Why Helmets Aren’t the Answer to Bike Safety — In One Chart


Better street design and getting more people on bikes — not blind faith in helmets — are the keys to making cycling safer, recent research has shown.

Want a good visual to get the point across? The Toole Design Group made this for you.

Of these countries, the U.S. has the highest rate of helmet usage among cyclists — around 55 percent — but also the highest cyclist fatality rate per distance traveled. Meanwhile, in the Netherlands, where helmet use is practically nil, cycling is much, much safer.

While this is just eight data points, higher helmet use seems to be associated with higher fatality rates. Intuitively, that makes some sense. The more dangerous an activity, the more people feel inclined to take steps to protect themselves.

Despite the high rate of helmet use in the U.S., helmet campaigns have clearly failed to make cycling as safe as it should be. If anything, they’ve distracted from the much more important work of designing safer streets and reducing motor vehicle speeds in cities.

Updated at 4:37 p.m to replace Toole’s line graph with Toole’s bar chart, based on the same data.

95 thoughts on Why Helmets Aren’t the Answer to Bike Safety — In One Chart

  1. Let’s not go too far here and say helmet campaigns distract from the much more important work of designing safer streets.

    It’s one thing to believe that increasing cycling deaths will result in greater pressure to fix our streets; that’s probably true. It’s another to criticize people who want to reduce deaths as working against safety.

  2. I don’t think its going too far. Pushing helmets is a way for everyone to dismiss the injuries and deaths, “if only they’d have had a helmet on, their legs wouldn’t have been crushed under the reckless driver’s car”.

    I don’t think its intentional (in most cases), but it is misguided. And if you can’t take, and evaluate constructive criticism of your policies, then chances are those polices aren’t based in evidence anyway.

  3. I don’t really know where you’re getting your second point from. Angie merely said that it’s likely the correlation between higher helmet-wearing rates and higher death rates is not causation in the sense that wearing helmets doesn’t actively kill people,. It’s just a proxy for people feeling safe on a bike or not.

    And to your first point, I do think they are a HUGE distraction. They’re minimally-effective safety gear that gets a disproportionate amount of promotion because passing them out makes great photo ops for politicians and–as danbrotherston says–their absence is a target for journalists to other-ize cyclist injuries and deaths. Even in my own field of public health/medicine, many injury researchers are infuriatingly (to me) still stuck on helmets because it’s easy. You can churn out a paper from a database that has a box checked about whether the cyclist was wearing a helmet or not quickly and easily–shamefully nearsightedly, but easily. Much harder to churn out a paper about design changes, which are generally slow and piecemeal.

  4. “While this is just eight data points, higher helmet use seems to be associated with higher fatality rates. ”

    Exactly – just eight data points. Correlation (which is weak to begin with) does not equal causation. And in this case we are missing a lot of other information such as speed limits (car speed is the most important variable in bike/ped survival), bike speed, types of infrastructure (most roads in Amsterdam do not have bike lanes), rates of driver distraction and alcohol/drug use, weather, etc…

    Also note this data isn’t a time series analysis so not sure why a line chart is being used.

  5. I think that’s the point of this article. That we place so much emphasis on helmet usage, even passing laws, in the name of safety, and less emphasis on what actually causes collisions and fatalities (i.e., speed, infrastructure, driver behavior). That gives us a false sense of security and given its relative lack of actually improving safety is wasted effort.

  6. Kudos to streetsblog for this article. It should be obvious to anyone with a world view that helmets does not equate to safety, else hundreds of thouands of Indians and Chinese cyclists would be getting killed every year.

    And let’s not forget the other negative of helmets: it makes cycling *seem* more dangerous, and it makes cyclists look *different*, which could arguably, result in more aggressive behavior by drivers.

    Certainly anything that makes cycling seem like walking…you just do it, no special equipment or fancy gear needed…is good for cyclists.

  7. “While this is just eight data points, higher helmet use seems to be
    associated with higher fatality rates. Intuitively, that makes some

    Nonsense. Using helmets (like wearing seatbelts) is supposed to save lives.

