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Pedestrians negotiate their way through stopped traffic on Spadina Avenue in central Toronto on Thursday. According to a count by The Globe and Mail, 46 pedestrians have been killed in Toronto in 2016, the most in any year since at least 2003.

J.P. MOCZULSKI/The Globe and Mail

On a clear Sunday this fall, Lydia Lebed was waiting her turn at a Kingsway intersection when the pickup truck in front of her vehicle hit a pedestrian.

The scene remains etched in her mind: the white hair of the 95-year-old victim; the tangerines the woman dropped when she was hit; a pair of broken glasses on the road.

Ms. Lebed knew by the time she got to the woman that there was nothing she could do. The woman's injuries were too severe. So she put her coat over the victim and tried to reassure her in the moment of her death.

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"I just kind of stroked her back and talked to her and told her, 'Hang on, we called an ambulance,'" remembers Ms. Lebed, a former registered nurse.

"There's nothing you can do except comfort."

The moment horrified her and left her "even more paranoid" about traffic. It also prompted her to write an anguished letter to Mayor John Tory, calling for more action on road safety.

This year, which turned into the deadliest for walking in Toronto in more than a decade, left a lot of people believing more had to be done to keep people safe.

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In June, when the initial version of a road-safety plan was released, it was panned so resolutely for its modest ambitions that politicians moved quickly to add funding. Around the same time, the mayor issued an official statement of condolence for Algie Parucha, who was killed on a sidewalk in June by a driver in an SUV – the first time Mr. Tory has done so for a slain pedestrian.

In October, friends and families of road victims, who had banded together to support each other, went public with a push for solutions. And early this month, after a day in which 24 people were hit while walking, Mr. Tory held an emergency meeting with police, civil-service staff and other politicians, acknowledging that the city needed to do more.

By the end of the year, the rising tide of casualties was accompanied by a cautious optimism among those fighting for a safer city. Advocates point to positive developments at city hall and new legislation on the provincial level. But they are even more buoyed by the way residents and politicians are treating the issue.

"I'm very encouraged by the attention pedestrian safety is having now among the public and elected officials," said David Stark, whose wife was run down and killed in 2013 while standing on an east-end sidewalk. "I think people realize we do not have to have fatalities on our roads."

According to a count by The Globe and Mail, 46 pedestrians have been killed in Toronto this year. The police use a narrower definition that wouldn't include, for example, a person killed in a private parking lot and put the death toll at 43. Either total makes 2016 the worst year for pedestrians since at least 2003.

This comes after bad years in 2013 and 2015, in which the city registered 40 and 39 pedestrian deaths, respectively. Toronto's average so far this century is 31.

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Although the number of deaths invariably fluctuates from year to year, Barbara Gray, Toronto's new head of Transportation Services, said, "I don't think you wait and see" if the recent rise is a statistical blip or a new normal.

Ms. Gray, who started her job this month, is promising to move aggressively to speed up the road-safety plan introduced this summer. But she warned that the progress won't be linear.

"It's a process, not an event. You know, in Seattle [where she worked before coming to Toronto] we've had a full-court press on pedestrian safety … and the numbers bounce around," she said. "They're not always on the downward trajectory … but I still think you need to track and manage the numbers and you always want to see them heading down."

Complicating the problem is that it's not clear what is causing the recent increase of pedestrian deaths in Toronto.

The city is growing, but much of the additional population is being added downtown, where walking is most common but also safest. Pedestrians being distracted by their phones appears unlikely to be behind the rise. Research in the United States found that pedestrians' use of an electronic device was a factor in only 0.1 per cent of people killed while walking over five years.

The increase in larger vehicles such as SUVs, which sit higher and are more likely to kill when someone is struck, may be partly to blame. And an aging population is more fragile and tends to suffer greater damage if hit. In Toronto this year, 67 per cent of the pedestrians who were killed were over 65.

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Another possible factor is drivers' use of electronic devices. This has proliferated in recent years – despite higher fines – and some police have taken to calling distracted driving "the new drunk driving." The safety organization Parachute Canada warns that drivers using a mobile phone are up to four times more likely to crash. And the CAA warns that checking a phone even while stopped at a red light, which is illegal, can distract a driver's mind until up to 27 seconds later.

Some jurisdictions have acted to clamp down on distracted driving, including a move in Oregon to raise the penalties to match those for drunk driving. Ontario's Transportation Minister Steven Del Duca said that distracted driving "continues to be a very serious challenge," according to a statement this week from his staff.

"It's obvious that drivers aren't sufficiently aware of, or afraid of, the consequences of being distracted while behind the wheel. So I am open to all ideas, including toughening penalties and working with safety partners, car manufacturers and smart-phone companies to eliminate distracted driving."

As the deaths in Toronto mounted in recent years, the city also realized it had to tackle the issue more aggressively. City staff put together a road-safety plan they called Toronto's version of the Swedish approach known as Vision Zero, which aims to eliminate all road deaths, including pedestrians and cyclists. But the plan came under withering criticism for targeting a 20-per-cent cut in road fatalities and serious injuries over 10 years. Politicians responded by adding some money and setting the goal at zero fatalities within five years.

Even now, advocates say the plan is insufficiently funded to reach its goal. Maureen Coyle, who sits on the steering committee of Walk Toronto, argued that the plan adopts the name Vision Zero, without really emulating the Swedish approach.

But Ms. Coyle also said that there are "lots of reasons" to be optimistic now about road safety. She pointed to greater attention among politicians, high quality work being done by city staff and an increasingly informed public discourse. She worries, though, that difficult decisions will spook elected officials.

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"The bottleneck is in the political system," she said. "The bottleneck is [that] politicians are afraid to make changes that will make them unpopular."

The biggest clue that this might be changing is the hiring of Ms. Gray to head the city's transportation department. She has made publicly clear that she views safety as an over-arching goal.

Ms. Gray said that the measures in Toronto's road-safety plan are the sort of tactics other cities are using. She added that it's too early for her to know if they're being applied aggressively enough here. The plan "has to be a living document," she said, and adapted as needed.

"If people feel safe and comfortable walking, they're going to make that choice more frequently," she said. "And if they are required to walk then we, I think, have a responsibility to try to make those routes safe. Especially to those places they're going to walk most frequently: to transit, to the grocery store, to medical services, to social services."

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