’s Bicycle Pedestrian Safety Program Manager. According to McPherson, Florida, which had the highest fatality rate in the country in 2010, faced unique demographic factors that made controlling the issue particularly difficult. “We have a lot more tourists, we have a lot of elderly pedestrians, we have a large transit-attendant population, and we have a transient population,” McPherson explained.

24/7 Wall St. considered a number of demographic characteristics of the states with the highest rates of pedestrian fatalities. Besides Florida, many of the states with the highest rates of pedestrian fatalities have among the largest percentages of elderly residents. Many, including Hawaii, Arizona, Florida, Georgia and North Carolina, are also popular tourist destinations.

However, not everyone agrees on the cause. According to Norm Cressman, Georgia’s Safety Project Manager for the Department of Transportation, age-related issues are important to citizens, but do not appear to be driving pedestrian fatalities. Older residents are concerned that “The amount of time people have to cross isn’t as sufficient because they can’t move as fast,” Cressman explained. However, “Looking at the data, I don’t see pedestrians being killed in Georgia as being older. But that does come up in meetings that I attend that it is a concern.”

A factor that many experts do agree on involves the consequences of urban sprawl and inadequate public transportation. In Florida, for example, McPherson said, “we have large urban areas surrounded by huge rural areas that are very often difficult to network between with alternative transportation resources” In these cities, it is extremely difficult to bike or walk. Georgia’s Cressman explained that residential areas built alongside of multilane roads frequently have crosswalks that are a half mile or more away from public transportation stops, effectively encouraging residents to cross roads unprotected.

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24/7 Wall St. also reviewed Walk Score‘s rating of each state’s “walkability,” which primarily measures the distance between residential areas and urban centers. Seven of the 10 states with the worst walkability scores were among the 15 with the worst fatality rates, including Arizona, which has the worst average score in the country among its 46 cities. Among cities with populations of 100,000 or more, three of the four worst cities are in Florida, including Palm Bay, which has the worst score in the country.

These are the most dangerous states for pedestrians.

10. Oklahoma
> Pedestrian fatalities per 100,000 people: 1.65
> Total pedestrian fatalities: 62
> Total traffic fatalities: 668
> Pct. of people who walk to work: 1.83% (8th lowest)

In 2008, Oklahoma was only the 20th-worst state in the country for pedestrian traffic fatalities, with 1.40 pedestrian deaths for every 100,000 residents. By 2010, the state was among the nation’s worst for pedestrian traffic deaths. Traffic safety concerns in Oklahoma extend beyond pedestrians. There were 17.76 traffic fatalities per 100,000 residents in 2010, the sixth-highest rate nationally. The state received poor marks for walkability, with Walk Score giving the state’s 30 cities an average score of 35.78, one of the worst nationwide.

9. Mississippi
> Pedestrian fatalities per 100,000 people: 1.68
> Total pedestrian fatalities: 50
> Total traffic fatalities: 641
> Pct. of people who walk to work: 1.78% (6th lowest)

In 2009, Mississippi was the nation’s fourth-worst state for pedestrian traffic deaths. Though the state managed to improve its rank by 2010, the state’s traffic record remained abysmal. For 2010, the state had the second-highest rate of traffic fatalities nationwide with 21.58 deaths per 100,000 people, even though total traffic fatalities declined from 783 in 2008 to 641 in 2010. It is also hard for the state to be particularly pedestrian-friendly as 96.5% of people drive to work, the third-highest rate nationwide. Additionally, the state’s 24 cities had an average Walk Score of 32.61, ranked sixth worst nationwide.

8. Georgia
> Pedestrian fatalities per 100,000 people: 1.73
> Total pedestrian fatalities: 168
> Total traffic fatalities: 1,244
> Pct. of people who walk to work: 1.54% (3rd lowest)

When it comes to pedestrian safety, Georgia has been getting much worse. In 2008, there were 1.51 pedestrian deaths for 100,000 people in the state, which was the 18th-highest rate in the country. The state’s rank worsened by five spots in 2009, when 1.53 pedestrians died out of 100,000 people. In 2010, the state once again jumped five spots to be the eighth-worst state for pedestrian safety. Georgia’s Walk Score is 35.47, the ninth worst in the country. Only 1.54% of Georgians said they walked to work, the third lowest in the country.

7. Maryland
> Pedestrian fatalities per 100,000 people: 1.75
> Total pedestrian fatalities: 101
> Total traffic fatalities: 493
> Pct. of people who walk to work: 2.38% (21st lowest)

Maryland’s seventh-worst rate of pedestrian fatalities in 2010 is actually an improvement in the state’s safety record compared to previous years. In 2008, Maryland had the sixth-most pedestrian fatalities, while in 2009 it had the third most of any state. Maryland’s cities received an average Walk Score of just 42.29, only the 23rd-best score nationwide. The state could be safer for walkers: pedestrian deaths account for 20.5% of all traffic fatalities, the sixth-highest percentage in the United States.

