Missouri bicycle & pedestrian injuries down 20%-30%

The number of bicycle and pedestrian injuries in Missouri has gone down significantly since 1994--even though our best data show that the amount of bicycling and walking has been increasing since 2000.

Recently MoBikeFed summarized data from the Missouri Highway Patrol indicating:

  • Bicycle injuries in Missouri down 36% between 2000 & 2008
  • Pedestrian injuries down 29%.

Below we summarize data from a different source, the Missouri Department of Health and Senior Services InjuryMICA. This is a different, more comprehensive source of injury data and goes back several more years than the Highway Patrol data.

Bicycle and pedestrian injuries down 20-30%
The good news: The overall trend is the same--down. 

Both bicycle and pedestrian injuries are down significantly since 1994. According to the Missouri Department of Health and Senior Services InjuryMICA data for the period 1994-2008:

  • Bicycle injuries are down 22%
  • Pedestrian injuries are down 26%
  • Bicycle injuries as a percentage of all roadway injuries have gone from 11.8% in 1994 to 10.5% in 2008, a significant decrease
  • Bicycle injuries (but not pedestrian injuries) showed an increase in the late 1990s through 2000, then a continual decrease since then
  • From their peak in 2000, bicycle injuries are down 30%

This sounds like good news. But what if the decrease in bicycling and walking injuries is caused simply because people are bicycling and walking less?

  • Unfortunately we don't have good data going back further than 2000, but since 2000, our best estimate is that bicycling and walking are up 40-50% in Missouri. (The 'hump' in the bicycle data may be because the year 2000 represented a low point in the amount of Missouri bicycling.)
  • One of the best established principles in bicycle and pedestrian injury studies is that the rate of injury goes down when the rate of bicycling and walking goes up. so it would be very surprising to see Missouri's injury rates go down so dramatically if the amount of bicycling and walking were edging down--you would expect the injury rate to remain flat or even increase if the amount of bicycling & walking were trending downwards.

For more details, read on.  For a larger version of any graph, just click the graph.

On-Road Bicycle Injuries, all causes

The graph of bicycle injuries shows the "hump" of increased injuries with a peak at the year 2000, followed by a steady decline.

Overall, comparing 1994 with 2008, bicycle injuries are down 22%.

From the high point at the year 2000 to 2008, bicycle injuries are down 30%.

This graph also clearly shows that the majority of bicycle injuries on the road are "bicycle alone" (the green line; compare to the total injuries, the blue line) while less than 10% involve a motor vehicle (red line).

One important difference between bicycle and pedestrian injuries is the proportion of injuries involving motor vehicles between pedestrians and bicyclists.  For pedestrians, injuries involving motor vehicles are the vast majority.  For bicyclists, motor vehicle injuries are a small minority; about 19 of 20 bicycle injuries are bicycle-alone crashes.

Although motor vehicle injuries tend to be more severe--and motor vehicle collisions are the main cause of bicyclist fatalities--it is important to not discount the importance and severity of bicycle-only injuries.

The injuries in this data are the ones serious enough to send the bicyclist to the hospital, and research shows the average cost of these injuries is about $3200 each.

Bicycle injuries have cost Missourians $396 million since 1996, an average of over $30 million each year.

The two pieces of good news: Bicyclist-alone injuries are very much under the control of individual bicyclists and the same techniques that dramatically reduce incidence of falls and bicyclist-only injuries also reduce bicyclist-motor vehicle injuries. Complementing this, improving our infrastrucure can make a huge difference as well--bicyclists are sensitive to everything from rough pavement, cracks and joints, poorly designed drain grates, dangerous expansion joints, and so on. 

Removing these hazards improves safety for bicyclists--and Missouri cities and government agencies are moving in that direction. 

On-Road Bicycle injuries involving Motor Vehicles only
Zooming in on just those injuries involving motor vehicles (the red line at the bottom of the graph above) shows the same basic story.

This graph also shows the same 'hump' --in this case the highest year is 1998, with injuries on a decreasing trend since then.  

