Predictors of Bicycle Helmet Use in an Urban Area

Background/Purpose: Cycling is enjoyed for recreation, exercise, and increasingly as clean transportation. This study was conducted to examine prevalence and predictors of helmet use among on street cyclists in an urban area.

Methods: Observations of 2088 cyclists were conducted during 2009 and 2010. Trained volunteer observers collected data at seven geographically diverse locations. Intersection locations were chosen due to their proximity to a specific type of area including downtown, college campuses, and general residential areas. The locations represent areas of potential high usage by pedestrians and cyclists, and they include a variety of infrastructure. The data were analyzed to examine the prevalence of helmet use overall and at each location. Odds ratios and 95% confidence intervals were calculated to determine predictors of helmet use and to show the strength of the association.

Results: The most significant predictor of helmet use found was age. Cyclists age 26 and older were 3.46 times more likely to wear a helmet than younger riders. Additional significant positive predictors of helmet use were riding on the road vs. riding on the sidewalk, riding with traffic vs. against traffic, and riding downtown. Whites were more likely to wear a helmet.

Conclusion: Our study suggests that lack of helmet use is associated with other high-risk behaviors; riding against traffic and riding on the sidewalk. Interventions to increase helmet use should target young adults and non-whites and include general bicycle safety skills.