Across the country, parents are expressing a mix of enthusiasm, contrition and uncertainty about the trendy mode of transportation.With e-bikes soaring in popularity, regulators have been unable to keep up with the quickly-evolving market. Safety and law enforcement officials note that many models marketed to children and teenagers exceed legal speed limits and more closely resemble motor vehicles, which require a license and registration to operate.For the moment, the power to decide what teenagers may or may not ride falls to a nongovernmental authority: parents. Across the country, they are expressing a mix of enthusiasm, contrition and uncertainty about the trendy mode of transportation.Some parents who initially embraced e-bikes now say their enthusiasm has waned with news of recent crashes involving teenagers.“Initially, it was a godsend,” said Julie Wood, whose daughter Sawyer, 14, got an e-bike this past spring. “She’s a teen — she wants to go everywhere.”For Ms. Wood of Boulder, Colo., that meant less time carting Sawyer in the car. But she had a firm rule that Sawyer wear a helmet.In early August, Sawyer crashed while riding her e-bike without a helmet. She did not tell her mother, fearing disciplinary repercussions, even though she was experiencing headaches and nausea and did not want to get out of bed. Several days after the crash, she had a seizure and underwent emergency brain surgery for a skull fracture and a brain bleed; she is expected to recover.Her mother is now rethinking how society should handle the technology. “These kids don’t have driver’s licenses,” Ms. Wood said. “As much as you want to believe they are riding a bike, it’s just different. They go really fast.”After news of Sawyer’s accident spread around town, Scott Weiss, a Boulder resident and parent of two teenagers, decided to sell the family’s two e-bikes. “I want to keep you alive as long as possible,” he told his 14-year-old daughter. He said he would sell the e-bikes only to someone “college-age” or older: “I don’t want to sell it to someone who is not prepared to make the mental judgments you have to make.”The questions around e-bikes fit squarely into a modern theme in which powerful technologies, like mobile phones and vape pens, enter the market and are sold directly to consumers, without much research available on the impact on behavior and safety.In the case of e-bikes, some models can be reprogrammed to exceed the 20-mile-per-hour speed limit permitted for riders under 16; they therefore fall into the category of motor vehicles. The federal government has not yet figured out how best to regulate them.A Super73 Z-series bike parked in Newport Beach.Alisha Jucevic for The New York TimesThat is just fine with some parents who say that the decision about whether to let a child ride an e-bike should be made by an individual family and be based on whether a teenager is able to handle the roads and speeds.“I know my son and I know his athletic ability,” said one Southern California mother, who asked that her name not be used because she felt that her views might draw criticism. Her son has two e-bikes, a Super73 he got for his 13th birthday and a Talaria he got for his 14th birthday. “He lives on two wheels,” his mother said, adding that the e-bikes were a source of fun for him.The teenager has modified each of the bikes to go faster than he is legally allowed to ride them; in fact, the Talaria can hit 70 miles per hour. His mother gave him her blessing, she said, and even helped him clip a wire that removes the speed “governor” that ordinarily limits the vehicle to 20 miles per hour.She posited that the companies designed the bikes to allow the speed caps to be removed. “They want you to be in charge of doing it,” she said, “because they don’t want to be held liable producing a bike that goes 55 miles per hour where a kid goes straight into the concrete.”Gari Hewitt, a nurse in the area and a friend of the mother’s, expressed more caution about e-bikes. Not long ago, she saw a 12-year-old boy lying unconscious in the street. He had been riding a Super73 when he hit a rock and “flew over the handlebars,” said Ms. Hewitt, who works as a nurse in a pediatric trauma unit. She checked out the boy before he was sent to the hospital; she later learned that he had a punctured lung, among other injuries.Ms. Hewitt has two teenagers of her own, a 15-year-old girl and a 14-year-old boy. Each received an e-bike for Christmas. “When they’re this age, how do you wow them?” Ms. Hewitt asked. “We only have a couple of years left to wow them.”The e-bikes came with rules: Always wear a helmet, don’t exceed 20 miles an hour, never ride at night. The hospital where she works considers any crash at speeds of 20 miles per hour or greater to be “a trauma activation,” she said.“But you could hurt yourself on a bike, too,” she said. “Everything comes with responsibility.”

The NewsOne-year-olds exposed to more than four hours of screen time a day experienced developmental delays in communication and problem-solving skills at ages 2 and 4, according to a study published today in The Journal of the American Medical Association Pediatrics.The research also found that 1-year-olds who were exposed to more screen time than their peers showed delays at age 2 in the development of fine motor and personal and social skills. But these delays appeared to dissipate by age 4.The study did not find that the screen time caused the developmental delays but, rather, found an association between babies who were exposed to more screen time and delays in their development. That pattern could well be explained by the value of face-to-face time for young children, experts said.The research also found that 1-year-olds exposed to more screen time than their peers showed delays at age 2 in the development of fine motor and personal and social skills.Kike Calvo/AlamyWhy It MattersDavid J. Lewkowicz, a developmental psychologist at the Yale Child Study Center, said that face-to-face interaction between parent and child is crucial in giving babies a rich set of information, including about how facial expressions, words, tone of voice and physical feedback all combine to convey language and meaning.“It doesn’t happen when you’re watching the screen,” he said, adding that he was not surprised by the research results.The findings, conducted by scholars in Japan, were drawn from questionnaires about development and screen time, which were given to parents of nearly 8,000 young children. In general, babies exposed to higher levels of screen time were found to be the children of first-time mothers who were younger, and with lower incomes and household education levels, and those suffering postpartum depression. (Only 4 percent of babies were reported to be exposed to screens for four or more hours a day, while 18 percent had two to less than four hours of screen time a day and a majority had less than two hours.)The study noted a “dose-response association” between screen time and developmental delays: The more screen time babies were given, the more likely they were to show developmental delays.What’s NextThe study’s authors noted that the research did not distinguish between screen time that was intended to be educational and screen time more focused on entertainment. Future studies, the researchers added, should explore that angle.Dr. Lewkowicz said that parents regularly asked him how much screen time was the right amount. His answer: “Talk to your child as much as you can, face-to-face as much as you can,” he said.To ask parents to withhold all screen time from their babies was impractical, he said: “No parent would listen to that. It just has to be in moderation. With a heavy dose of real-life social interaction.”