  8. I absolutely support this message; helmets are at best a drop in the bucket in terms of things that actually keep people safe. That said, I wish the graphic would make more clear exactly what the axes are measuring. What is a 55% fatality rate for the US? The article says per distance traveled, but that still doesn’t quite make sense. The helmet usage side is more clear but it would still be nice to know if this is per cycling population, national population, etc.

  9. My comments refer to the tendency, displayed here, to pit efforts that aren’t in conflict against each other. It’s not a distraction to want to get people to wear helmets, because helmets save lives. It doesn’t take away from the fact that our unsafe transportation system is the problem that makes helmets necessary. We need safer facilities. But it’s certainly not a distraction to say “here’s something you can do to make yourself safer right now” while simultaneously pushing to change the system.

  10. Last week a pedestrian running across the street 10 feet from a crosswalk was screaming out to me “Where’s your helmet! You need a helmet.”

    Seriously? You’re not using a crosswalk and yelling at a cyclist going 3 blocks at a moderate pace on the sidewalk to put on a helmet? Ok.

  11. The use of athletic/racing equipment (for example, helmets) for transportation is associated with unsafe road conditions, which lead to the higher fatality rates.

  12. It is in fact a massive distraction. Why? It lets everyone — the cops who are at the scene of a bicycle-car accident, the media who report on it, and the justice system that usually never presses charges against motorists who screw up and hit bicyclists — avoid the elephant in the room: that bicyclists are being hit in the first place and even need to armor themselves as a response. You read any mainstream media article about a bicycling accident, and almost always they mention whether or not the bicyclist was wearing a helmet and almost never say something like, “Had there been a protected bicycle lane in this location, this collision wouldn’t have occurred.” And that is why the helmet thing is nothing but a distraction. By allowing society to just say, “Hey bicyclist, put a helmet on”, everyone can feel absolved from having to address the root cause, which is that the safety of bicyclists has been almost completely neglected in our road design.

  13. “But it’s certainly not a distraction to say “here’s something you can do to make yourself safer right now” while simultaneously pushing to change the system.”

    100% agreed with this statement. But *never* does the media, the policy, or city planning offices say it like this. Never. If they occasionally talked about helmet use but much more talked about the root cause — crappy infrastructure — then it would not be a distraction. But this is not how it goes down in reality.

  14. The problem with the data is that US is a big country with a much more diverse geography, and that a lot more people bike for recreation than transportation. Recreational cyclists may opt for more physically challenging routes that may be more dangerous, and perhaps ride at higher speed. So these factors may contribute to a higher fatality rate and a corresponding increase use of helmets to mitigate such risks.

  15. It’s even debatable whether or not helmets actually save lives. Here are the traumatic brain injury deaths by cause in the USA:

    All causes 53014 100%
    Motorists 7955 15%
    Pedestrians 1825 3.4%
    Motorcyclists 1361 2.6%
    Cyclists 325 0.6%

    If we assume in the case of cyclists that TBI was the sole cause of death, the cyclist who died wasn’t wearing a helmet, and helmet would have been 100% effective preventing TBI, then at most you could save 325 lives per year if everyone wore helmets.

    Now let’s dissect things further. Roughly 90% of cyclist deaths in the US are caused by collision with a motor vehicle. In just about ALL of these cases either there were additional causes of death, such as blunt force trauma to major organs, or the impact to the head was too severe for a helmet to protect against. Or in layman’s terms, in these cases wearing a helmet wouldn’t have affected the outcome. That brings us down to 30 or so lives we might save annually which didn’t involve collision with a motor vehicle. However, we don’t know how many of these 30 were in fact wearing helmets but died anyway. If the number is the same percentage as in the general cycling population, then only 15 could have potentially been saved. If not, then perhaps 30. Both of these assumptions still assume helmets would be 100% effective preventing TBI. They’re not.

    Bottom line—when you look at everything, at best some tens of cyclists could be saved if everyone wore a helmet. However, mandatory helmet use would discourage millions from riding, probably resulting in tens or hundreds of thousands eventually dying from heart disease. And then you also have safety in numbers. With fewer people riding, the risk of getting hit by a motor vehicle goes up for the remaining helmeted cyclists. That might actually increase the number of cyclist TBIs.

    If we want to save lives by pushing helmet use, then I might suggest advocating for motorcycle-type helmets for motor vehicle users will save a lot more lives than advocating for bike helmets.

