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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.
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.
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.
The 20 year trend is similar for head injuries:
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.
Different injury types
Total injuries are an effective proxy for cycling participation. Below are charts and data sourced from the NEISS.
* 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
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:
From 2003 to 2016, the percentage of cyclists among all traffic fatalities in America has worsened despite the increase in helmet wearing.
Dataset for all charts above can be downloaded as Excel or as CSV.
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