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American cyclist injury data update: 2000 to 2019

In November 2019, the National Transportation Safety Board in the United States recommended that "all 50 states, the District of Columbia and Puerto Rico, require that all persons wear a helmet while riding a bicycle" - i.e. that all-age mandatory bicycle helmet laws be enforced in all US jurisdictions.

It is estimated that about 63% of children and 46% of adults in the US regularly wore bike helmets in 2019.

Surveys by America's Outdoor Industry Association (OIA) suggest a 36.8% decline in 6-17yo cycling participation from 2006 to 2016. US Census Bureau data show a 42.5% decline in 7-17yo cycling participation from 1995 to 2009.

OIA figures suggest a 15.5% increase in 6yo+ cycling from 2006 to 2016, with numerous studies reporting the overall gain in participation is due to an increase in adult cycling - particularly among baby boomers.

The chart below, based on National Household Travel Surveys, shows the number of child cyclist trips in 1995 was 221.9% higher than 1985 but by 2017 was only 18.5% above the 1985 level.

americans cyclist participation

The chart below of NHTS results shows the percentage of trips by American children and teenagers has dropped from about 58% in 2001 to 22.1% in 2017. Million daily bike trips per annum within this youth demographic fell by 48.9% from 2009 to 2017.

americans child cyclist participation

Cyclist injuries

All following data is sourced from the National Electronic Injury Surveillance System (NEISS) maintained by the US Consumer Product Safety Commission.

The ongoing decline in American youth cycling participation is demonstrated in the animated timeline below showing a substantial reduction in child and teenage injuries and an increase in adult injuries from 2000 to 2019. The animation should be compared with the cycling participation data and graphics above.

timeline of cyclist injuries in america

The 20 year trend is similar for head injuries:

timeline of cyclist head injuries in america

Head injuries totalled 25.46% of all cyclist injuries from 2000 to 2019 (25.16% in 2000-2009 and 25.79% in 2010-2019).

Among the 1-19yo demographic, head injuries totalled 32.27% of all cyclist injuries from 2000 to 2019 (32.55% in 2000-2009 and 31.85% in 2010-2019).

Among the 20yo+ demographic, head injuries totalled 16.51% of all cyclist injuries from 2000 to 2019 (11.38% in 2000-2009 and 18.62% in 2010-2019).

The table below shows that from 2000 to 2019, when both mandatory and voluntary helmet wearing increased substantially in all age groups, the proportion of head injures fell slightly for children and teenagers but increased for adults, while concussion ratios increased for both demographics.

america cyclist injury table

Different injury types

Total injuries are an effective proxy for cycling participation. Below are charts and data sourced from the NEISS.

all cyclist injuries in america

youth and adult cyclist injuries in america

hospitalised cyclist injuries in america

youth and adult cyclist head injuries in america

youth cyclist head injuries in america

hospitalised youth cyclist head injuries in america

youth cyclist injuries and consussions in america

adult hospitalised cyclist injuries and head injuries in america

adult cyclist injuries and concussions in america

all cyclist injuries and head only injuries in america

youth cyclist injuries and head only injuries in america

adult cyclist injuries and head only injuries in america

all hospitalised cyclist injuries and head only injuries in america

youth hospitalised cyclist injuries and head only injuries in america

adult hospitalised cyclist injuries and head only injuries in america

cyclist head and non-head injuries in america

youth cyclist head and non-head injuries in america

adult cyclist head and non-head injuries in america

head only and other head cyclist injuries in america

youth head only and other head cyclist injuries in america

adult head only and other head cyclist injuries in america

cyclist head only and toe injuries in america

youth cyclist head only and toe injuries in america

adult cyclist head only and toe injuries in america

hospitalised cyclist head and non-head injuries in america

youth hospitalised cyclist head and non-head injuries in america

adult hospitalised cyclist head and non-head injuries in america

upper extremity cyclist injuries in america

youth upper extremity cyclist injuries in america

adult upper extremity cyclist injuries in america

lower extremity cyclist injuries in america

youth lower extremity cyclist injuries in america

adult lower extremity cyclist injuries in america

upper and lower extremity cyclist injuries in america

male and female cyclist injuries in america

youth male and female cyclist injuries in america

adult male and female cyclist injuries in america

* Head injuries include head, face, eyeballs, mouth, neck and ears. Non-head injuries includes shoulders, elbows, lower arms, wrists, upper arms, hands, fingers, pubic region, lower trunk, knees, lower legs, ankles, upper legs, feet, toes, upper trunk and internal organs.

* Upper extremity injuries include shoulders, elbows, lower arms, wrists, upper arms, hands and fingers. Lower extremity injuries include pubic region, lower trunk, knees, lower legs, ankles, upper legs, feet and toes.

Total and head injuries for all ages

ages 1-5yo cyclist injuries in america

ages 1-5yo cyclist head injuries in america

ages 6.10yo cyclist injuries in america

ages 6-10yo cyclist head injuries in america

ages 11-15yo cyclist injuries in america

ages 11-15yo cyclist head injuries in america

ages 16-20yo cyclist injuries in america

ages 16-20yo cyclist head injuries in america

The CPSC does not provide data for years in which there were less than 1,200 injuries. This primarily means there is little or no data for ages above 20yo in 2000-2009, making head injury comparisons meaningless.

However, there is adequate data for total cyclist injuries aged 21yo+ to compare 2000-2009 with 2010-2019, as below:

ages 21-25yo cyclist injuries in america

ages 26-30yo cyclist injuries in america

ages 31-35yo cyclist injuries in america

ages 36-40yo cyclist injuries in america

ages 41-45yo cyclist injuries in america

ages 46-50yo cyclist injuries in america

ages 51-55yo cyclist injuries in america

ages 56-60yo cyclist injuries in america

ages 60-65yo cyclist injuries in america

From 2003 to 2016, the percentage of cyclists among all traffic fatalities in America has worsened despite the increase in helmet wearing.

americans child cyclist participation

Dataset for all charts above can be downloaded as Excel or as CSV.

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