Title
Protecting Youth With California’s Largest Regional E-Bike Injury Warning System (Districts: All)
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Overview
San Diego County is facing an electric bike (e-bike) safety crisis, and children are paying the price. E-bikes are currently on pace to be the leading cause of trauma cases at Rady Children’s Hospital in 2026. As e-bike use has grown, hospitals across our region have seen a surge in serious, life-altering injuries. Children are arriving with skull fractures, spinal injuries, and brain bleeds - injuries more commonly associated with motorcycle crashes than ordinary bicycle accidents.
A 2026 UC San Diego-led study found that reported e-bike collisions across California increased from two in 2018 to 1,566 in 2024, with children and teenagers facing the highest collision rates. Here in San Diego County, pediatric e-bike trauma cases at Rady Children’s Hospital climbed from just three in 2021 to 262 in 2025.
This crisis has already cost young lives. On September 12, 2026, a 14-year-old San Diegan was struck by a car and killed while riding his e-bike in Pacific Beach, the latest in a pattern that includes a 15-year-old boy, killed on El Camino Real in Encinitas in June 2023.
Given the growing number of tragedies, the County has treated this as the public health emergency it is. On May 28, San Diego County’s Public Health Officer issued a health advisory urging riders, parents, schools, healthcare providers, and local governments to take action to prevent further injuries and deaths.
But San Diego County is fighting this crisis in the dark, without a complete or timely picture of who is getting hurt, where crashes are happening, or what devices are involved. Critical information is scattered across hospitals, trauma centers, Emergency Medical Services providers, law enforcement agencies, and state reporting systems. Much of it remains incomplete, delayed, or misclassified.
The current injury data is collected locally and sent to the state, compiled, and returned to local decision-makers through a reporting process that takes more than a year. Additionally, without updated device classifications, legal e-bikes may be grouped with conventional bicycles or high-powered electric motorcycles that are illegally marketed as e-bikes. By the time an emerging pattern becomes visible, more children will have been hurt or even killed.
San Diego County needs more immediate, detailed local data to identify new threats and respond before they grow. As the region’s public health agency, the County already uses timely health data to identify emerging threats and guide its response. Through syndromic surveillance and partnerships with hospitals, trauma centers, emergency departments, EMS providers, and law enforcement, the County can coordinate fragmented information, detect dangerous patterns earlier, and act swiftly before more children are hurt or killed.
The proposed system would collect and analyze information, to the extent possible, including:
• Rider age and relevant demographic information
• Date, time, and zip code of the crash
• Helmet use and other relevant crash circumstances
• Type of bike/device
• Injury type and severity
• Whether the patient was transported to the hospital, treated in the emergency room, admitted to the hospital, or died
Knowing where injuries are rising, who is being hurt, and which devices are involved will allow the County and its regional partners to target prevention efforts where they can have the greatest impact. The County already works with the San Diego County Bicycle Coalition and Scripps Health Trauma Prevention to provide e-bike safety courses and helmet giveaways, as well as actively partners with SANDAG who also offers the courses. Timely injury and crash data would support targeted education efforts, bringing these programs directly to the schools and neighborhoods experiencing the greatest harm.
Today’s action directs the County to establish California’s largest regional E-Bike Injury Warning System. Working with hospitals, trauma centers, emergency departments, community clinics, EMS providers, law enforcement, and other regional partners, the County will develop a system to collect and analyze more timely and comprehensive injury data, identify emerging threats, and publicly report regional trends on an ongoing basis.
San Diego should not have to experience a 14-month delay in learning that more children are getting hurt. We need the information sooner so we can target our response and prevent the next injury.
Body
Recommendation by Supervisor Terra Lawson-Remer and Supervisor Paloma Aguirre
1) Direct the Chief Administrative Officer (CAO) to establish a Regional E-Bike Injury Warning System to collect, aggregate, and publicly report regional e-bike injury data on an ongoing basis using currently available data.
2) As a subsequent part of this initiative, the CAO should coordinate with hospitals, trauma centers, emergency departments, community clinics, EMS providers, and other regional healthcare and law enforcement partners, as appropriate, to monitor emerging injury trends, deliberate data quality improvement efforts, and discuss additional potential data sources and sharing that may be beneficial to collect, aggregate, and publicly report of the Regional E-Bike Injury Warning System.
