Among its 25 other recommendations, the review by the Office of the Chief Coroner urges municipalities to adopt a "complete streets" approach that takes into account pedestrian safety and the province to adopt a strategy aimed at making walking both safe and convenient.
"Common driving errors and common pedestrian behaviour should not lead to death and injury," said deputy chief coroner Dr. Bert Lauwers, who led the review.
"The traffic system should help users cope with increasingly demanding conditions."
The study looked at the 95 pedestrians killed in Ontario in 2010. Among its findings were that two-thirds of the deaths occurred on roads with posted speed limits higher than 50 kilometres an hour, while only five per cent occurred below that limit.
That speed kills is an inescapable fact, Lauwers said, citing statistics that show a pedestrian hit at 50 kilometres an hour is five times more likely to die than if hit at 30 kilometres an hour.
"The data are irrefutable," Lauwers said. "The higher the rate of speed at which a pedestrian is struck, the greater the chance of death."
As a result, the report urges the default limit in the province be reduced to 40 kilometres an hour — down from the current 50 — unless otherwise posted. Municipalities should further restrict traffic in residential areas to 30 km/h, it said.
Seniors are especially vulnerable, accounting for 36 per cent of those killed while representing only 13 per cent of the population, according to the report.
In an interview, Lauwers said it appeared drivers and pedestrians were about equally responsible for the fatal collisions.
While 20 per cent of pedestrians appeared to have been distracted by cellphones or similar devices or pets they were walking, 21 per cent of drivers failed to yield to those on foot at intersections or crosswalks.
On hand for the release was Marie Smith, with United Senior Citizens of Ontario, who talked about how her 89-year-old friend was hospitalized for four months and her companion killed when they were hit from behind by a driver making a left turn.
"Drivers today seem to be in such a hurry that we need to slow traffic down," Smith said in urging implementation of the recommendations.
In a statement, Transportation Minister Bob Chiarelli gave no guarantees the province would do so, saying only the government would review them "in a timely manner."
A pedestrian advocacy group called the report a "breakthrough" for walkers and also urged implementation of the recommendations.
"A community is only as viable as the ability of its citizens to walk safely," said Jacky Kennedy, director of Canada Walks.
"Encouraging walk-friendly outdoor environments not only reduces the risk of injury or death from vehicles, it helps to decrease the 21,000 Canadian deaths per year that result from sedentary lifestyles."
Kennedy noted that provinces such as B.C., Alberta and Nova Scotia have cut speeds in school zones to 30 km/h and Ontario should follow suit.
Children accounted for three per cent of the pedestrian deaths in Ontario in 2010.