The NewsBinge drinking among adults aged 35 to 50 occurred at record prevalence in 2022, according to research funded by the National Institutes of Health. A new study found that nearly 30 percent of people in this age group reported binge drinking in 2022, continuing a consistent upward trend in the behavior. In 2012, 23 percent of such adults reported binge drinking.Use of marijuana in this group also reached historical levels, with 28 percent reporting the behavior, up from 13 percent in 2012. In 2022, 4 percent of adults in this group reported using a hallucinogen, double the figure in 2021.The survey also looked at behavior among adults 19 to 30 years old. For this group, use of marijuana in 2022 was significantly greater, at 44 percent, up from 28 percent in 2012. But their self-reported binge drinking had fallen to 30.5 percent, down from 35.2 percent a decade earlier.A recent study found that alcohol-related deaths among women are rising at a faster rate than among men.Damian Dovarganes/Associated PressWhy It Matters: Alcohol-related deaths have risen among people 65 and older.Different generations use different drugs and at different levels. “Drug use trends evolve over decades and across development, from adolescent to adulthood,” said Megan Patrick, a research professor at the University of Michigan and principal investigator on the study, known as Monitoring the Future.The research has been supported since 1975 by the National Institutes of Drug Abuse, or NIDA, which is a part of the N.I.H. NIDA typically draws attention for its study of behavior and drug use patterns among young people in middle and high school. But the research also follows people throughout their lives, looking at the use of alcohol, marijuana, cigarettes and other substances.“It’s important to track this so that public health professionals and communities can be prepared to respond,” Dr. Patrick said.The implications of what drugs a generation tends to use can be significant. For instance, a recent study found that alcohol-related deaths continued to increase among people 65 and older, with deaths among women in this age group rising at a faster rate than among men.What’s NextThe study suggests that substance-use behavior is heavily influenced by the culture of a generation and the legal status of various drugs at various periods of life. For instance, among the adults aged 35 to 50, the 50-year-olds had tried marijuana the least — only 68 percent of them reported having used it sometime in their life. “These respondents graduated from high school in 1990, when marijuana and other drugs were at or near historical lows across the past four decades, suggesting a cohort effect,” the study noted.Nora Volkow, the director of NIDA, said in a news release that the data from this study and others like it can inform how health officials and individuals address the risks posed at different life stages. “We want to ensure that people from the earliest to the latest stages in adulthood are equipped with up-to-date knowledge to help inform decisions related to substance abuse,” Dr. Volkow said.

Americans are drinking more water. How best to contain it: That’s the burning question.Carrie Frost is well equipped for hydration. A registered nurse and a mother of two from Colorado, she estimates that her family has accumulated “upward of 25 to 30” reusable flasks at home for keeping cold drinks: flasks large and small, of various designs and colors, with a straw and without. But last month, as she sat in 90-degree heat at her son’s travel baseball tournament, she drank from a plastic water bottle that she had purchased for $3 at a local grocery store.“Convenience,” she said, laughing, as she tried to piece together why, once again, she was not using one of her many beverage containers. “I guess we’re just a lazy society.”Americans are drinking a lot of water, but they are on the fence about how best to do it. More than $2 billion in reusable water bottles were sold the United States in 2022, up from around $1.5 billion in 2020, according to Greg Williamson, the president of CamelBak, which is a maker of reusable bottles.And sales of single-serving water bottles have been rising steadily, too, reaching 11.3 billion gallons in 2022, according to the most recent data from the Beverage Marketing Association, which tracks beverage sales.In other words, consumers are spending billions of dollars a year on reusable bottles to stay hydrated and then buying bottled water anyway, even as faucet water remains free.“Faucet?” said Jason Taylor from Georgia, whose son was playing the same Birmingham baseball tournament. “Faucet? I haven’t drunk from the faucet since I was 18.” He had heard stories about tainted water, like in Flint, Mich., and did not trust the faucet water at the hotel, he said, so he filled his reusable flask with ice from the hotel and poured bottled water over it. The hotel ice he trusted; the faucet water there, not so much.Beverage consumption is in a fluid period. Americans are moving away from empty sugar calories but are still hooked on the convenience of a chilled plastic bottle from the corner-store fridge. So we are amassing containers, single-use and reusable, in kitchen cabinets and landfills alike.Sales of reusable water bottles “are absolutely skyrocketing,” said Jessica Heiges, a sustainability consultant based in Berkeley, Calif., where she recently completed a Ph.D. in the creation of waste-free systems. But, she added, people who fill their reusable flasks with water from a bottle have not fully embraced the environmental proposition.“They are not all the way there or are not fully convinced,” Dr. Heiges said. And, she noted, reusable water bottles take resources to make, so having too many isn’t great for the environment, either. “You can find them at every Goodwill and Salvation Army. People are overflowing with them.”Hydro Flask, one of many popular brands on which stores are instituting a “limit one per customer” rule.AlamyAlaina Waldrop, in Birmingham, has around 20 water bottles, as precious to her as purses, she said: “You have a decent water bottle and you get sick of it, or you’re used to seeing it all the time, and find a new one that’s pretty or it’s a new color or it holds more water or fits in a cup holder better.”Ms. Waldrop, 20, works at Dick’s Sporting Goods, about a mile from Birmingham’s baseball fields. The store has multiple displays of reusable flasks, featuring major brands like Yeti and Hydro Flask. A display of Stanley flasks ($45 each) came with a sign: limit four per customer. “They’re so popular,” Ms. Waldrop said. “I bought one for my mom and one for my sister. We’re all water-bottle freaks. We all have this obsession. I wish it made more sense but it doesn’t.”She tends to fill her bottles at home with filtered water but doesn’t trust faucets on the go, so she buys single-serving bottles at the gas station or convenience store and pours that water into her reusable container. “I drink whatever is in the plastic and then I throw the plastic away,” she said with a laugh. Why not simply drink all the water from the plastic bottle she just purchased? “It doesn’t stay cold for as long,” she said.In practice, there may be little difference in quality or safety between bottled water and tap water, said Ronnie Levin, an instructor and expert in American public drinking water at the Harvard T. H. Chan School of Public Health. “It’s often just some random tap filling those water bottles,” Ms. Levin said. “Monitoring of bottled water is somewhere between zero and not routine.”When putting bottled water in the flask, “you’re not necessarily getting anything better, except that you’re now polluting the environment.”In the baking heat at the baseball fields, a line had formed at a snack shack that sold water for $3 and charged $2 for ice in a Styrofoam cup. Steps away was a refillable filtered-water tap that was used by some people but had no line. Maybe that’s because the filtered tap was free.Water has become popular enough that it is often as or more expensive than soda, despite having less substance — in the form of sugar — to offer. At a handful of nearby convenience stores, the prices of water and soda were neck and neck; at Walgreens, bottles of Dr Pepper and other sodas sold at $4 for two, as did bottles of Dasani and Aquafina water.Michael Bellas, the chairman and chief executive of the Beverage Marketing Company, said that bottled water remained far less expensive if purchased in bulk, at Costco, say, or the supermarket. But prices rise sharply for single-serving bottles when the retailer has a thirsty audience on the go, he noted.