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June 8, 2017

The staggering cost of bicycle injuries, in one chart

Daily Briefing

    As bike riding becomes more popular, bike accident injuries are becoming more common, and those injuries are costing billions of dollars annually, according to a study published in Injury Prevention.

    3 steps to prioritize population health interventions

    The study looked at nationally representative data to estimate the incidence and cost of bike accident injuries between 1997 and 2013. The researchers' definition of "costs" includes hospital charges, emergency transport, nursing home and rehabilitation facility stays, and the cost of lost work and quality-of-life losses, among other expenses. The researchers expressed cost in 2010 dollars.

    Study findings

    The researchers found that there were 288,501 cases of non-fatal bike accident injuries in the United States in 2013, up from 177,275 in 1997. The number increased by about 6,500 annually over the study period.

    Meanwhile, the annual cost of non-fatal bike accident injuries increased 140 percent from $9.3 billion in 1997 to $22.4 billion in 2013.

    Thomas Gaither, a medical student at the University of California-San Francisco and one of the study's authors, said the cost increase could be explained in part by changes in the nature of bike accidents. In 2013, 66.5 percent of total costs came from injuries on the street or highway, up significantly from 46 percent in 1997, according to the study. The percentage of costs related to incidents on the street or highway increased "steadily" by 0.8 percent annually, the researchers said.

    Gaither noted that street riding can increase "the velocity of the crash impact and, as a result, the severity of the injury." Further, the researchers said that "streets might also predispose to more injuries due to the coexisting environment with urban areas, increased population density or the presence of more unyielding street furniture"—such as fire hydrants, parking meters, and telephone poles.

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    In addition, the researchers found that the percentage of accident costs related to riders age 45 and older grew over the study period by 1.6 percent annually. According to the study, 53.9 percent of costs in 2013 stemmed from accidents involving older riders, compared with 26 percent of costs in 1997. Similarly, the number of miles ridden annually by older bikers increased from 1.9 trillion in 2001 to 3.6 trillion in 2009.

    The researchers concluded, "The growth in costs is especially associated with rising ridership, riders 45 and older, and street/highway crashes."

    The researchers said they did not find a significant linear trend in cost changes based on rider sex. However, they found that male riders make up the majority of costs, accounting for 77.3 percent in 2013.

    Despite the increase in injuries and related costs, the study authors said they think the health benefits of biking outweigh the risks and that the findings highlight a need for a policy focus on injury prevention. They said it might be time for improvements in the design of roadway infrastructure as well as bikes and cars (Eunjung Cha, "To Your Health," Washington Post, 6/3; Gaither et al., BMJ Injury Prevention, 6/1).

    3 steps to prioritize population health interventions

    Explore three steps you can take to establish each patient’s current and future risk level, the root causes of the patient’s health risks, and which interventions would make the biggest impact.

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