Wrong-Way Driving and Injury Risk on a Rural Four-Lane Corridor: A Descriptive and Spatial Analysis of US Highway 10, 2019–2024

Heather Rhodes-Lyons, PhD; Rachel Symons, BSN; Gina Brandl, MSN; Erin Klarr, BSN; Lucy Martinek, MD

WMJ. 2026;125(4):445-450. Published November 1, 2026.

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ABSTRACT

Introduction: Motor vehicle collisions (MVCs) on rural highways pose unique challenges due to high speed limits, limited access points, and varied environmental conditions. This study aimed to describe crash characteristics, identify predictors of injury and fatality, and evaluate geospatial trends along a rural segment of US Highway 10 in Wisconsin.

Methods: We conducted a retrospective analysis of MVCs reported on US Highway 10 from January 1, 2019, to March 1, 2024. Incident-level dispatch data were analyzed with corresponding environmental and temporal factors using descriptive statistics, geospatial analysis, and logistic regression. Geospatial mapping was used to identify high-risk roadway segments, and descriptive statistics and logistic regression were used to identify factors associated with injury or fatality.

Results: Among 239 MVCs, 21.3% (n = 51) involved injury or death. Angle collisions were significantly associated with increased odds of injury or fatality (OR 2.52; 95% CI, 1.04–6.09, P = .04). Wrong-way driving, though rare, was associated with a higher proportion of injury-producing crashes. Deer-related crashes comprised 38.0% of events but rarely resulted in injury (4.3%). Environmental factors, including lighting conditions, road surface conditions, and weather, were not independently predictive. Spatial clustering was observed near major intersections, transition zones, and roadway merging areas.

Conclusions: Collision mechanism, particularly angle collisions and wrong-way crashes, are key predictors of injury on this rural 4-lane highway corridor. In contrast, deer-related collisions were common but infrequently associated with injury. These findings support targeted roadway-engineering improvement, enhanced signage, and behavioral interventions to reduce crash-related injury along rural corridors such as Highway 10.

Author affiliations: Center for Clinical and Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, Wisconsin (Rhodes-Lyons); Department of Trauma, Marshfield Clinic Health System, Marshfield, Wisconsin (Brandl, Klarr, Martinek, Symons).
Corresponding author: Heather Rhodes-Lyons, PhD, 1000 N Oak Ave, Marshfield, WI 54449; email Heather.Rhodes@ThedaCare.org; ORCID ID 0000-0001-6003-3654
Funding/support: Funding for this publication was partially supported by the Clinical and Translational Science Award (CTSA) program of the National Institutes of Health under award number UL1TR002373, and the Raymond and Marie Goldbach Foundation (580050-00).
Financial disclosures: None declared.
Acknowledgements: The authors thank the Wood County Sheriff’s Department, especially Sheriff Shawn Becker and Sergeant Scott Goldberg, for their collaboration and for providing access to dispatch sheets that made this analysis possible. Their partnership was crucial in identifying high-risk segments along the Highway 10 corridor and in developing actionable traffic safety insights. The authors also thank Ronald Thomas, EdD, of the Kaytlyn Madison Thomas Memorial Foundation (www.kmtmf.org), whose personal experience with the devastating effects of wrong-way driving in Wisconsin motivated this project. Dr Thomas played a key role in forming the stakeholder committee and continues to lead efforts in rural roadway safety advocacy. This work is dedicated to the shared commitment of this multidisciplinary team to keep Wisconsin’s roads safe through data-driven, community-informed interventions.

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