“The airports just soak you,” Mr. Bellas said.At the Hudson store at the Birmingham airport, 20-ounce bottles of Dasani water and Smartwater (both owned by the Coca-Cola Company) cost $4.29 with tax, while all the 20-ounce sodas (Coca-Cola, Diet Coke, Sprite) cost $4.09.“Everyone has to hydrate, and people think it makes their skin look nice,” Kim Shoemaker, a Hudson employee, said of water. “No sugar, no chemicals, no additives.” Ms. Shoemaker, 60, said she bought cases of water at Costco and kept single-serving bottles in every room of her home, but also owned many reusable flasks. “Oh, my gosh, probably about six,” she said. “I don’t use them. I don’t know why.”Just outside the Hudson store was a water dispenser for reusable containers, its water filtered and free of charge and mostly going unused.Out at the baseball fields, Ms. Frost, who had traveled from Colorado for the tournament, said she had family members who didn’t understand why a person would spend on a reusable water container and single-serving water bottles and not just fill a cup from the tap.“Ask my husband,” she offered. “He thinks it’s the stupidest thing in the world.”To which her husband, Spencer Frost, gruffly added: “Just drink from the hose.”

With a throttle and no pedals, Super73’s new “electric balance bike” blurs the lines of regulation and safety. “No license, registration or insurance required,” its marketing promises.LeGrand Crewse, co-founder and chief executive of Super73, recently showed off the company’s latest product, a diminutive motorized bike called the K1D. Aimed at riders 4 years old and up, the vehicle lacks pedals, in the spirit of a training bicycle, and has a throttle. The company calls the K1D an “electric balance bike.”“But you can also call it a motorcycle,” Mr. Crewse said during a tour of the company’s 60,000-square-foot headquarters. In “normal mode” the K1D can go 13 miles per hour. “Then we have a race mode,” Mr. Crewse said — at 15 miles per hour.The e-bike industry is already pushing the boundaries of youth transportation, and Super73 is an early darling among customers. The company aims to sell more than 25,000 units this year, a significant portion of them for teens, Mr. Crewse said. Unlike the K1D, most Super73 e-bikes come with pedals as well as a throttle-powered electric motor. What the company is selling, Mr. Crewse said, is a lifestyle, featuring “cool” products that are not subject to heavy regulation.“Ride without restrictions,” the Super73 website declares, in bold letters. “No license, registration, or insurance required.”Mr. Crewse added: “Actually no helmet requirement even, except for one class of bikes — and even then, specifically around younger age riders.”State and federal laws essentially treat e-bikes as traditional bicycles so long as they don’t exceed speed limitations — although many e-bikes can easily be altered to do so. This laissez-faire oversight, Mr. Crewse said, “dovetails perfectly” with the ethos of the younger generation.“If you think of Gen Z and millennials, if they can’t have instant gratification, they want nothing to do with it,” he said. “They’re not interested in taking time to learn something: ‘I’m not going to get my motorcycle license, I don’t want to go through this course that takes X-amount of hours — it’s too much of a hassle.’”One of the recently released K1D bikes, in pink, on display with the adult models at Super73’s showroom in Irvine, Calif.Alisha Jucevic for The New York TimesSuper73-themed collages, featuring mountain peaks, a disco ball and young people on e-bikes, decorate bathroom stalls at the company’s service center.Alisha Jucevic for The New York TimesBut law-enforcement officials and some safety experts worry that many e-bikes are dangerously unlike traditional bicycles: too fast for sidewalks and not built for the complexity and speed of roads. Some retailers decline to carry Super73 e-bikes or others like them, contending that they tempt young riders, untrained in road safety, to think they are safe mingling with high-speed auto traffic. Several children in their teens have died recently in e-bike accidents. Some e-bikes can travel at speeds that may qualify them as motor vehicles, but federal regulation has not kept up.“There is pressure from the market to sell novel and interesting things that are faster and more fun,” said Christopher Cherry, a civil engineer at the University of Tennessee, Knoxville, who studies e-bike safety.Mr. Crewse entered the nascent e-bike industry more than a decade ago, when he began tinkering with ways to add motors to bicycles. In 2012 he toured China as a wide-eyed entrepreneur. “I booked a trip with no plans,” he recalled. “In that two-week period, I wound up meeting a whole bunch of people, went to a whole bunch of factories — relationships I still have today.”In 2016 he co-founded Super73 with Michael Cannavo and Aaron Wong, with the aim of selling more stylish e-bikes that were not “for the geriatric crowd,” Mr. Crewse said; the typical Super73 model resembles a dirt bike or a minimotorcycle with pedals. “I read somewhere that something like 98 percent of people think they’ll look cool on a motorcycle,” he said. “We bring moto-heritage with youth culture.”A beachgoer rides a Super73 Z-series bike in Newport Beach, Calif.Alisha Jucevic for The New York TimesThe company’s 60,000-square-foot headquarters in Irvine, Calif.Alisha Jucevic for The New York TimesMany retailers initially would not carry the company’s first mass-produced Super73, introduced in 2017. “‘This is not a bike, this is not a bicycle,’” Mr. Crewse recalled being told by retailers. “We got laughed out of every place.”PeopleForBikes, the trade group that represents traditional biking companies and e-bike manufacturers, has taken issue with Super73 and other manufacturers that sell products that can be reprogrammed to effectively become motor vehicles and not e-bikes at all.Most of Super73’s models offer a re-programmable option, including the Z-Miami, which is small, comes in pink and, Mr. Crewse said, is “popular with younger riders.” Parental controls were not possible on existing models, he said, because of “a limitation of the current software.” He added, “That will absolutely happen in future software releases.”He floated the prospect of e-bike training for young riders. “The motorcycle training program I took has literally saved my life,” he said. But he noted that requiring e-bike training could harm an industry that he credited with creating more sustainable transportation. “The question is, how much do we want to force,” he said.A father of five, Mr. Crewse advised parents who buy an e-bike to invest in a high-quality helmet and other safety equipment. “The biggest thing is understanding the risk of a vehicle going 20 miles per hour,” he said. “There are consequences. Things can go wrong.”

