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Just to devil's advocate here... it ALSO shows that rural USA is worse than downtown USA pedestrian deaths.
You mostly have to use the clutch/shift when you are in stop and go mode (downtown), not so much while driving in rural areas.
Doesn't seem totally consistent w that hypothesis.
But maybe it is that the clutch slows you down anyhow bc tooling around a neighborhood in a high gear is a very visual reminder of HOW FAST you are going.