Bicycling in U.S. is Risky Business

The US has never encouraged cycling as a practical mode of travel, and as a result, biking to work is a rare and hazardous activity, with four times the fatality rate of some European countries. A Rutgers University study shows how that can change.

"John Pucher and Ralph Buehler of the Bloustein School of Planning and Public Policy at Rutgers University recently examined how three of the northern European countries with the highest rates of bicycling managed to get so many of their residents onto bikes. Pucher and Buehler contend that what's worked in Europe would produce significant results in North America - if governments take the necessary actions.

In the US, bikes are "rarely used for practical, everyday travel needs," Pucher and Buehler say; the principal reason is that cycling conditions here "are anything but safe, convenient, and attractive."

Pucher and Buehler's observations appear in "Making Cycling Irresistible: Lessons from the Netherlands, Denmark, and Germany," an article that has been circulating on the Internet and will be published in the July 2008 issue of Transport Reviews. The authors disabuse American readers of the notion that the US is so inherently different from Europe that biking will never catch on here in a big way. They point out that biking wasn't always pervasive in the three European countries they studied. Quite the contrary, from 1950 to 1975 the rate of biking in Europe plummeted, and in many European nations, such as Britain, it hasn't shot back up. But the Netherlands, Denmark, and Germany introduced policies, programs, and designs that ended up making cycling both safer and more common."

Thanks to The Intrepid Staff

Full Story: Biking needs a boost in American cities



dedicated lanes

I think the number one thing government can do to encourage more bicycling is to build dedicated lanes on busy streets. I don't like to ride on fast moving cross town streets with just a painted line protecting me. The design of sidewalk, bike lane and then parking would be great and create a more pedestrians friendly environment as well.

Bike Commuting is Growing

Well designed and well marked bike boulevards on low traffic streets combined with segregated bike lanes on higher speed limit roads have helped me become a full time bike commuter. Every day I continue to see more and more people on two wheels joining me. I'm fortunate to live in a city that has invested a lot (relatively) in bike infrastructure. I think there are lessons to be learned from what is being done here in the US as well as the cities mentioned in this study.

Agreed. A bike lane is a

Agreed. A bike lane is a great improvement from nothing, but to see children, elderly, business suits on bikes, we will need more than that. Making enhancements to neighboring residential streets to make them more bicycle accommodating can also help.

NY has recently unveiled their first physically separated bike lanes.
It must be doing well since they have plans to expand it another 10 blocks. Anyone from NY reading have a thought on them?

Exclusive Motorcycle Lanes (EML)

This article brings up a point that is rarely seriously discussed in the US. Many decision makers simply believe that those who want to ride bikes can do so on the roads we have - this logic is flawed.

I would also broaden the discussion to include scooters and small motorcycles. As gas prices continue to rise, so does the number of small motorcycle, scooter, and bicycle deaths. If we build exclusive bus lanes, why don't we build exclusive motorcycle lanes? Surveys by Vespanomics and others suggest that latent demand for scooter commuters is tremendous; they are affordable, fun to ride, and great on gas. I believe that this is truly a case of "if we build it, they WILL come".

Exclusive Motorcycle Lanes (EML)

Bicycling is a worldwide

Bicycling is a worldwide activity. In both developed and developing countries it serves as an important means of transportation as well as an enjoyable recreational activity for adults and children. Thus, injuries related to bicycling are comparatively common, and head injuries account for one third of visits to emergency departments, up to two thirds of hospitalisations, and three quarters of deaths.1 Head injuries also carry a substantial risk of long term disability. Thus, preventing head injuries associated with this common, worldwide activity is important.

Safety helmets for bicycling have been available for at least 20 years. Although randomised controlled trials have become the gold standard for providing evidence of the effectiveness of clinical interventions, these trials are not feasible for examining whether helmets prevent head injuries. Given that the rate of head injury is about 20 injuries per 100000 people, a randomised controlled trial would need to involve tens of thousands of people.2 Evidence for the effectiveness of helmets has come from two other types of studies: case-control studies, in which the proportion of people wearing helmets among cyclists with head injuries is compared with that of cyclists without head injuries, and ecological studies examining changes in the rate of head injury over time among populations wearing helmets and those not wearing helmets.

The strongest evidence for the effectiveness of helmets comes from case-control studies; this design is one of the cornerstones of modern epidemiology. A systematic review of five case-control studies, published in the Cochrane Library, found that helmets reduced the risk by 63-88% for head, brain, and severe brain injury among cyclists of all ages.1 Four of the studies controlled for a series of important covariates.3–6 Helmets seemed equally effective in reducing injuries in crashes involving motor vehicles and in accidents associated with falls and other causes.

In this week's journal Cook and Shiekh (p1055) describe a study that used an ecological time series analysis.7 Examining all admissions to NHS hospitals in England over a four year period, the authors found that head injuries as a proportion of monthly admissions for trauma related to bicycles fell from 40% in 1991-2 to 28% in 1994-5 while total emergency admissions for trauma related to bicycles did not change. These changes showed a consistent year to year trend in which the proportion of head injuries related to trauma from bicycles became lower in each successive year. Changes occurred in all age groups and are ascribed by the authors to an increase in the use of helmets. Similar findings from ecological studies have also been reported in the United States, New Zealand, and Australia8,9,10; these findings were associated with an increased use of helmets occurring as a result of educational and legislative initiatives.

Despite this large body of evidence on the effectiveness of helmets in preventing head injuries in cyclists and their beneficial effects for populations of cyclists, critics, especially in the United Kingdom, continue to question the usefulness of helmets. Their criticisms fall into two main categories: “risk homeostasis” and lack of adjustment for other confounders. Hillman has argued that while helmets may offer some inherent protection to cyclists there is no overall benefit because cyclists who wear helmets ride in a less cautious manner so that their overall risk of injury is unchanged.11 This theory of risk homeostasis has been discussed for decades, but the evidence that it applies to helmet use and bicycling is non-existent.12 The other criticism is that case-control studies on helmets have not adequately controlled for all potential confounders, especially unmeasured factors such as differential risk taking behaviour in cases and controls. Adequate adjustment for differences between cases and controls is important for the validity of any case-control study. Four of the five studies in the Cochrane review controlled for potential differences between cases and controls, such as age and severity of the crash.3,4,5,6 Crash severity can be used as a proxy for the hypothesised effects of risk taking behaviour. The magnitude of the protective effect of helmets found by these studies (threefold to eightfold ) makes it clear that unmeasured confounders cannot explain the differences in the risk of injury between cyclists who wear helmets and those who do not.

Healthcare providers and public policy makers have a duty to promote the health of the public and to base their recommendations on evidence of effectiveness. The evidence that bicycle helmets prevent head injuries is as strong as that for any injury prevention programme. While many programmes have their critics, the weight of the evidence for the effectiveness of helmets is strong; the evidence for a lack of protection is weak, circumstantial, and largely based on rhetoric. Further delays in promoting the use of helmets will be measured in the number of lives ruined by the devastating consequences of preventable brain injury.

Submited by : Dietas

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