The e-bike industry is booming, but many vehicles are not legal for teenagers, and accidents are on the rise.On a Thursday evening in late June, Clarissa Champlain learned that her 15-year-old son Brodee had been in a terrible crash, the latest teen victim of an e-bike accident.He had been riding from home to shot-putting practice. The e-bike, a model made by Rad Power, had a top speed of 20 miles per hour, but his route took him on a busy road with a 55-mile-per-hour limit. While turning left, he was clipped by a Nissan van and thrown violently.Ms. Champlain rushed to the hospital and was taken to Brodee’s room. She could see the marks left by the chin strap of his bike helmet. “I went to grab his head and kiss him,” she recalled. “But there was no back of his head. It wasn’t the skull, it was just mush.”Three days later, another teenage boy was taken to the same hospital after the e-bike he was riding collided with a car, leaving him sprawled beneath a BMW, hurt but alive. In the days following, the town of Encinitas, where both incidents occurred, declared a state of emergency for e-bike safety.The e-bike industry is booming, but the summer of 2023 has brought sharp questions about how safe e-bikes are, especially for teenagers. Many e-bikes can exceed the 20-mile-per-hour speed limit that is legal for teenagers in most states; some can go 70 miles an hour. But even when ridden at legal speeds, there are risks, especially for young, inexperienced riders merging into traffic with cars.“The speed they are going is too fast for sidewalks, but it’s too slow to be in traffic,” said Jeremy Collis, a sergeant at the North Coastal Station of the San Diego County Sheriff’s Office, which is investigating Brodee’s accident.To some policymakers and law enforcement officials, the technology has far outpaced existing laws, regulations and safety guidelines. Police and industry officials charge that some companies appear to knowingly sell products that can easily evade speed limits and endanger young riders.“It’s not like a bicycle,” Sergeant Collis said. “But the laws are treating it like any bicycle.”Two federal agencies, the Consumer Product Safety Commission, and the National Highway Traffic Safety Administration, said they were evaluating “how best to oversee the safety of e-bikes,” according to a statement provided by the highway safety agency.Brodee’s parents, Clarissa Champlain and Troy Kingman, with their daughter, Violet Champlain Kingman.Ariana Drehsler for The New York TimesMedals that Brodee earned for math, chess and an egg-drop contest; his bedroom; messages written to Brodee at a recent candlelight vigil on display in Ms. Champlain’s home.Ariana Drehsler for The New York TimesCommunities have begun to alert their residents to the dangers of e-bikes. In June, the police department in Bend, Ore., ran a public service campaign acquainting the public with the e-bike laws that were frequently being broken there. Days later, a 15-year-old boy was killed when the e-bike he was riding was struck by a van.Sheila Miller, who is the spokeswoman for the Bend police and helped develop the public service campaign, emphasized that not everything that calls itself an e-bike qualifies as one, or is safe or legal for minors. Under Oregon law, which is more restrictive than those in most states, a person must be at least 16 to ride an e-bike of any kind.“Parents, please don’t buy these bikes for kids when they are not legally allowed to ride them,” Ms. Miller said. “And if you own an e-bike, make sure that everyone who is using them knows the rules of the road.”Booming Industry, Modest RegulationThe typical e-bike has functioning pedals as well as a motor that is recharged with an electrical cord; the pedals and the motor can be used individually or simultaneously. Unlike a combustion engine, an electric motor can accelerate instantly, which makes e-bikes appealing to ride.E-bikes are also seen as vital in shifting the transportation system away from emission-spewing cars and the congestion they create, said Rachel Hultin, the policy and governmental affairs director for Bicycle Colorado, a nonprofit advocacy group for bicycle safety and policy. E-bikes and electric scooters are part of the so-called micromobility movement, propelling commuters and other people short distances across crowded spaces.The number of e-bikes being sold is unclear because, like regular bikes, they do not need to be registered with the government. (Cars, motorcycles and mopeds must be registered through a state’s Department of Motor Vehicles.) Many are sold directly to consumers over the internet, rather than through physical retailers that often track sales. John MacArthur, an e-bike industry expert with the Transportation Research and Education Center at Portland State University, estimated that roughly one million e-bikes would be sold in the United States this year.Ashely Kingsley and her daughter, Scout, at Charlie’s Electric Bike store in Encinitas, where they were renting e-bikes for the day.Ariana Drehsler for The New York TimesLeGrand Crewse, a co-founder and the chief executive of Super73.Alisha Jucevic for The New York TimesThe minimal regulation around e-bikes is a selling point for the industry. Super73, a company in Irvine, Calif., that makes popular models, advertises on its website: “RIDE WITHOUT RESTRICTIONS. No license, registration, or insurance required.”