Overall, comparing the year 1994 to 2008, the injuries are down by 13%.

We don't have an explanation for the sudden decrease in injuries in 2001 and increase in 2003--it could be just normal variability in the data (though the "all-cause" data above, green and blue lines, shows a less pronounced version of this same feature, so there may be some real-world effect going on here).

Bicycle injuries as a percentage of all traffic injuries
How great a percentage are bicycle injuries of all roadway and highway injuries?

This is an important question, because the answer should be used to determine priorities and spending for highway safety dollars.

Pedestrians are about 3.5% of all traffic-related injuries in Missouri.

Bicyclists represent far more--ranging from just about 10% to just under 12% in the years 1994-2008.

The good news is that this percentage, too, is trending downwards.

But looking at the relative proportion of bicycle injuries on Missouri roads, we come to these conclusions:

  • Far more highway safety funding should be spent on bicycle safety and education
  • Far more road and highway funding should be spent on providing safe accommodations for bicyclists and removing road hazards that cause bicyclist injuries


  • The decrease in bicycle and pedestrian injuries is a positive trend. We should work to continue and accelerate it.
  • Bicycle and pedestrian injuries are common and serious; they require serious and dedicated attention and funding
  • Specifically, bicycle injuries are a large and overlooked portion of the total amount of roadway injuries; a greater percentage of roadway safety funding should be dedicated to bicycle safety programs and education
  • Because many of these injuries involve the bicyclist alone, bicycle education is one key to reducing these injuries. We believe that good bicycle education programs should be universal in our K-12 education system. 
  • Poor facilities--roads and trails--also contribute to these injuries, many of which happen when bicyclists are riding along poorly maintained trails, along the crumbling edge of roads, when encountering drain grates, expansion joints, and debris.
  • Bicyclists are more sensitive to both poor construction and materials (i.e., dangerous drain grates and expansion joints in the road) and poor maintenance (potholes, deteriorated seams and slots in the road). Improving construction and maintenance can improve conditions dramatically.
  •  For the bicyclist: Your safety is almost entirely in your own hands.  If you change the way you ride, you can dramatically improve your safety.

The Technical Details

The Department of Health and Senior Services InjuryMICA has these advantages over the Highway Patrol data, particularly for bicycle injuries, because:

  • InjuryMICA includes many more injuries not counted by the Highway Patrol data (Highway Patrol data counts only those injuries involving a collision with a motor vehicle, missing many thousands of bicycle and pedestrian injuries)
  • InjuryMICA includes six more years of historica data

One difference between the InjuryMICA and Highway Patrol data is that the InjuryMICA data includes about 10% 'double count' of patients, because some patients are re-admitted to the hospital a second time for the same injury.


Definitions: The terms used in the charts above refer to these types of injuries

  • Bicyclist - Motor Vehicle and Pedestrian - Motor Vehicle: Injured bicyclists and pedestrians who are hit by motor vehicles on a trafficway 
  • Bicyclist - No Motor Vehicle and Pedestrian - No Motor Vehicle: Bike riders and pedestrians not injured by motor vehicles, as with a person who is injured by hitting his/ her head on the road after falling off a bike
  • There is a third, much much smaller group of injuries which include bicyclists and pedestrians not injured by a simple fall but also not injured by motor vehicles--those injured by ATVs, for example.  Because the number of injuries is relatively small and also not road or traffic related we have not shown this group on the graphs above, but you can see the raw data at the InjuryMICA web site by selecting Mechanism "Motor Vehicle-Non Traffic" and then drilling down on that category to break it down to "Pedestrian: Non-traffic" and "Bicyclist: Non-traffic", or by downloading the Excel spreadsheet.

Download an Excel Spreadsheet with the detailed data and graphs here.

MoBikeFed's Vision of Bicycling and Walking in Missouri includes two ambitious goals: (1) Double the amount of bicycling and walking in Missouri and (2) Simultaneously cutting the injury and fatality rates in half. The downward slope of the graphs above shows that we are getting there.