Also Read: The Most Dangerous Cities in America

6. North Carolina
> Pedestrian fatalities per 100,000 people: 1.77
> Total pedestrian fatalities: 169
> Total traffic fatalities: 1,319
> Pct. of people who walk to work: 1.89% (11th lowest)

North Carolina ranked ninth for pedestrian safety in 2008, with 1.73 deaths per 100,000 people. The state managed to lower the pedestrian death rate to 1.56 per 100,000 in 2009, moving North Carolina off the 10 most dangerous states for pedestrians. However, the improvement did not last too long as the state’s rate of 1.77 pedestrian fatalities per 100,000 people in 2010 was the sixth highest in the United States. North Carolina’s Walk Score of 34.93 is the seventh worst of all states. Of the five largest cities in the state, the city with the highest Walk Score is Raleigh, whose score of 41.4 is still below the national average of 43.3.

5. Hawaii
> Pedestrian fatalities per 100,000 people: 1.91
> Total pedestrian fatalities: 26
> Total traffic fatalities: 113
> Pct. of people who walk to work: 4.75% (6th highest)

Unlike other states on this list, only 84.7% of Hawaiians drive to work, the fourth-lowest proportion nationwide. Instead, Hawaii has the sixth-highest percentages of people choosing to walk and choosing to use public transportation to get to work. Generally, fewer drivers mean safer roads, as evidenced by Hawaii’s 11th-lowest number of traffic fatalities per 100,000 people in 2010. The exception to this was pedestrians, who accounted for 23% of all traffic deaths that year, the third-highest percentage nationwide. One the worst states for pedestrian safety, Governor Neil Abercrombie has made August 2012 Hawaii’s “Pedestrian Safety Month.”

4. South Carolina
> Pedestrian fatalities per 100,000 people: 1.94
> Total pedestrian fatalities: 90
> Total traffic fatalities: 810
> Pct. of people who walk to work: 1.97% (12th lowest)

South Carolina was one of the five worst states for pedestrian safety each year from 2008 to 2010. The state is not very walking-friendly, as the average Walk Score for cities in South Carolina is just 35.28, the eighth-lowest score in the country. Counting pedestrian deaths, South Carolina had 17.47 total traffic fatalities per 100,000 people, the eighth-highest rate nationwide, and 810 traffic deaths in total. Pedestrian deaths accounted for 11.1% of this total in 2010, an increase from 10% of all traffic deaths in 2009.

3. Arizona
> Pedestrian fatalities per 100,000 people: 2.28
> Total pedestrian fatalities: 146
> Total traffic fatalities: 762
> Pct. of people who walk to work: 2.12% (14th lowest)

Pedestrian traffic fatalities are a growing problem in Arizona. Between 2008 and 2010, the rate of pedestrian deaths per 100,000 people rose from eighth highest to third highest among all states. Arizona is hardly pedestrian-friendly; the state’s cities received an average Walk Score of 28.57 out of 100, the worst score in the U.S. and the only state with an average score below 30. With a Walk Score of 6.2, Rio Rico was the least-walkable city in the U.S., tying with only Badger, Ark. The state has tried in the past to address pedestrian safety — in 2009 Arizona completed its Pedestrian Safety Action Plan report, designed to identify methods to curb pedestrian injuries and deaths.

2. Delaware
> Pedestrian fatalities per 100,000 people: 2.45
> Total pedestrian fatalities: 22
> Total traffic fatalities: 101
> Pct. of people who walk to work: 2.32% (19th lowest)

From 2008 to 2009, pedestrian fatalities per 100,000 people fell by nearly 30%, moving from second-most dangerous to ninth in one year. However, Delaware was once again the second-most dangerous state for walkers in 2010, with deaths per 100,000 increasing 45% from the year before. Off all traffic fatalities, 21.8% were pedestrians, the fifth-highest proportion in the country. Surprisingly, Delaware had pretty strong Walk Scores — the five cities in Delaware measured had a walk score of 47.22, beating the U.S. average of 43.3. Delaware’s largest city, Wilmington, has a score of 66.8.

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1. Florida
> Pedestrian fatalities per 100,000 people: 2.58
> Total pedestrian fatalities: 487
> Total traffic fatalities: 2,445
> Pct. of people who walk to work: 1.73% (4th lowest)

Florida’s 2.58 pedestrian deaths for every 100,000 people makes it the most dangerous state for pedestrians — a title it also held in 2008 and 2009. With 487 pedestrian traffic deaths in 2010, more than one-tenth of all such fatalities in the United States occurred in Florida. Nearly 20% of all traffic fatalities were pedestrian fatalities, the seventh-highest proportion of all states measured. The average Walk Score for 202 cities in Florida that were measured was 37.7, well below the national average of 43.3. Jacksonville, the state’s largest city, had a score of 32.6, but the score was 72.5 in Miami, the second largest city. The other three cities in the top five had scores above the national average as well: Tampa scored 51.1, St. Petersburg 44.5 and Orlando 47.1 Despite being the most dangerous state for pedestrians, Florida is one of only 15 states not to ban texting while driving.

Michael B. Sauter, Alexander E. M. Hess, and Samuel Weigley

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