“It’s one of the very unique categories of vehicle that there really isn’t any kind of onerous regulation,” a company co-founder, LeGrand Crewse, said in an interview, noting that helmet requirements were also modest, depending on the state and the rider’s age.Law enforcement officials have begun to express concerns about the minimal training required of teenage e-bike owners, and about their behavior. Car drivers ages 16 to 19 are three times as likely to be killed in a crash as drivers 20 or older, and bicyclists ages 10 to 24 have the highest rate of emergency room visits for crashes, according to the Centers for Disease Control and Prevention. Some states have begun to raise the training requirements for young drivers, including adding graduated license programs that require extended hours of supervised driving, limit night driving or restrict the number or age of passengers.The California Legislature is considering a bill that would prohibit e-bike use by people under 12 and “state the intent of the Legislature to create an e-bike license program with an online written test and a state-issued photo identification for those persons without a valid driver’s license.”“I know the e-bike situation is evolving,” said Sergeant Collis of the San Diego County Sheriff’s Office. “But personally, with all these bikes, you should have at least a permit or a license to ride them at the speed they’re going.”As a transportation solution, e-bikes seem promising. “I’m really bullish about middle and high schoolers being able to use e-bikes,” said Ms. Hultin of Bicycle Colorado. She noted that e-bikes offered children and busy families more transportation options at lower cost. But she worried that the vehicles could lead to an unsafe mix of untrained e-cyclists and unaware car drivers.That problem, Ms. Hultin said, was exacerbated by “an algae bloom of noncompliant e-bikes.” She was referring to products on the market that call themselves e-bikes but are not, either because they can go faster than allowed by law or because, once purchased, they can be modified to do so.An e-bike shop in Encinitas.Ariana Drehsler for The New York TimesAn intersection near the site of Brodee’s accident.Ariana Drehsler for The New York TimesOne vehicle that has drawn attention for its speed is made by Sur-Ron, whose products have been involved in several recent deaths. In June in Cardiff, Wales, two boys on a Sur-ron bike died in a crash while being followed by the police; days earlier, a boy riding a Sur-ron in Greater Manchester had died after colliding with an ambulance.In its marketing materials, Sur-ron describes one model, the Light Bee Electric Bike, as “easy to maneuver like a bicycle, with the torque and power of an off-road motorcycle.” Its operating manual cautions the owner to “please follow the traffic rules and with the safe speed (the top speed for this electric vehicle is 20 km/h).”But the speed restraint — equivalent to about 12 m.p.h. — can be removed by simply clipping a wire, a procedure that is widely shared in online videos, and which law enforcement officials said appeared to be there by design.“There are all kinds of videos on how to jailbreak your Sur-ron,” said Capt. Christopher McDonald of the Sheriff’s Department in Orange County, Calif., where e-bike accidents and injuries are rising. With the speed wire clipped, the vehicle can approach 70 miles per hour, he said. Several requests for comment were sent through the Sur-ron website but did not receive a response.Matt Moore, the general counsel for PeopleForBikes, the main trade group for bicycles and e-bikes, said he worried about products like Sur-ron’s. “Some products are sold as ostensibly compliant but are easily modified by the user with the knowledge and presumably the blessing of the manufacturer,” he said. “Unfortunately, there appears to be a lack of resources at the federal level to investigate and address e-mobility products that may actually be motor vehicles.”Tragedy in EncinitasA memorial for Brodee in Ms. Champlain’s kitchen.Ariana Drehsler for The New York TimesThe day after Brodee entered the hospital, his family sat at his bedside. They played his favorite music, including Kendrick Lamar and early Wu-Tang Clan. “I read to him for hours,” his mother said. “We wanted to wake up his brain.”Three days later, as Brodee clung to life, Niko Sougias, the owner of Charlie’s Electric Bike, a popular e-bike shop in town, was driving in Encinitas on Highway 101 when he saw two teenage boys riding Sur-Rons in the opposite direction.“They were doing wheelies,” Mr. Sougias said. He has grown concerned about the e-bike industry, he said, and does not sell many models that are popular with teenagers.His route that Saturday followed the path of the boys on the Sur-rons. Moments later, after a turn, Mr. Sougias saw that one of the Sur-Ron riders had collided with an S.U.V., had been thrown from his bike and was under a BMW.According to the police, the Sur-ron rider had been seen driving recklessly and was found at fault. “He was lucky to escape with his life,” Mr. Sougias said.Ms. Champlain was at the hospital with Brodee when the boy who had been riding the Sur-ron was brought in. Paramedics stopped by Brodee’s room to check in. “I can’t believe I’m here again for this,” she said one of them had told her; the same paramedic had brought in Brodee by ambulance.Hours later, Brodee was pronounced dead. He was a beloved young man with a bright future ahead of him. He was fluent in Spanish and had a college-level knowledge of Japanese; he could dead-lift 300 pounds and, in 2020, was named student of the year at his high school. “I had so many people call me to tell me they’d lost their best friend,” his mother said.Ms. Champlain said witnesses had told her that her son “did everything right,” including signaling to make a left turn.“There should be more education for drivers with the change that’s happened,” she said. “I’d never seen an e-bike on the road until three years ago. Now I see hundreds.”“They’re treated like bicycles when they’re not. They’re not equal.”

