Correlates of Helmet Use Among Recreation and Transportation Bicyclists

Helmet use prevents injury and mortality if a bicyclist is in a collision while riding. This cross-sectional study sought to identify domain-specific (recreation versus transportation) correlates of helmet use among U.S. adult bicyclists, using nationally representative data from 2012.

This analysis, conducted in 2015-2016, utilized data from the 2012 National Survey of Bicyclist and Pedestrian Attitudes and Behaviors, administered for the National Highway Traffic Safety Administration. Bivariate logistic regressions identified sociodemographic, behavioral, and environmental correlates of helmet use among U.S. adult bicyclists. Backwards elimination procedures selected final multivariate models for bicyclists' helmet use in both domains.

Among recreation cyclists, helmet use was significantly associated with income ($30,000-$75,000, OR=1.79, 95% CI=1.04, 3.10; ≥$75,000, OR=2.34, 95% CI=1.38, 3.97), safety training (OR=2.94, 95% CI=1.46, 5.93), not riding at dark (OR=1.92, 95% CI=1.24, 2.98), feeling threatened while riding (OR=2.24, 95% CI=1.12, 4.45), and using bike lanes/paths (OR=2.04, 95% CI=1.42, 2.93). Helmet use among transportation riders was significantly associated with education (less than high school, OR=2.45, 95% CI=1.13, 5.32; post-high school, OR=3.55, 95% CI=1.96, 6.42), income ($30,000-$75,000, OR=2.11, 95% CI=1.17, 3.8; ≥$75,000, OR=2.33, 95% CI=1.26, 4.27), unemployment (OR=0.29, 95% CI=0.11, 0.76), not using electronics while riding (OR=2.3, 95% CI=1.41, 3.75), safety training (OR=3.19, 95% CI=1.44, 7.07), and injury while riding within the past 2 years (OR=2.81, 95% CI=1.14, 6.94).

Correlates of helmet use among bicyclists are domain specific. Although confirmatory longitudinal studies are needed, findings suggest that interventions to increase bicyclists' helmet use consider riding domain.