Monday, November 28, 2011

Bicycle Helmets are for Everyone (Marin IJ)

Some time ago, I received a call from a friend of mine named Ecke. A retired Ross Valley Fire Captain, Ecke was wondering if he’d seen me biking down Butterfield Road earlier that day. Why yes, I said, that was me. “I couldn’t help but notice,” he rejoined, “that you weren’t wearing a bicycle helmet.” He was absolutely right, I hadn’t been. “Here you are,” Ecke continued, “talking big in the paper about safety and stuff and really you’re just a phoney-baloney.”

Thankfully, Ecke is just about the most good-natured guy I know, and he was just poking fun at me. But nonetheless, I felt a wee bit ashamed. Because I do know better; head injuries are by far the leading cause of death and disability among cyclists and helmets have repeatedly been proven a powerful preventive device. For example, a 1991 study from the U.C. Berkeley Institute of Transportation Studies found that out of 1,430 bicycle-related head injuries, 1,216 (85 percent) could have been prevented or mitigated by helmet use, with a potential savings (in hospital charges alone) of $16.7 million. Because of evidence like this, the state of California mandated helmet use for children under the age of 18 back in 1993. Similarly convinced of helmets’ worth, the city of Berkeley recently gave away nearly 1,500 of them.

The helmet give-away (which ended last month) was paired with instruction on safe biking practice and was part of a year-long injury prevention program sponsored by the City of Berkeley and the California Office of Traffic Safety. Kate Clayton, MPH, Chief of the Health Promotion Section for Berkeley Public Health, explains; “Recognizing that helmets are an important strategy for reducing morbidity and mortality when collisions do occur,” she said, the program “focused on youth and their families in low-income neighborhoods with relatively poorer health outcomes compared to the rest of the city.”

This seems like a noble endeavor, but can giveaway programs really make much of a difference in helmet compliance? Two decades ago, a seminal study in Seattle demonstrated that the barriers to bike helmet use go beyond cost and include knowledge and perception. In the Seattle area (and elsewhere as well, I’m sure), a significant factor behind children’s failure to don helmets was their concern that “wearing a helmet would result in their being viewed as ‘nerds.’” Thus, if helmet use is to be encouraged (without the strong arm of the law) a multi-pronged approach – one that includes education and culture change – offers the best chance at lasting success. This observation was borne out by a meta-analysis (a study reviewing multiple prior studies) published in Injury Prevention in 2006. The authors re-analyzed data from multiple publications on the topic of encouraging bike helmet use without legal interventions, and reported that the most effective tactics were community-based efforts to give away free (rather than subsidized) helmets.

Promising, but what about also giving helmets an image makeover – re-inventing them to exude style and fashion? Impossible? Probably. But there are brands that are bravely trying to market the hipster helmet. Yakkay, ( for example, uses the tagline “brainwear for smart people” and makes helmets that look like hats with chin strap accessories.  And while they don’t carry a 49ers lid, and their style is not quite Supra-esque, the checkered Cambridge design does make a certain statement.

Fortunately, even though most helmets remain style-deficient, here in Marin a large percentage of our cyclist population is cool with wearing them. In fact, on weekends, the streets of Fairfax (where I live) are practically teeming with helmeted cyclists. Yet, there is still room for improvement. Some people who reflexively click their seatbelts every time they get in the car somehow have a blind spot for head protection. For example, I routinely see parents biking down busy streets to school with their kids, and the child is wearing a helmet, while mom and/or dad is not. I’ve obviously been guilty of something like this too. Sometimes we forget (that’s my excuse!), sometimes items are misplaced, and sometimes we just don’t think there is much of a risk. But, parents need to remember three things: 1) children model their behavior, 2) biking without a helmet is indeed taking a significant risk, and 3) a traumatic brain injury is an awful thing to have.

My friend Ecke has a favorite saying: “Yesterday’s history, tomorrow’s a mystery, today’s a gift. That’s why they call it the present.” If you think it’s no big deal to forego your helmet when biking, remember today IS a gift, protect it. Use a helmet to safeguard your head and your reputation.