Inequalities in the use of helmets by race and payer status among pediatric cyclists

Gulack, Brian C.; Englum, Brian R.; Rialon, Kristy L.; Talbot, Lindsay J.; Keenan, Jeffrey E.; Rice, Henry E.; Scarborough, John; Adibe, Obinna O.

doi:10.1016/j.surg.2015.02.025

Cited by 19 publications

(6 citation statements)

References 21 publications

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“…Legislation, education, and authorities figures such as parents and pediatricians may play important roles in increasing rates of helmet use among children. 11,12,[23][24][25][26][27][28] Although the current body of literature concentrates exclusively on bicycle traumas in children, this study focused on the adult population. The same demographic characteristics that predict helmet use among children could not previously be assumed to apply to adults.…”

Section: Discussionmentioning

confidence: 99%

“…7-10 However, the rate of helmet use is known to be lower among children who are either of color or lower income. [11][12][13][14][15][16][17] Although helmet laws increase helmet usage, there are currently only 22 states with active helmet laws; moreover, these laws overwhelmingly focus on children and none of them pertain to statewide helmet use for all ages. 18,19 Although much of the current literature on bicycle trauma describes race and SES with respect to children, the National Highway Traffic Safety Administration has found the highest fatality rate among bicyclists to be in the 55-59 age group and the highest injury rate to be in the 20-24 age group.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Race and Insurance Status as Predictors of Bicycle Trauma Outcome in Adults

Chen

Scarborough

Zens

et al. 2020

Journal of Surgical Research

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Race and Insurance Status as Predictors of Bicycle Trauma Outcome in Adults

Chen

Scarborough

Zens

et al. 2020

Journal of Surgical Research

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“…This finding is notable given that the proportion of publicly insured patients injured from AWHUR increased during the pandemic. Given that publicly insured patients are more likely to present unhelmeted and this population may have had more significant impacts from pandemic-induced societal disruptions as documented in other studies, this is a population that may have the most benefit from targeted helmet interventions (McGeehan et al 2004 ; Ali et al 2020 ; Gulack et al 2015 ).…”

Section: Discussionmentioning

confidence: 90%

Changes in pediatric injuries sustained while engaged in activities where helmet usage is recommended during the COVID-19 pandemic

Troy,

Fraser Doh,

Linden

et al. 2023

Inj. Epidemiol.

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Background Unintentional injuries, including traumatic brain injuries (TBI), are the leading cause of pediatric morbidity and mortality in the USA. Helmet usage can reduce TBI incidence and severity; however, the epidemiology of pediatric TBI and helmet use is ever evolving. With lifestyle changes potentially accelerated by the pandemic, we predicted a decrease in helmet utilization with an associated increase in TBI during the pandemic compared to the pre-pandemic period. Results There were 1093 patients that presented with AWHUR injuries from 2018 to 2020 with an annual increase from 263 patients in 2018 up to 492 in 2020. The most frequently implicated mechanisms included bicycles (35.9%), ATVs (20.3%), skateboards (11.6%), scooters (8.3%), and dirt bikes (7.4%). Unhelmeted patients increased from 111 (58.7%) in 2018 to 258 (64.8%) in 2020. There was not a significant difference in the proportion of injuries that were unhelmeted from 38.9% in 2018–2019 to 35.2% in 2020 (p = 0.30), as well as the proportion of head injuries from 2018 to 2019 (24.3%) to 2020 (29.3%) (p = 0.07). A significant increase was seen in neurosurgical consultation from 17 (6.5%) in 2018 to 87 (17.7%) in 2020 (p = 0.02). Notably, there was an increase in the percentage of publicly insured patients presenting with injuries from AWHUR during 2020 (p < 0.001); this group also had suboptimal helmet usage. Conclusion This study found an increase in patients presenting with injuries sustained while engaged in AWHUR in relation to the COVID-19 pandemic. Concerningly, there was a trend toward decreased helmet utilization and increased injury severity markers. Further analysis is needed into the communities impacted the most by AWHUR injuries.

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“…The role of helmet use in the prevention of CSI is less clear. The literature reports divergent results, from an increased risk of CSI with helmet use, via no protective effect of the helmet, to a decreased risk of CSI when wearing a helmet [ 35 , 38 , [42] , [43] , [44] , [45] , [46] ]. We did not design our study to detect whether helmets protect bicyclists against CSIs.…”

Section: Discussionmentioning

confidence: 99%