  16. Reporting on helmet use is factual. Stating, “Had there been a protected bicycle lane in this location, this collision wouldn’t have occurred.” is conjecture. If a cyclist is riding on the wrong side of the road, a “Protected” bike lane is not going to protect him from a turning vehicle. Plastic flex posts are not going to protect a rider from a speeding/drunk motorist that looses control of their vehicle.

    I agree that non-helmet use should not be a reason to blame the victim; but it is also not the media’s responsibility to push bicycle infrastructure agenda.

  17. Reporting whether or not a bicycle helmet was worn is (perhaps? see below) factual, but is it irrelevant? Do they also report the color of the clothes the bicyclist wore? How about the color of the car that hit them? We’re not talking about a police report, but about media coverage where reporting on helmet usage may be totally irrelevant, e.g. if the bicyclist was run over by a truck (which happens a lot).

    And is it really factual? How do we know the helmet wasn’t knocked off the bicyclist’s head? Or maybe they weren’t wearing their helmet and they had the helmet hanging on their handlebars (I actually see this a far amount, and have been known to do it myself when traveling very short distances)?

    Bottom line: the media doesn’t report on bicycle helmet usage because it’s a useful “fact” relevant to understanding the situation but because they have been biased by the idea that wearing helmets is somehow important, or at least more important than the conditions that led to the collision in the first place.

    And it is a proven *fact* that protected bicycle lanes reduce bicyclist (and pedestrian and motorist) collisions and injuries. So clearly for an individual incident they can’t state that the lack of infrastructure was at fault, but certainly they could reference the general relationship. This is the sort of thing media dose all the time, and that’s good … except when it’s biased (as is the case with helmet usage).

    By the way, plastic flex posts do not make a protected bike lane but a buffered bike lane. I’m talking about true protected bike lanes, i.e. where a curb or parked cars protect the bicyclist from road traffic. Paint and plastic posts do not create truly safe infrastructure.

  18. Reporting on whether or not a dead cyclist was wearing a helmet may be factual but putting such thing in a news article lends itself to the conjecture by readers that the cyclist may have been saved by a helmet. In the kind of collisions which kill the most cyclists, namely bike-motor vehicle collisions, this is almost never true. The end result of such reporting is an unknowledgeable person will strap on a helmet, perhaps feel invulnerable to motor vehicles, and end up dead as a result.

  19. What he have here is classic Fallacy of Composition. Crime rates increase during the summer. Ice cream sales increase during the summer. Eating ice cream causes more crime…

    What should be noted here is the level of education motorists and cyclists in countries such as Germany, Denmark, and The Netherlands receive. Unlike the United States, in these countries Drivers’ Licenses must be earned, not dolled out with simple tests. Cycling education is part of the drivers’ license education. There is also strict liability and punishment for motorists involved in collisions.

    The “Blue” data set could be changed to hours of education. Then you would see an inverse correlation, with The Netherlands having a “Blue” bar that would extend past 100 and the U.S. with a “Blue” bar hovering around 1.

  20. While driver (and to a much lesser degree, bicyclist) education is part of it, it has been shown repeatedly that this is not the main issue. By minimizing opportunities for cars to collide with bicyclist via separated infrastructure, slower speeds for motorists, and more heavy punishment for motorists who do break laws, this is what truly reduces injuries. No matter how crappy of a driver you are, if you have much less opportunities to hit a bicyclist because the car physically cannot get to them, then you will reduce collisions.

  21. Exactly. If you take this to its extremes, in a world where bikes are grade-separated from motor vehicles everywhere there would be zero bike-motor vehicle collisions regardless of how lousy the drivers were.

  22. As I stated in my post, I agree that helmet use should be irrelevant when it comes to reporting bicycle fatalities. I am also a motorcyclist and we had the same argument in 1991 when Pete Wilson signed the mandatory helmet law.

    Motorcyclists that took AMA sponsored MSF courses where less likely to have fatal accidents. Without proper education, a motorcyclist wearing a helmet is simply an uneducated rider that is still more likely to get into an accident than an educated rider.