Surprisingly tricky questions about an increasingly popular vehicle.E-bikes are increasingly visible on roads and bicycle paths, with a growing number of teenagers among the riders. But the recent deaths of several teenage riders has raised concerns about the safety of some types of vehicles, and about whether they legally qualify as e-bikes. Here’s what’s known about e-bikes and their risks.What Is an E-Bike?The Consumer Product Safety Commission, the federal agency responsible for regulating the safety and sale of low-speed electric bicycles, defines an e-bike as a two- or three-wheel vehicle that has pedals and an electric motor.The motor must be rated below 750 watts, which is roughly twice the power that a professional cyclist can generate. The rider can use the pedals or the motor, singly or in combination. With the motor alone, the bike must not be capable of going faster than 20 miles an hour on a level surface. State laws govern where e-bikes can be ridden, the minimum age for riders and other rules about how the vehicles are used.To meet the federal regulations, bicycle manufacturers have developed a three-tier classification system for e-bikes.Class 1: Maximum speed, 20 m.p.h.; the motor may provide power only while the rider is pedaling. (This is known as “pedal assist.”) Age restrictions: None in most states, although some states, such as Oregon, do not permit the use of any class of e-bike by riders younger than 16.Class 2: Maximum speed, 20 m.p.h.; the motor may provide power independently of the pedals. Age restrictions: none in most states. (These e-bikes in particular attract criticism because, by relying solely on the motor, they can achieve immediate bursts of speed.)Class 3: Maximum speed, 28 m.p.h. — but only if the pedals and the motor are used simultaneously. These vehicles are intended for commuters and other riders who are interested in traveling farther than a traditional bicycle would easily allow. Use not permitted by riders younger than 16, in many states.Notably, the federal consumer agency does not recognize the three-class system.What Are the State Rules?According to PeopleForBikes, the trade group that helped craft the three-class system for manufacturers, 42 states have laws that are largely in line with the classification system. In most states, then, riders under 16 can use Class 1 and Class 2 e-bikes, while riders of Class 3 e-bikes must be 16 or older.But enforcing those rules is tricky, according to local and state law enforcement officials. It can be hard to tell by looking if a teenage rider is too young for the e-bike being ridden. And glancing at an e-bike’s motor does not establish whether it can go faster than 20 m.p.h.That has led some jurisdictions, such as Bend, Ore., to design public service campaigns alerting riders and parents to the laws. In Orange County, Calif., officials have impounded some models, like the Sur-ron, that the county considers to be unlicensed and unregistered electric motorcycles.In most states, riders under 16 can ride e-bikes up to 20 miles per hour, while riders on faster e-bikes must be 16 or older.Alisha Jucevic for The New York TimesWhy Is 20 M.P.H. Meaningful?The origins of that parameter are unclear, safety experts said, but it appears to have emerged from legislative wrangling as a way to balance the risks posed by increased speed.“That’s the point at which Congress, the Consumer Product Safety Commission and the Department of Transportation decided the break was between a consumer product and a motor vehicle,” said Chris Cherry, a professor of civil engineering at University of Tennessee who advises the federal government on e-bike safety.By various measures, the risks of serious injury and death rise sharply at around 20 m.p.h., although much of that research involved collisions between cars and pedestrians. For instance, the risk of severe injury to a pedestrian is 25 percent when the car is moving at 16 m.p.h., and it rises to 50 percent at 23 m.p.h., according to the AAA Foundation for Traffic Safety. The risk of fatal injury follows a similar curve. But e-bikes are new, so there is much less data on the relationship between speed and injury risk.Mr. Cherry said that the 28-m.p.h. limit appears to be derived from an effort to match the European standard of 45 kilometers per hour so that e-bike manufacturers could serve both markets.But Don’t Many E-Bikes Go Faster Than 20 M.P.H.?Yes.E-bikes are allowed to go faster than 20 m.p.h., and up to 28 in the case of a Class 3 bike, if the rider is pedaling while also using the motor.But those limitations can, in many cases, be bypassed with little effort. For instance, some e-bikes are sold with speed “governors” that restrict the speed at the point of sale to 20 m.p.h. But that electronic governor can be eliminated by cutting a wire or changing the limitation with a smartphone app. Unrestricted, some models can exceed 55 m.p.h. Law enforcement officials and industry experts have said that e-bike manufacturers who sell these products are aware that the speed governors are regularly removed.“Some products are sold as ostensibly compliant but are easily modified by the user with the knowledge and presumably the blessing of the manufacturer,” said Matt Moore, the general counsel for PeopleForBikes, the trade organization that represents bicycle and e-bike manufacturers. “The real question is what to do about it.”What Is Being Done About This Loophole?Good question, safety experts say.“PeopleForBikes has been pointing out these issues to regulators for some time now,” Mr. Moore said. “Unfortunately, there appears to be a lack of resources at the federal level to investigate and address e-mobility products that may actually be motor vehicles.”The federal government appears not to have a clear answer as to whether some of these products have ceased to be e-bikes — which are regulated by the Consumer Product Safety Commission, or C.P.S.C. — and instead have become motor vehicles, which are regulated by the National Highway Traffic Safety Administration.A spokesperson for the federal consumer protection agency replied in an email that products that go at higher speeds “would be motor vehicles outside of C.P.S.C. jurisdiction” and added that the highway traffic agency “has jurisdiction over motor vehicles.”The highway traffic agency responded to inquiries from The Times with a written statement: “Due to emerging e-bike designs that can vary in speed capability, in how they combine motor power and pedal power, and in other design factors, NHTSA is evaluating, in conjunction, with C.P.S.C., how best to oversee the safety of e-bikes.”

The NewsMental health-related visits to emergency rooms by children, teenagers and young adults soared from 2011 to 2020, according to a report published on Monday in the Journal of the American Medical Association. The sharpest increase was for suicide-related visits, which rose fivefold. The findings indicated an “urgent” need for expanded crisis services, according to the team of researchers and physicians who published the report.The research, drawn from data from the National Hospital Ambulatory Medical Care Survey, looked at the annual number of mental health-related E.R. visits by people 6 to 24 years old. From 2011 to 2020, the figure rose from 4.8 million to 7.5 million, the team found, a period in which the overall number of pediatric E.R. visits fell. In effect, the proportion of E.R. visits for mental health-related issues roughly doubled, from 7.7 percent to 13.1 percent.The number of visits rose for many conditions, including mood and behavioral disorders, substance use and psychosis. But the increase in suicide-related issues was most pronounced, increasing to 4.2 percent of all pediatric emergency room visits in 2020 from 0.9 percent in 2011.Tim Gruber for The New York TimesWhy It MattersA growing number of children and adolescents are grappling with mental distress, but medical systems have not kept up. Insufficient treatment options and availability of preventive care is leading many families to seek help in emergency rooms, which are ill-equipped to deal with mental health-related issues. A recent New York Times investigation found that hundreds of young people sleep in emergency rooms every night, as they wait for placement in proper treatment programs.“A dedicated national commitment will be needed to address the gaps,” the JAMA paper concluded.BackgroundFor many decades, the nation’s medical infrastructure was built to serve young people dealing with infections, broken bones and other injuries suffered in accidents. Even as those issues remain, a significant shift has taken place in the nature of ailments suffered by children, teenagers and young adults. In 2019, the American Academy of Pediatrics issued a report noting that “mental health disorders have surpassed physical conditions” as the most common issues causing “impairment and limitation” among adolescents.The training of pediatricians has not kept pace, and emergency rooms are designed to triage patients, not to serve as psychiatric units, even as options for inpatient and outpatient treatment have eroded.What’s NextThe JAMA investigation describes a “critical need” to expand nonhospital treatment options, including programs in schools and more outpatient centers and urgent care clinics, with round-the-clock service. Legislators in some states and at the federal level are exploring ways to expand coverage to deal with changing risks faced by young people.

