A lot has changed for Mary Forrest since her husband and daughter dropped her off at a street corner near Lawrence West subway station almost seven years ago.

She remembers walking on the sidewalk and seeing a car coming towards her “a little too fast.” The next thing she can recall is waking up in a hospital bed, she thinks, a few days later.

Forrest, says she then found out that she’d been hit by that car and was told her skull had cracked and blood had gushed out of her ear.

The better part of a decade later, the 50-year-old North York resident still has trouble hearing. She says she’s lost her sense of taste and smell, suffers vertigo, panic attacks and has trouble remembering things.

Forrest’s lingering injuries are symptoms of what some health workers, researchers and Toronto city staff are now recognizing as a public health problem: road safety.

In a city where police say more than 1500 pedestrian and almost 950 cyclist collisions had been reported in 2016 up to the end of October, Forrest is not alone.

“We are exposed to this day in and day out,” said Joanne Banfield, manager of trauma injury prevention at Toronto’s Sunnybrook Hospital. “It becomes very frustrating for us day after day having to treat people who are here because of a preventable injury.”

In November, Sunnybrook’s trauma centre saw a 20.7 per cent hike in pedestrian injuries in 2016, compared to the same time last year.

“There are no additions to the healthcare teams, but we still have to manage this,” Banfield said. “We can’t maintain the status quo right now. I mean if we continue with these high numbers of injured people, the health care system can’t accommodate it.” She thinks collaboration and prevention are key to addressing traffic safety in Toronto.

For Amanda McFarlan, a Toronto cyclist and pedestrian who manages the trauma program registry at Saint Michael’s Hospital, road safety is something she thinks about both during her commute and at her job.

“We consider trauma as a preventable disease, generally speaking in all its forms, so we very seldom use the word accident,” said McFarlan.

“These are all preventable injuries, and there are predictable factors that are associated with many of these injuries — speed, attention, alcohol are all things you can fix.”

McFarlan thinks traffic safety can be improved through safer infrastructure, better lighting on roads, lower speed limits and enforcement of traffic rules.

Ward Vanlaar, chief operating officer of the Traffic Injury Research Foundation in Ottawa, said until the last decade or so, road safety was thought of as a transportation issue.

“The take on it was that we have a price to pay for mobility, and the price is that certain people will die and that was considered to be acceptable,” he said.

Vanlaar said that in recent years he’s seen a shift in thinking about traffic safety, both globally and across Canada. “People working in this field, and also in other health-related fields have had this epiphany almost, like ‘Hey, there are really a lot of people dying,’” he said.

When people started seeing road safety as a health issue, he said, the approach to address it also changed. Many cities around the world are now designing themselves with safety prioritized over mobility.

“Essentially you’re acknowledging that human beings are prone to making mistakes, and if you accept that then you accept that we have to design a transportation system that will mitigate those risks and will basically eliminate those instances where, because of human error, people will die.”

The approach he is describing, Vision Zero, originated in Sweden and has since been adopted in many cities around the world. Toronto’s 2017-2021 road safety plan says it will adopt this approach too.

The World Health Organization calls traffic-related deaths and injuries “a major health and development concern” and estimates that about 1.25 million people die on roads around the world every year.

Cutting the number of global deaths from road traffic collisions in half by 2020 is a United Nations’ goal, included in its 2030 Agenda for Sustainable Development. The U.N. says almost half of those who die on the world’s roads are not people in cars.

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“People are risking their lives every time they leave their homes,” said UN Environment’s Erik Solheim in statement released this past October.

“But it isn’t just about accidents. Designing transport systems around cars puts more vehicles on the road, increasing both greenhouse gas emissions and deadly air pollution. We must put people, not cars, first in transport systems.”

Closer to home, Monica Campbell, a spokesperson for Toronto Public Health, said traffic safety falls within the realm of her department.

“If you invest in safer roads, safer streets, better infrastructure for cyclists and pedestrians – does that reduce the burden on the healthcare system? Absolutely it does,” she said.

Toronto’s new road safety plan notes that active modes of transportation – such as biking and walking – have health advantages, but also that those modes put the people who use them at a higher risk of serious injuries from collisions than those who commute in cars or on public transit.

“We’ve been concerned about this for a while, as we do more research we understand the need and the benefit of better road design” said Campbell.

She said public health’s contribution to the city’s new road safety plan will come by way of research and an education push: an effort to make sure health is considered within the city’s future infrastructure.

While Toronto’s new road safety plan is set to get fully underway in the New Year, the city has already seen more than 40 pedestrians killed on its roads this year, making 2016 the deadliest in at least a decade for the city’s walking commuters.

Every time she hears of a pedestrian or cyclist who has been struck, it makes Forrest cringe. She knows too well that the repercussions of a split-second hit can last much longer than the coverage they’re given on the daily news.

“Anything you can think of has forever changed for me,” she said. “But you can’t see it because I look fine.”

While there are no longer the reminders posted around Forrest’s house prompting her to turn off the oven or unplug the iron — like the ones she used to need right after the accident — her life hasn’t been the same since Jan. 22, 2010.

Over the years, her family has helped her fill in many of the gaps in her memory the collision seemed to wipe out. Forrest is now on long-term disability, after she made an attempt to go back to work.

“I want to be who I was,” she said. “… and I can’t get any of that back.”