  23. Hi Angie thanks fro the article. It would be nice if Toole put out a few more details regarding their study. I would like to know where bicycle miles for the USA come from since that is not a metric commonly computed. You could use National Household Travel Survey but getting trip distances for bike trips would be somewhat suspect. Maybe there is another way i am not aware of?

  24. Assuming the data is correct, there is actually good news displayed in the graph…

    Yes the U.S. rate per billion kilometers is the highest presented. But it is still only 45 fatalities per billion kilometers. Which is 45 per 621 million miles. Which is one fatality per 13.8 million miles.

    That is the statistic that needs to be presented. Even in the U.S. cycling is safe. And by cycling, you reduce the chances of heart attack, stroke, and cancer.

  25. I am not sure the evidence supports the idea that bicycling is safe, at least not compared to riding in a car. A few studies have worked on this and mile per mile or trip per trip biking is less safe.


    Now the non-motorized critic might say “see we shouldn’t advocate for more of this activity” while the advocate would (should?) say “Look at this disparity we need to do better”.

  26. You could say that, but at the same time infrastructure can virtually eliminate the cause of roughly 90% of cyclist fatalities, namely motor vehicles. That makes it somewhat safer than riding in a car. Of the remaining 10%, I wonder how many of those are from sport cycling as opposed to utility cycling? It might be that utility cycling in an environment free of high-speed motor vehicles is two orders of magnitude safer than driving. To my knowledge no country has yet created such an environment. The Netherlands has done the best job so far. It shows in their much lower fatality rate.

  27. Just curious, but does anyone know how many lives might be saved each year if people in cars were required to wear helmets? Has anyone seen a study that looked at how many people die from head injuries each year?

  28. I think you’re misreading the chart. The fatality rate uses the yellow axis on the right, so for the US it means 45 fatalities per billion km cycled.

  29. I would argue that the fatality rate for cyclists in the US is not higher than it is, precisely because so few people do it on the roads for commuting, shopping, etc. If we had 80% of our American population regularly riding around on the streets, including young children and the elderly, I’m willing to bet that there would be way more deaths. The chart above is a good starting point, but it’s also not particularly comparable because in many of those other countries, a much larger proportion of the population gets around by bike on the city streets.

  30. Yes, you could tease this out in many different ways – like cycled kms vs. driven kilometers instead of helmet use. However, as the outside community often uses the helmet fallacy (which is well disputed through this data visualization) to place the burden of responsibility on cyclist for not being the victim, it is a very welcome, pertinent, and useful piece of information.

  31. I’ve personally experienced the misguided perception and expectations on what a bicycle helmet could, should or would do in a given situation. With its heavy promotion in Denmark, my good friends are one such family that had finally succumbed to the fear-mongering and for many years now, even wear helmets on their short, 2-minute ride (on separated bicycle paths) to the local bakery. A few years ago, their son was hit by a motorist and suffered a broken wrist as a result. They were telling me how thankful they were that he was wearing a helmet. While I understand what they were probably trying to say, what was actually expressed was quite illogical to me. Would he have had a severed arm if it wasn’t for the helmet?

    It’s very easy to instill fears into people when something is repeated over and over and over again, particularly in regards to “safety.” And once it happens, it’s practically impossible to reverse. You see it very obviously with a lot of Danes,and even the Dutch are not immune to it. I currently live in the Netherlands and while the vast majority of the population still doesn’t use any special gear when cycling, you are starting to see some kids (and not just little kids, but also 10 year olds or older) wear helmets and some adults wearing hi-vis or bright jackets.

  32. Except for the fact that there even more data saying that helmet use in most populations causes lower rates of cycling and also data that indicates that higher rates of cycling elevates the safety level of all cycling.

    Another point: if advocates allow the focus to be placed on helmets, there is less time, energy, and will to be spent on the issues you yourself mentioned as the true factors which will improve safety AND participation.

  33. I am not able to read references for used data and do not recognize the displayed low helmet use in Denmark. A 2013 survey in Denmark (n=1233) found, that 20 %always use helmets; 12 % often and 11 % seldom. 56 % never use helmet. See attached screen clip.

  34. From the caption of the graph, it looks like the data from Denmark is from 2000, which I think would explain why the % is so low. I was last in Copenhagen in 2011 and would estimate from personal observations that about 15-20 % of all cyclists were wearing helmets then. During my first visit in 2005, I remember it being much lower and more comparable to the value shown on the graph above.

