Safer Cycling Through Improved Infrastructure

American Journal of Public Health
Publication date: 
December 2016

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It is crucial to improve cycling safety in the United States. The Centers for Disease Control and Prevention’s injury statistics Web site (WISQARS) reports that in 2014, there were 902 cyclist fatalities and 35 206 serious cyclist injuries (requiring hospi- talization). The United States has much higher fatality and serious injury rates per kilometer cycled than comparable high- income countries. Controlling for exposure levels, cyclist fatal- ities in 2010 per 100 million kilometers cycled were 4.7 in the United States versus 1.0 in the Netherlands, 1.1 in Denmark, and 1.3 in Germany.1 Serious injury rates in 2010 were also much higher in the United States: 207 serious injuries per 100 million kilometers cycled versus 44 in Germany.

Clearly, the United States has a long way to go to achieve the Vision Zero goal described by Cushing et al. As emphasized in that article, traffic fatalities and serious injuries are not in- evitable, and they can be reduced to low levels by implementing the right policies, especially improved infrastructure and technology. Traffic safety experts now use the term “crashes” instead of “accidents” to emphasize that the design of the transportation system contributes to most traffic fatalities and in- juries. Although Cushing et al. focus on Sweden, all Scandinavian countries—as well as the United Kingdom, the Netherlands, Germany, Switzerland, and Austria—for decades have been implementing the sorts of policies advocated by Vision Zero, which applies to all means of travel. The new perspective of Vision Zero is that traffic fatalities and injuries can and should be reduced far below current levels and should not be accepted as an inevitable risk of travel.

Cushing et al. apply Vision Zero to the case of cycling and pose the question of whether improved cycling infrastructure can make cycling safer in the United States. The article by Pedroso et al. shows that the large growth in bicycle in- frastructure in Boston from 2007 to 2014 was associated with a reduction in the cyclist injury rate and a large increase in cycling levels.

Except for some college towns and a few large cities, most roads in the United States have no cycling infrastructure, and what exists is often dangerously designed, poorly maintained, and not connected to form a useful network. Bicycle infrastructure with physical separation from motor vehicles is especially important on high-speed, high-volume arterials with large vehicles such as trucks and buses.4 In addition, intersections are dangerous for cyclists because of turning motor vehicles. Yet only a few American cities have been redesigning intersections to reduce that danger.