Conference Coverage

Bicycle helmet use remains low, varies by ethnicity and socioeconomic status



ORLANDO – Only 11.3% of more than 1,200 children involved in bicycle-related accidents were wearing a helmet at the time of the accident, a study showed.

Children over age 12, and those of minority background and lower socioeconomic status, had the lowest rates of helmet use; thus the findings have implications for targeted education and prevention strategies, Dr. Veronica Sullins reported at the annual meeting of the American Academy of Pediatrics.


Only 11.3% of more than 1,200 children involved in bicycle-related accidents were wearing a helmet at the time of the accident, a study showed.

Of the 1,248 children from Los Angeles County who were included in the retrospective study of all injuries related to pediatric bicycle accidents between 2006 and 2011, most (85%) were boys. More than a third (35.2%) of white children wore helmets, but the rates were much lower for Asian (7.0%), black (6.0%), and Hispanic children (4.2%), said Dr. Sullins of the Harbor-UCLA Medical Center in Torrance, Calif.

This is despite laws mandating helmet use in Los Angeles County, Dr. Sullins noted.

The differences in helmet use also appeared to vary based on socioeconomic status; helmets were worn by 15.2% of those with private insurance, compared with 7.6% of those with public insurance, Dr. Sullins noted.

Children in the study had a median age of 13 years. Those over age 12 were less likely to wear helmets than were those aged 12 years or younger (odds ratio, 0.7).

Emergency surgery was required in 5.9% of the children, and only 34.1% returned to their preinjury status. Nine patients (0.7%) died as a result of their injuries; eight of those were not wearing a helmet.

The findings suggest that targeting low-income middle and high schools and minority communities with bicycle safety education and accident prevention strategies may help improve helmet use in children, Dr. Sullins said.

"We really need to focus our efforts and resources on education programs targeting the highest-risk groups. In Los Angeles County, these groups are middle and high school–aged children, minorities, and those of lower socioeconomic status," Dr. Sullins said in an interview.

According to the Centers for Disease Control and Prevention, an estimated 33 million children ride bicycles – for a total of 10 billion hours - each year, and nearly 400 children die as a result of bicycle crashes.

More than 150,000 emergency department visits each year are due to bicycle-related head injuries.

Helmet use has been shown to reduce bicycle-related head injuries by 80%; yet, as the results of this study and others show, the rate of helmet use remains low. The CDC reports that only 15% of adults and 19% of children wear helmets most or all of the time when riding a bicycle.

"We encourage other investigators to perform similar studies to identify [the highest-risk] groups specific to their regions or cities in order to more efficiently direct local injury prevention programs," Dr. Sullins said in the interview.

She reported having no relevant financial disclosures.

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