The mass production of automobiles in the early 1900s was met with high rates of traffic injuries. Over time, people learned how to drive, governments established rules of the road, and manufacturers (at times under federal mandate) incorporated safety features into the design of cars.1 These interventions improved safety. In contrast, one of the most consequential and often overlooked developments that affected safety was a road infrastructure that favors cars and speed.
It is within this context that Austin and colleagues provide their insightful analysis of the rise of e-bikes and e-bike injuries in California.2 The authors provide a list of interventions that, if well-implemented, will reduce e-bike injuries, which are often more severe than traditional bike injuries—likely because of the higher speeds they travel on roads designed for cars.
The suggested advocacy targets listed in table 3 of the manuscript include the e-bike rider (eg, graduated licensing, helmet use) and the vehicle (eg, speed regulation, battery/fire safety).2 However, it is the “dedicated infrastructure” category that holds the greatest promise. The higher prevalence of unsafe speed and improper turns among e-bike riders compared with traditional cyclists, noted by the authors, is critical for injury prevention. Rather than treating these incidents as isolated behavioral failures, we must recognize them as systemic symptoms of a mismatch in the built environment. Moving through intersections and turning into mixed traffic are high-threat conflicts forced upon riders because our legacy road networks prioritize automobile flow over safety. Cyclists face disadvantages from the historical under-investment in bicycle infrastructure in addition to those resulting from their devices’ design features, such as size and, for e-bikes, speed.
Road design matters. Engineering and design efforts that consider all road users move people more safely. Protected bike lanes separate cyclists from cars and pedestrians; bridges and tunnels provide safe travel for vulnerable road users across fast-moving intersections; and bike trails offer cyclists alternatives to roads and highways. Sweden has led the way in these innovations, and their road traffic death rate is among the lowest in the world.3 In the USA, big cities and small towns (including in California) are investing in cycling infrastructure to make travel safer for all.4 Safe Streets for All provides federal funding to support safer road design.5
There is a reason that e-bikes are on the rise. They are more affordable, sustainable, and offer greater flexibility than cars.6 As e-bikes become increasingly common, accelerating efforts that prioritize road design and safety is critical to addressing the injuries that Austin and colleagues document. Advocacy efforts to support the strategies outlined in the accompanying paper are tangible actions readers can take with public health and transportation professionals to realize reductions in injuries among all cyclists.
