Originally Posted by
tjspiel
I don't want to turn this into a helmet debate but I find this kind of argument deceptive if not outright disingenuous. There are a lot of differences in cycling in the US vs the Netherlands aside from helmet use, infrastructure being one of them as you've pointed out. You can not compare the head trauma rates between the two countries and come up with any meaningful conclusion regarding helmets. There are simply too many other variables.
If you don't want to use a helmet that's fine, but please don't twist facts in order to convince others to do the same. Pushing for better infrastructure is a worthy goal that ultimately will make everybody safer than any helmet would. However, most places in the US are not there yet. Using a helmet may be a good idea even if it violates the image of what cycling should look like in some peoples' minds.
The differences in infrastructure and overall danger is the reason to use the rate rather than any other number. You are roughly 9 times as likely to be involved in an injury/fatality crash riding a bicycle in the U.S. as in The Netherlands. But the types and percent of injuries are fairly consistent. Regardless of how many total crashes there are you'll have a relatively certain percent of broken collarbones, broken wrists, broken femurs, etc. The larger the sample the more consistent these become country to country. So for every 1,000 crashes you'll have about 70 broken collarbones and this will be consistent in the U.S. and NL and DM and DE and wherever. So while the infrastructure in The Netherlands reduces the total number of severe or fatal crashes it doesn't have much impact on the types of injuries sustained in those crashes.
The same happens with head trauma. For every 1,000 fatalities about 320 will involve TBI or Traumatic Brain Injury. It's actually a bit higher in the U.S., about 36% I believe, but this is not a significant difference. If helmets were effective then the number of TBI's per crash, the rate, would be significantly lower.