Abstract
Objectives: This study sought to identify factors associated with bicycle helmet use at both individual and regional levels. Methods: We analyzed data from community health surveys conducted in 2016 in 254 municipal districts (si, gun, and gu) by the Korea Center for Disease Control. In total, 49,105 bicycle riders were enrolled from among the 228,452 adults systematically sampled using the resident registration database. Regional (municipal)-level data were provided by K-Health ranking (Hallym University, South Korea), which represents a collection of indicators processed from various sources. Multilevel binary logistic regression analysis was performed for the dependent variable, a self-reported response of "I always wear a helmet." Results: The percentage of bicycle helmet use was 13.7% among men and 6.2% among women. Regional-level factors accounted for 11% and 10% of the variance of bicycle helmet use among men and women, respectively. Among regional variables, the proportion (%) of the population that was elderly significantly decreased the odds of helmet use (adjusted odds ratio [AOR] = 0.97, 95% confidence interval [CI], 0.95-0.98 for men; AOR = 0.96, 95% CI, 0.94-0.98 for women). Conclusion: Community efforts to promote bicycle helmet use are needed, especially in areas with a large elderly population.
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