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Equity Impact Statement
Without current and comprehensive regional data the County cannot know whether e-bike injuries are falling disproportionately on certain communities, age groups, or geographic areas. A dashboard that captures demographic and location information is a prerequisite to an equitable response, one that directs education, enforcement, and infrastructure resources to where the harm is concentrated rather than where it is most visible.
Sustainability Impact Statement
E-bikes are a cornerstone of San Diego County's sustainable transportation future, reducing vehicle miles traveled, expanding mobility access, and supporting regional climate commitments. Current and complete injury data allows the County to pair that growth with the safety measures needed to sustain it, supporting the long-term viability of active and clean transportation in our region. The actions directed in this board letter are consistent with the County's climate, public health, and active transportation goals.
Fiscal Impact
There is no fiscal impact associated with today’s recommendations. Implementation of the recommendations will be absorbed within existing staff resources. There is no impact to General Fund cost, and no additional staff years.
Business Impact Statement
Rising e-bike injuries on public streets, bike lanes, and school routes pose a risk to the businesses and industries that depend on safe, accessible public spaces. Tourism, coastal recreation, and local retail all benefit from streets and paths that are safe for riders, pedestrians, and drivers. Building the regional data infrastructure to understand and address this crisis supports the long-term safety and economic vitality of San Diego County's communities.
Advisory Board Statement
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Background
E-bike ridership across San Diego County has grown rapidly in recent years, and local trauma data confirms that injuries are growing with it. San Diego County's system of trauma centers reported 294 e-bike-related injuries in 2024, a 54% jump from the 191 reported the year before. At Rady Children's Hospital, pediatric e-bike trauma cases climbed from three in 2021 to 262 in 2025, and the hospital has already logged nearly 90 cases in just the first quarter of 2026, putting e-bikes on pace to become the leading cause of pediatric trauma cases at Rady's this year. Physicians across the region report treating children for skull fractures, spinal injuries, and brain bleeds consistent with motor vehicle collisions, not conventional bicycle crashes.
Despite this trend, the County has no way to track these incidents in real time. Hospitals and trauma centers have only recently begun coding e-bike injuries as a distinct category, and that data is not aggregated or shared across jurisdictions. What data does reach the state is filtered through a reporting cycle that takes up to fourteen months to return to local officials, and e-bike injuries are frequently misclassified alongside conventional bicycles or electric motorcycles along the way, further obscuring the true scope of the problem. As a result, County public health officials, hospitals, and cities are currently responding to a crisis using data that is both incomplete and outdated.
The County already has a model for closing a gap like this. Its syndromic surveillance systems track other fast-moving health threats in real time through direct, ongoing data-sharing agreements with regional healthcare partners, rather than waiting on the state's reporting cycle. Other counties have shown what applying that model to e-bikes can accomplish: when Marin County Public Health began classifying 911 responses by device type in October 2023, officials found within the first month of collection that the e-bike accident rate among youth ages 10 to 19 was nine times higher than for residents over 20. That single finding led directly to a public health advisory, a public-facing injury dashboard, and a series of local safety measures, all built on current regional data rather than the state's delayed reporting cycles.
San Diego County, with a larger population, more jurisdictions, and injury trends of comparable severity, has both the need and the capacity to build something similar at regional scale. Today's item directs the CAO to establish a Regional E-Bike Injury Warning System to collect, aggregate, and publicly report regional e-bike injury data on an ongoing basis, and to coordinate with hospitals, trauma centers, emergency departments, community clinics, EMS providers, and law enforcement partners to build the data-sharing processes that make it possible. With injuries climbing and youth bearing the brunt of the harm, the County cannot afford to keep making policy decisions based on outdated data.
Linkage To The County Of San Diego Strategic Plan
This item supports the County of San Diego's 2026-2031 Strategic Plan by advancing the goals of protecting community health, safety, and quality of life. Directing the CAO to establish a Regional E-Bike Injury Warning System that aligns with the Strategic Plan's commitment to evidence-based policymaking, equitable public health, and a safe and thriving region for all residents.
Respectfully submitted,
Terra Lawson-Remer Paloma Aguirre
Supervisor, Third District Supervisor, First District
Attachment(s)
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