  35. I certainly agree that helmets are grossly over promoted, and that the minimal dangers of cycling are grossly exaggerated.

    But regarding “grade-separated … everywhere”, I think a mania for that nirvana is no better. If we’re to think of bicycling as too dangerous until bikes and cars never cross paths, we may as well melt down all bikes in the world. Only one or two European countries have any really significant amount of totally segregated infrastructure for bikes, because that requires huge costs, possible only if the country already has a historic bike culture.

    Streetsblog should not be demanding the most expensive solution. Other improvements should be much easier: better driver licensing, better cycling education, publicity campaigns emphasizing cyclists’ rights to all roads, strict liability, lower speed limits especially in business and residential areas, etc.

    And yes, let’s end to the “bicycling is dangerous!” nonsense. As pointed out above, U.S. cyclists ride something over ten million miles between fatalities. Pedestrian and motorist deaths are far, far more common than bike deaths. And NOT noted above, every study on the topic has found that the benefits of cycling greatly outweigh its tiny risks. It’s literally more dangerous to NOT cycle!

    See http://ohiobike.org/images/pdfs/CyclingIsSafeTLK.pdf for some data.

  36. I actually think that the cited visualization misrepresents the actual research results cited in the first paragraph. The original study looked at a within-country comparison in Canada, and found that helmets are less effective than other initiatives in that country. That’s great data analysis and useful for a conversation about policy. The bar chart here on the other hand is just another example of correlation without causation. As a statistician, I can prove anything you want with just 8 data points and make a chart accordingly.

  37. I think the key here is to slow down motor vehicles to ~20 mph or less on minor streets, perhaps bollard them off at one end so they can’t be used as through routes (except by bikes) in order to reduce traffic volumes. Both those things make probably more than 50% of streets safe for cycling with little additional treatment.

    Arterials with fast moving traffic require separation. You also should have grade separation at busy cross streets, both for safety, and to avoid delaying cyclists at red lights.

    Complete grade separation of every cycling route is hardly necessary, but at the same time we must acknowledge that it sometimes needs to be used. Two key factors get people cycling. One, they need to feel safe and actually be safe. Two, they need to avoid stopping or slowing. Unlike a motor vehicle, most cyclists can’t repeatedly start and stop every few blocks at stop signs or red lights. Even for those who can, this represents an enormous increase in the energy needed to cycle a given distance. It also makes for extremely unpleasant cycling. Therefore, on an ideal cycle route a cyclist should never need to stop or slow down, other than when they reach their destination. A third factor is gradients. Those should be kept to a minimum for the same reasons stopping should be.

    On the cycling is dangerous thing, best thing we could do for a start is to get rid of mandatory helmet laws for children. As far as I know, no place in the US has them for adults. We shouldn’t have them for children, either. Generations of children, including mine, grew up riding bikes without helmets. Despite what some people might think, we didn’t spend our childhood in trauma wards. Mandatory helmet laws are yet another symptom of the helicopter parenting which is all too prevalent.

  38. Show me a statistic of fatalities of helmet wearers who crash on protected multi-use bike paths.

  39. This graph is silly. Of course helmets don’t reduce fatalities; they’re not designed to!

    Helmets are not life saving devices; they are injury prevention devices. I don’t wear a helmet because I believe it will save my life if I end up under a big rig, I wear a helmet in case I wipe out or go over the handle bars (likely non-fatal injuries) and risk slamming my head into the ground. Slamming your head into concrete in a non-fatal way is still a bad day, and I’d like to have a helmet on in that scenario.

  40. Yes, I did initially misread it. I think the axes’ labels could still benefit from some clarity with respect to what exactly is being measured.

  41. All of that is good and fine, but at the end of the day, you’re still going >10mph completely unprotected on a bicycle.

    I wouldn’t mandate helmet use, but I never ride without one myself. I remember biking on the bike lane by the belt when I was younger at about ~15mph, and somebody’s dog ran out from the brush. I swerved to avoid it and ended up going down. I had a lot of nasty, nasty road rash, and my helmet was cracked! It probably saved me from a concussion or worse.

    I’d never let anyone close to me ride without one.

