An estimated 67 million bicyclists in the United States ride roughly 15 billion hours per year for recreation, exercise, and transportation. Each year, serious bicycle-related injuries result in lifelong debilitation and fatalities. These injuries account for more than 1.2 million physician visits, 580,000 emergency department (ED) visits, 23,000 hospital admissions, and approximately 900 deaths each year at an estimated cost of more than $8 billion. If riders simply wore a standard bicycle helmet many of these injuries may have been prevented. Wearing a standard bicycle helmet reduces a cyclist’s risk of injury by 88% and reduces the risk of a serious injury by a minimum of 75%.1 Helmet use can specifically reduce bicycling-associated head injuries, which account for 62% of bicycle fatalities, 33% of ED visits, and 67% of hospital admissions. The social-ecologic theory is a strategy for behavioral modification that addresses numerous social and ecologic factors that affect risky behavior. This commentary reviews the literture for interventions shown to increase the prevalence of helmet use among children and present a social-ecologic public health framework to increase helmet use and reduce bicycle-associated head injuries among children. The 4 levels explored include individual factor relationships, community, and societal opportunities. (Author/publisher)
Abstract