Nationwide, poor children and adolescents are participating far less in sports and fitness activities than their more affluent peers.Over the last two decades, technology companies and policymakers warned of a “digital divide” in which poor children could fall behind their more affluent peers without equal access to technology. Today, with widespread internet access and smartphone ownership, the gap has narrowed sharply.But with less fanfare a different division has appeared: Across the country, poor children and adolescents are participating far less in sports and fitness activities than more affluent youngsters are. Call it the physical divide.Data from multiple sources reveal a significant gap in sports participation by income level. A Centers for Disease Control and Prevention study found that 70 percent of children from families with incomes above about $105,000 — four times the poverty line — participated in sports in 2020. But participation was around 51 percent for families in a middle-income range, and just 31 percent for families at or below the poverty line.A 2021 study of Seattle-area students from fifth grade through high school found that less affluent youth were less likely to participate in sports than their more affluent peers. The study also found that middle schoolers from more affluent families were three times as likely to meet physical exercise guidelines as less affluent students.A combination of factors is responsible. Spending cuts and changing priorities at some public schools have curtailed physical education classes and organized sports. At the same time, privatized youth sports have become a multibillion-dollar enterprise offering new opportunities — at least for families that can afford hundreds to thousands of dollars each season for club-team fees, uniforms, equipment, travel to tournaments and private coaching.“What’s happened as sports has become privatized is that it has become the haves and have-nots,” said Jon Solomon, editorial director for the Aspen Institute Sports and Society Program.Recent Aspen Institute research found that among children from families making less than $25,000 a year, participation in a healthy level of activity fell to 26.6 percent in 2021 from 34.1 percent in 2013. For children from families with $25,000 to $50,000 in income, participation fell during that time to 35.7 percent from 38.1 percent.But among families with incomes above $100,000, participation rose in that period, to 46 percent from 43.9 percent, the Aspen Institute found.“Particularly for low-income kids, if they don’t have access to sports within the school setting, where are they going to get their physical activity?” Mr. Solomon said. “The answer is nowhere.”Schools are not always filling the gap. A recent report from the Physical Activity Alliance, a nonprofit organization, gave schools nationwide a grade of D– for physical fitness. That is a downgrade from a C– in 2014, with the new grade reflecting even less access to regular physical education classes, gym time and equipment in schools.Ann Paulls-Neal, varsity track coach at Highland High, has noticed that more affluent students, with access to club sports, “are more comfortable moving, where the students in low-income areas are not.” Adria Malcolm for The New York TimesAnn Paulls-Neal, a longtime physical education teacher and track coach in Albuquerque, has watched the trend play out. For nearly 20 years, until 2017, she taught at John Baker Elementary, which drew students largely from middle- and higher-income families (less than one-third qualified for free or reduced-price lunch). There, “all of my students did at least one sport after school,” she said. “Club soccer or pretty much club anything.”Then she moved to a school, Wherry Elementary, where 100 percent of the students qualified for free or reduced-price lunch. Students played on the playground, she said, “but we had just three kids that were playing any kind of sport outside of school.”She speculated about the reasons. Families couldn’t afford private sports or didn’t have cars or time to ferry their children to practice, she proposed, and clubs were unthinkable “if these sites or clubs don’t hold practice on a bus line.”In 2019, Ms. Paulls-Neal became the department chair of health and physical education at Highland High School, where 100 percent of students qualify for free lunch. Here, she said, she was seeing the impact of “this club and school divide.”More affluent children are often highly trained in sports — “a little bit ahead,” said Ms. Paulls-Neal, who is also the executive director of the New Mexico chapter of the Society of Health and Physical Educators, or SHAPE America. “And they are more comfortable moving, where the students in low-income areas are not.”A similar pattern is emerging in Unit District No. 5 in McLean County, Ill. Faced with budget shortfalls, the district’s board of education voted this year to make a series of cuts, including to sports. Next year all the junior high sports will be gone: boys’ and girls’ basketball, cross-country, track, boys’ wrestling and baseball, and girls’ softball and volleyball.The cuts also include freshman sports at the district’s two high schools; proposed cuts for the 2024-25 school year include junior varsity high school sports. In November, district voters rejected a proposal to raise taxes to fund those programs.Kristen Weikle, superintendent of Unit 5 District Schools in McLean County, Ill. Faced with budget shortfalls, the district’s board of education voted this year to eliminate numerous sports, including basketball, baseball and track.Mustafa Hussain for The New York Times“It’s devastating for the kids,” said Kristen Weikle, the district’s superintendent. She said that school sports promote good grades and boost physical and emotional health among students who participate.Private sports are accessible to some lower-income families, she added, but not to all. “It’s not just the cost to participate,” Ms. Weikle said. “It’s the cost to travel to competitions. It’s the time to take their child to club activities and then purchase the equipment.”To improve equity, Valentine Walker, the coach of high school boys’ and girls’ soccer in the district, started a free soccer club in 2008. At the time, his 8-year-old son was participating in baseball and soccer clubs that cost hundreds of dollars a season. Mr. Walker noticed “an influx of Jamaicans and Africans and Hispanic kids whose families could not afford pay-to-play.”Mr. Walker, who grew up in a poor family in Jamaica, saved money by borrowing school equipment and a 13-seat van from a friend for travel to tournaments and by having six or seven players share a hotel room. “I had to stick my nose under the door so I could get some fresh air,” Mr. Walker said with a laugh.Mr. Walker is now fielding the second generation of that team, at a cost of around $400 per season; families that can’t afford it don’t pay, and more affluent families and sponsors subsidize the experience.He conceded that his private team tended to take players who were more gifted or showed particular potential. But on his public high school teams he makes no cuts, because many less affluent students who lack club experience would not be able to play otherwise. In the summer, he holds open soccer workouts from 6:30 to 8:30 a.m., followed by strength training in the weight room.