Bicycle helmet laws for kids effective but not yet the norm

June 17, 2009 Volume 6 Issue 4
  • 1 in 4 children age 4-17 never wear a helmet when riding a bicycle.
  • Nearly 1 in 2 children from the lowest income families never wear a helmet when riding a bicycle.
  • Helmet use in places that have child bicycle helmet laws is more than twice as high as helmet use in areas without such laws.
  • Nearly 9 in 10 adults support helmet laws for children.

Every 3 days in the United States, a child is killed while riding a bicycle. In 2006, 95% of all bicyclists killed were not wearing helmets. Every day, 100 children are treated in emergency rooms for bicycle-related head injuries. Wearing a helmet reduces the risk of brain injury by about 90%.

These statistics underscore the importance of wearing helmets whenever children ride bikes, yet only 21 states have bicycle helmet laws for children. The CS Mott Children’s Hospital National Poll on Children’s Health conducted a survey earlier this year to gauge current rates of children’s helmet use, and to measure adults’ opinions about cycle helmet laws for children.

Bicycle Helmet Use

In this poll, 78% of parents report their children age 4-17 ride bicycles. Of these children,

  • 42% always wear a helmet
  • 31% sometimes wear a helmet
  • 27% never wear a helmet

Older children age 12-17 are much less likely to wear a helmet than younger children age 4-11 (Figure 1).

Children in lower-income households were much less likely to wear a helmet than their counterparts in higher-income households (Table 1).

Why Not Wear a Helmet?

Among parents who report that their children never
wear a helmet;

  • 32% believe helmets are too expensive
  • 59% say that their children do not like wearing helmets

More than half (52%) of parents whose children never wear helmets believe that bicycle helmet laws are an important way to protect children and 57% would support bicycle helmet laws.

Helmet Laws, Higher Helmet Use

Among parents whose children ride bicycles, 36% indicated they live in an area that has a state or local bicycle helmet law, 23% said there is no helmet law and 41% are unsure about bicycle helmet laws in their community.

Child bicycle helmet use in areas with bicycle helmet laws is more than twice as high as helmet use in areas without such laws (Figure 2). In fact, in areas without a bicycle helmet law, nearly one-half of children age 4-17 never wear a helmet.

Strong Support for Helmet Laws

Overall, there is very strong support for helmet laws. Among all adults in the US, 86% favor bicycle helmet laws for children.

Support for helmet laws differs substantially, however, by whether adults report the presence of laws where they live. Adults who report that there is a helmet law for children in their state or locality show the greatest support for such laws (Figure 3).

Implications

Bicycle helmets save lives and reduce the severity of head injuries related to bicycle accidents. Based on findings from this poll, rates of children’s helmet use are substantially higher when parents know that helmet laws are present than when there are no laws present.

We expect that broader implementation of state laws for helmet use would substantially reduce the number of deaths and serious injuries from bicycle accidents in the US—likely protecting hundreds to thousands of children per year. A substantial majority of respondents to this poll say that they support bicycle helmet laws. Several states currently have pending legislation on bicycle helmet laws and as other states consider such laws, the time may be right for advocates of helmet laws to move this agenda forward.

However, it is also evident from this poll that simply passing new laws may not be sufficient to change behavior. Because cost appears to be an issue for some families, it may be necessary to implement programs to provide free bicycle helmets to lower-income children. Other strategies should target teenage riders, who often do not wear helmets.

Data Source

This report presents findings from a nationally representative household survey conducted exclusively by Knowledge Networks, Inc, for C.S. Mott Children’s Hospital via a method used in many published studies. The survey was administered in January 2009 to a randomly selected, stratified group of adults aged 18 and older (n=2,125) with and without children from the Knowledge Networks standing panel that closely resembles the U.S. population. The sample was subsequently weighted to reflect population figures from the Census Bureau. The survey completion rate was 64% among panel members contacted to participate. The margin of sampling error for this sample is plus or minus 1 to 9 percentage points. For results based on subgroups, the margin of error is higher.

C.S. Mott Children’s Hospital National Poll on Children’s Health
Director: Matthew M. Davis, MD, MAPP
Associate Director: Sarah J. Clark, MPH
Manager & Editor: Dianne C. Singer, MPH
Data Analyst: Amy T. Butchart, MPH

This Report includes research findings from the C.S. Mott Children's Hospital National Poll on Children's Health, which do not represent the opinions of the investigators or the opinions of the University of Michigan. The University of Michigan reserves all rights over this material.

This section is related to ATVs (all-terrain vehicles) and bicycles.

[Parents with child(ren) 4 -17 year of age]

1. Does your X-[insert age of oldest child] year-old child ride either of the following?

  • ATVs (all-terrain vehicles, 3 or 4 wheelers): yes/no
  • bicycle: yes/no

[If Q1= Yes to any wheeled equipment/vehicle, then Q2]

2. How often does your X-[insert age of oldest child] year-old child wear a helmet when riding? [Populate table with responses from Q1]

[List wheeled activities indicated in Q1] Always Sometimes Never
       
       

[ALL RESPONDENTS]

3. Do you ride either of the following?

  • ATVs (all-terrain vehicles, 3 or 4 wheelers): yes/no
  • bicycle: yes/no

[If Q3= Yes to any wheeled equipment/vehicle, then Q4]

4. How often do you wear a helmet when riding?
[Populate table with responses from Q3]

[List wheeled activities indicated in Q3] Always Sometimes Never
       
       

[ALL RESPONDENTS]
5. Please indicate whether or not you support the following:

Please check one box in each row

  Support Do not support
Bicycle helmet law for children    
Bicycle helmet law for adults    
ATV helmet law for children    
ATV helmet law for adults    

[ALL RESPONDENTS]
6. For each statement below, please mark one response that is closest to your opinion.

Please check one box in each row.

  Strongly Agree Agree Neutral Disagree Strongly Disagree
There is not much risk of children getting hurt when riding a bicycle without a helmet          
Bicycle helmet laws are an important way to protect children.          
There is not much risk of children getting hurt when riding an ATV without a helmet          
ATV helmet laws are an important way to protect children          
My child(ren) does not like wearing a helmet          
Helmets are too expensive          

[ALL RESPONDENTS]

7. Does your state have a bicycle helmet law for children?

  • Yes
  • No
  • Unsure

8. Does your city/town have a bicycle helmet law for children?

  • Yes
  • No
  • Unsure

All information is the sole property of the University of Michigan CS Mott Children's Hospital National Poll on Children's Health.  It can only be used if there is an acknowledgment that "The information came from, is copyright by and is owned by and belongs to the Regents of the University of Michigan and their C.S. Mott Children's Hospital National Poll on Children's Health. It cannot be republished or used in any format without prior written permission from the University."

C.S. Mott Children’s Hospital National Poll on Children’s Health
Director: Matthew M. Davis, MD, MAPP
Associate Director: Sarah J. Clark, MPH
Manager & Editor: Dianne C. Singer, MPH
Data Analyst: Amy T. Butchart, MS

Click on an image to download the full-size version

Bicycle helmet use among children
Bicycle helmet use for children age 4-17 by family household income
Bicycle helmet laws and frequency of helmet use for children age 4-17
Support for bicycle helmet laws for children by awareness of current laws