  42. Just start reading on this site:


    We could all start with anecdotes. Here’s mine: I hit a pothole at 37 mph and came out of it with just road rash. I wasn’t wearing a helmet. I never did, never plan to. Neither of our anecdotes means squat. The reams of studies on that site I linked to provide clear evidence helmets are at best marginally effective is a few types of situations where cyclists probably wouldn’t have gotten severely hurt anyway. I’ll go so far as to say sometimes they’ll prevent some bruises or bumps on the head BUT the fact it you rarely hit your head in most common bike incidents. The design of cycle helmets pretty much makes them ineffective in the types of incidents which kill cyclists. Will a helmet help me if I’m rear-ended by a car going 30 or 40 mph? Almost certainly not. Will they help if I hit my hit after a crash from a 55 mph descent? No way. Anyway, just dig around that site and make up your own mind. That site helped convince me that I wasn’t taking any more risk by not wearing a helmet. If you still want to wear one after learning more, that’s fine. If not, that’s fine, too. The idea is to come to a decision on your own after researching the subject rather than being swayed by the fear mongers.

    Here’s a list of downsides to helmets in case you weren’t already aware of them:

    1) By increasing the radius of the head by 25% to 50%, helmets make it more likely that the head will be twisted by something which would have been completely missed an unhelmeted head. Moreover, the increased head radius causes a greater torque to be applied, increasing the severity of such rotational injuries. In very oblique impacts a bicycle helmet can convert a minor laceration into a brain injury.

    2) Some bicycle helmets can block vision, especially at the periphery. This is especially true for cyclists who ride in an aerodynamic tuck. Vision is the primary sense which cyclists use to avoid potential hazards.

    3) Some bicycle helmets can either impede hearing, or change the pitch of certain sounds. Hearing is very important for safe cycling in that it allows you to be aware of potential hazards, such as motor vehicles, from areas other than those which you may be looking at.

    4) Helmets may cause cyclists to overheat, and the chin strap may be irritating, uncomfortable, and distracting. Sweat pouring into the eyes may impede visibility. The general level of discomfort will divert attention from the task of safely guiding the bicycle.

    5) Increased sun exposure for cyclists who would otherwise wear a cap.

    There are also several behavioral side effects of helmets which will have the net effect of decreasing their overall effectiveness:

    1) Studies have shown that motorists will pass closer to helmeted cyclists than unhelmeted cyclists, increased the probability of a collision which otherwise may not have occurred.

    2) Cyclists using helmets may feel safer, and as a result take more risks, which in turn means being involved in accidents they otherwise wouldn’t have been involved in.

    3) If helmet use is mandated, the resulting decrease in cycling will cause more injuries and deaths due to lack of exercise than injuries/deaths which would have occurred if a larger number continued to cycle without helmets.

    4) Studies have shown that larger numbers of cyclists on the road means greater safety for every cyclist due to greater motorist awareness of cyclists in general. If helmet use is mandated, then cycling will decrease, to the detriment of those who choose to continue cycling.

    This is part of a letter I wrote to the CDC, along with others, which got them to take down the outdated helmet information on their website which grossly overstated the efficacy of bike helmets.

  43. Generally though a competent cyclist can pretty much avoid that type of scenario. Any effort spent promoting helmets by bicycle advocacy groups means less effort spent teaching proper riding techniques. Learning how to stop a bike quickly without doing an endover, learning to steer around obstacles, learning to fall properly once you realize you’re going down despite your best effects, giving yourself an out to avoid no-win situations in the first place, and so forth are techniques every cyclist should learn. I’m self taught in these areas, but I haven’t had a fall in 20 years. You can’t avoid every possible scenario with these techniques, but those you can’t avoid are generally ones where a helmet won’t help anyway, like getting rear-ended at very high speed by a motor vehicle.

  44. And fatalities of non-helmet wearers who crashed in protected multi-use paths. There are actually very few studies of helmets protecting for much of anything. Really as far as I can tell they protect from serious bleeding head wounds and maybe some skull fractures, but most do nothing for concussions which can be incredibly serious head injuries as well.

  45. See I would bet there would be more deaths, but a lessor percent of deaths as if more people cycled more people would learn what it takes to actually share the rode and look out for cyclists.

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