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Head Injuries Didn't Rise in Bike-Share Cities. They Actually Fell

Late last week, several media outlets ran stories on a study published in the American Journal of Public Health that allegedly showed head injuries increasing in cities with bike-share programs. Kay Teschke, who studies city cycling at the University of British Columbia, read the news with great interest. Then she read the actual journal publication, and her interest changed to alarm.

The study is Public Bicycle Share Programs and Head Injuries, led by Janessa Graves of Washington State University.

Results. In PBSP cities, the proportion of head injuries among bicycle-related injuries increased from 42.3% before PBSP implementation to 50.1% after (P < .01). This proportion in comparison cities remained similar before (38.2%) and after (35.9%) implementation (P = .23). Odds ratios for head injury were 1.30 (95% confidence interval = 1.13, 1.67) in PBSP cities and 0.94 (95% confidence interval = 0.79, 1.11) in control cities (adjusted for age and city) when we compared the period after implementation to the period before.

Despite the conclusions being strongly about pushing helmets on bike share users, if you read carefully this is all about the proportion of injuries which were head injuries, and in the bike share cities head injuries declined 14% while overall injuries declined 28%.

While I'm not going to rant against helmet use (even though per hour of activity, you're still less likely to get a head injury from cycling than while walking or driving), reporting this as "bike share cities need to promote helmet use" is beyond irresponsible.