Sustainable urban transportation is fundamentally linked to public health outcomes, specifically the mitigation of fatal traffic risks under environmental stress. While stressors like adverse weather affect entire cities, traditional road safety models often assume uniform risk, thereby masking the spatial inequalities inherent in the urban fabric. This study addresses this gap by investigating the geographically heterogeneous impact of environmental stressors—including rainfall, surface moisture, and lighting conditions—on the conditional probability of fatal crash outcomes in Melbourne, Australia. Analyzing 43,075 severe crashes through a multi-stage geospatial framework (Getis-Ord Gi* and Geographically Weighted Logistic Regression), this research diagnoses how varying urban development patterns mediate the lethality of these stressors. The findings unmask a critical “threshold-crossing” effect for wet surfaces, where risk transitions from protective to hazardous based on local infrastructure form and street geometry. Significant spatial inequalities are identified: high-density inner-urban cores and adjacent coastal corridors exhibit a heightened sensitivity to visibility failures and moisture, whereas newer industrial peripheries show stronger protective “risk compensation” effects. These results reveal a systemic mismatch between historical urban form and contemporary climate-driven public health risks. By identifying localized “lethality thresholds”, this study provides a robust evidence base for integrated planning and equitable resource allocation. It enables urban planners to move beyond generalized safety warnings toward targeted structural interventions, ensuring that sustainable transportation networks prioritize safety equity for all citizens regardless of their location within the urban environment.