SB 192, the Proposed Helmet Mandate, Would Have a Negative Impact on Safety

The California Bicycle Coalition does not believe that mandating helmets for adults is an effective approach to making our streets safer for bicycling or protecting people who bike. We have looked at the evidence, and concluded that a mandate would actually make our streets less safe and lead to an increase in injuries. We are not anti-helmet. Our stance against the mandate has been a difficult one, as the issue ignites passions on both sides. We did not take this stance with the goal of promoting freedom, but rather with the goal of promoting public health and safety.

Helmet mandates discourage bicycling and are not effective at reducing injuries.

While no state in the U.S. has passed a bicycle helmet mandate, several municipalities have, and broader helmet mandates have been enacted in several countries, including New Zealand and Australia. Studies of these laws have found that when a helmet mandate is enforced, bicycling rates drop or stagnate. A meta-study of the available data on helmet mandates found that they provided no net benefit to health. “Before and after data,” the study reads, “show enforced helmet laws discourage cycling but produce no obvious response in percentage of head injuries… no studies have found good evidence of an injury-reducing effect in countries that have introduced bicycle helmet legislation.” A 2013 statistical analysis of large data sets from hospitals across Canada found that mandatory helmet laws in Canada had no clear effect on injury rates. (This excellent editorial on that study — reproduced on our website with permission from BMJ — helps elucidate its findings.)

Promoting bicycling is good for public health when you weigh the benefits against the risks, even when looking at non-helmeted riders.

Thinking about bicycling in terms of risk alone is the wrong way to evaluate how risky it is. Yes, there is some risk in bicycling, and a helmet can reduce the risk for many collisions. But there is much greater risk in being sedentary. Numerous studies have found that bicycling extends life. The risk-benefit ratio, often expressed as the number of deaths compared with deaths avoided, has been widely studied. A recent meta-study found a risk-benefit ratio of between 1:9 and 1:91. A peer-reviewed study of the Barcelona bike share program (in which riders typically do not wear helmets) found a risk-benefit ratio of 1:77! Non-helmeted commuter cyclists have been found to have lower mortality rates than non-cyclists. Another study looked at the overall health impacts of mandatory helmet laws and found a negative impact. This review of studies found no association between child helmet laws in the United States and reduction in head injuries in those states with such laws.

Bicycling is safer than many other everyday activities, and is getting safer in California.

Bicycling has an undeserved image of being particularly unsafe, but it is actually a safe activity when compared with other everyday activities. Per mile, a pedestrian has a 3.5 times greater chance of a fatal injury than a bicyclist.

Safety in Numbers: More People Riding Means It’s Safer for Everyone.

Many studies have shown that the more people ride bicycles, the safer the streets are for people who bike, walk, and even drive. An analysis of multiple data sets on intersections found that increases in walking and bicycling led to decreases in motor vehicles colliding with bicycle riders or pedestrians. A recent study showed that in cities with new bike share systems — New York, Washington, D.C., Minneapolis, Montreal — the number of head injuries went down even with the thousands of new, unhelmeted cyclists on the streets. After 23 million bike share trips in the U.S. (almost all of them unhelmeted), there have been no fatalities.

To Promote Bicycling, and Safer Streets, California Should Invest in Infrastructure.

Senator Liu, who proposed SB 192, has long been an ally of bicycling and walking. We hope that she will turn her attention from a helmet mandate — ineffectual at best, dangerous at worst — to promoting better bicycle infrastructure, which would really make California’s streets safer. For every $1 million invested in bicycle infrastructure, society saves $2.8 million in health care costs. A 2011 analysis of the SF Bay Area Regional Transportation Plan by the California Department of Public Health found that increasing current average daily minutes of walking and bicycling from 4.4 minutes to 22 minutes would result in 2,300 fewer deaths and 23,121 years of life saved, even after accounting for injuries and fatalities from crashes.

A Helmet Mandate Would Unfairly Impact Disadvantaged Communities.

A wide array of peer-reviewed research has documented how low-income neighborhoods and people of color are disproportionately targeted for traffic violations. For low-income people, prohibitively high penalties can become compounded and result in jail time. This punitive policy would compound these problems. And helmets are expensive for many low-income people who rely on a bicycle to get to work or school. To improve the rates of helmet wearing in low-income communities, a helmet subsidy would be a better policy.