“This is not a policy — it’s just me,” he said. “It’s because of my desire to reduce the inequities.”Valentine Walker, coach of high school boys’ and girls’ soccer in Unit District No. 5. In 2008, he started a free soccer club for children who “could not afford pay-to-play.”Mustafa Hussain for The New York TimesAs public schools grapple with the economics of physical activity, a private youth sports industry has blossomed. Annual market revenue from team registrations, travel, apparel, equipment and other expenses grew to $28 billion in 2021 from $3.5 billion in 2010, according to WinterGreen Research, a private data company.“It started with software” that enabled teams to organize and collect money, said Susan Eustis, WinterGreen’s president. And then, she said, “schools started defunding their sports.”At first, she added, “these two things didn’t have much to do with each other.” But increasingly, entrepreneurs and private coaches used technology to market, organize and create tournaments and to serve a growing population of parents who wanted deeper experiences for their children, and whose schools were divesting from sports and gym programs.She cited cost as a barrier to lower-income children’s participation in private sports. The Aspen Institute found that families spend on average $1,188 per year per child for soccer, $1,002 for basketball, $714 for baseball and $581 for tackle football.Ms. Eustis largely champions private youth sports, which she says provide “elite” training, reduce bullying with professional coaches and start at young ages, as early as 3. Then there is the chance to travel with family as a group activity — “dynamic new travel teams that consume nights and weekends for families,” she wrote in her 2022 report. “The best and the brightest want top-notch sports training for their children.”

In an interview with The Times, Dr. Vivek Murthy ascribed the mental health challenges among young people in part to “hustle culture” values.In December 2021, Surgeon General Vivek Murthy issued a rare warning: Mental health challenges were leading to “devastating effects” among young people. His statement came as the suicide rate for young Americans ages 10 to 19 jumped by 40 percent from 2001 to 2019, while emergency room visits for self-harm rose by 88 percent.Lately, Dr. Murthy has been using his position to highlight the issue, much as Dr. C. Everett Koop, who was surgeon general in the 1980s, famously addressed the dangers associated with smoking. Dr. Murthy has been on a listening tour of sorts, speaking with students, health care workers and community groups across the countryHe recently spoke with The New York Times about the growing intensity of his focus on this issue. This conversation has been edited for clarity and brevity.You have described mental health as “the defining public health crisis of our time.” Why?I think of mental health as the fuel that allows us to show up for our communities, our friends, our family and our lives. And when that fuel tank is low, it compromises our ability to be who we can be in our best moments and to show up at work or in school.Other generations have faced mental health challenges. Is something different today?There is something that’s worse. It’s not just about greater detection; yes, there is greater willingness to talk about their mental health, and that has contributed to increased reporting. But hospitalizations have gone up, and suicides have gone up. Those are real things. Something is driving the greater pain and despair.You’ve pointed to a number of causes, including the stigma that keeps young people from seeking help and insufficient treatment resources. What other causes do you see?There are factors driving the mental health crisis that we have to address if we really want to get at the root of the problem. Those include the growing crisis of loneliness and isolation; the fact that bullying is taking place not only offline but online; the fact that our kids are surrounded by an information environment that is coming at them 24/7 and that often stokes fear and anxiety.It’s also being driven by the fact that young people, when they think about the future, see the profound threats that we are facing today, like violence and racism and climate change, but they don’t see effective solutions.By the information environment, do you mean social media?Young people, particularly in early adolescence, are at a sensitive phase of development. Their brains are developing, their relationships with others are developing, their identity and self-esteem are also developing. And right now, when I talk to young people on the road, they consistently tell me three things about social media: They say it makes them feel worse about themselves; it makes them feel worse about their friendships; and they can’t get off it.This is not surprising, in part because these platforms have been designed to maximize the amount of time people spend on them, not necessarily to maximize how well you spend that time or how supported you are in your development of healthy relationships. Not only are adolescents spending many hours on social media each day, but that is time that they are taking away from sleep, from exercise, from in-person interaction with people, from schoolwork and from other activities that may bring them joy.There’s also the experience that many people have on social media of being exposed to harmful content, and of being immersed in a culture where they are constantly comparing themselves to other peoples’ profiles and posts, which often leads them to feel worse about themselves. This is despite the fact that what you see on social media is not always an accurate reflection of what’s happening.These platforms also allow young people to connect and to explore different ideas. How do you consider the tension between information overload and freedom of exploration and expression?Life is much more complicated for people today than it was 20 years ago and certainly 100 years ago. I don’t think we should we go back 100 years. But with more choices, the anchoring values that guide you in your definition of success become all the more important. Moments like this are ones where we have to ask, What are the values that are guiding us as a society?What’s the connection between values and mental health?Values are the filter that we use to help us make decisions when we are faced with choices. But our values are also what inform what we drive toward in life.Young people tell me they feel caught up in hustle culture. What they’re saying to me was that they felt that they were being asked to chase certain objectives — getting a job with a fancy title, making a lot of money, becoming famous, acquiring power. And not only did many of them say that they were exhausted, but they weren’t sure that was going to bring them happiness. This is where we have to pause and ask ourselves: Are we pushing our kids to pursue what’s really going to lead to their happiness and their fulfillment?