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Sources:

No clear evidence from countries that have enforced the wearing of helmets. D L Robinson, BMJ. 2006 Mar 25; 332(7543): 722–725. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1410838/?tool=pubmed

Helmet legislation and admissions to hospital for cycling related head injuries in Canadian provinces and territories: interrupted time series analysis Dennis J, et al ” BMJ 2013. http://www.medpagetoday.com/CriticalCare/HeadTrauma/39122

Bicycling: Health Risk or Benefit? Kay Teschke, Conor C.O. Reynolds, Francis J. Ries, Brian Gouge, Meghan Winters. MARCH 2012 3(2). UBC Medical Journal. http://www.ubcmj.com/pdf/ubcmj_3_2_2012_6-11.pdf

The health risks and benefits of cycling in urban environments compared with car use: health impact assessment study. D Rojas-Rueda. BMJ 2011; 343 http://www.bmj.com/content/343/bmj.d4521

All-cause mortality associated with physical activity during leisure time, work, sports, and cycling to work. Andersen LB, Schnohr P, Schroll M, Hein HO. Arch Intern Med. 2000 Jun 12; 160(11):1621-8. http://www.ncbi.nlm.nih.gov/pubmed/10847255

The Health Impact of Mandatory Bicycle Helmet Laws De Jong, Piet. (February 24, 2010). Risk Analysis, 2012. Available at SSRN: http://ssrn.com/abstract=1368064 or http://dx.doi.org/10.2139/ssrn.1368064

Bicycle Helmets and the Law: Canadian legislation had minimal effect on serious head injuries Ben Goldacre, David Spiegelhalter. BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f3817 (Published 12 June 2013) http://www.bmj.com/content/346/bmj.f3817

Making Walking and Cycling Safer: Lessons from Europe. Pucher, J Dijkstra, L. Transportation Quarterly, Volume: 54, Issue Number: 3 http://trid.trb.org/view.aspx?id=658932

Children’s cycling participation, injuries, fatalities and helmet legislation in the United States. Gillham C, Rissel C., Volume 21.1 January 2015,  World Transport Policy and Practice. http://www.eco-logica.co.uk/pdf/wtpp21.1.pdf

TRAFFIC SAFETY FACTS 2012 Data. US Dept of Transportation. National Highway Traffic Safety Administration. http://www-nrd.nhtsa.dot.gov/Pubs/812018.pdf

Safety in numbers: more walkers and bicyclists, safer walking and bicycling. P L Jacobsen. Injury Prevention 2003;9:205–209 https://www.calbike.org/wp-content/uploads/Jacobsen-safetyin-numbers-Inj-Prev.pdf

Cities With Bike Shares Have Fewer Bike-Related Injuries Overall Mary Beth Griggs, June 17, 2014 http://www.smithsonianmag.com/smart-news/head-injuries-rise-cities-bike-sharing-180951743/?no-ist

Costs and benefits of bicycling investments in Portland, Oregon. Gotschi, T. (2011). Journal of Physical Activity and Health, 8(1), S49­S58. http://www.ncbi.nlm.nih.gov/pubmed/21350262

Cycling in the Netherlands Mobycon / Fietsberaad / Ligtermoet & Partners, Ministerie van Verkeer en Waterstaat. Ministry of Transport and Fieretsbaad. 2009 http://www.fietsberaad.nl/index.cfm?lang=en&repository=cycling+in+the+netherlands

2010-2012 California Household Travel Survey Final Report. California Department of Transportation, June 2013. http://www.dot.ca.gov/hq/tsip/FinalReport.pdf

California Highway Patrol Statewide Integrated Traffic Records System http://iswitrs.chp.ca.gov/Reports/jsp/userLogin.jsp

CNET Sci-Tech, “Brain Surgeon: there’s no point in wearing helmets”, article by Chris Matyszczyk, April 2014.

TedX Copenhagen, “Why We Shouldn’t Bike with a Helmet,” by Mikael Colville-Andersen, Youtube video