Bicycling Advocacy Groups and Helmet Use

Bicycle Helmet

 

Helmets are the only piece of cycling equipment whose use is debated by cyclists and non-cyclists alike. Among cyclists there are two opposing camps. One fervently favors helmet use. The other vehemently opposes it. Among non-cyclists there are those who believe that they are somehow being imposed upon by helmet-less riders and those who see helmet use as an issue of personal freedom.

From the cyclist’s vantage point, the issue of helmets comes down to whether the individual cyclist sees value in wearing a helmet. Pro-helmet cyclists see any protection to the head as worth pursuing. Anti-helmet cyclists see the issue in terms of whether they will die without a helmet. They are often unable or unwilling to view non-life-threatening injuries as something to be avoided. It’s all or nothing for them. Anything less than death isn’t worth giving up their freedom to choose to sustain an injury.

From the non-cyclist’s vantage point, the issue is often seen as a societal one. This group often makes the argument that when a non-helmet-wearing cyclist sustains a serious brain injury, it’s society who bears the cost of their medical care. In other words, the exorbitant cost of their care is born by others in the form of increased insurance premiums or costs absorbed by the system for unpaid medical bills.

Many cyclists, and most medical professionals, recommend wearing helmets on every ride because the benefits outweigh the risks. From this position comes the view that cyclists should be required to wear helmets when riding a bike. And, that’s where the real arguing begins. People can’t agree on whether laws should be passed to mandate helmet use.

As a result of this debate, the Bicycle Transportation Alliance (BTA) — a non-profit membership organization working to promote bicycling and improve bicycling conditions in Oregon and SW Washington —  took a survey of their members to get feedback which would help them to clarify the BTA’s official position on helmet use. The survey’s key question asks: “How do you think the BTA should be involved in encouraging helmet use and/or supporting a mandatory helmet law?” This is an interesting question. What role should bicycling advocacy groups play in the debate over helmet use and whether it should be mandated by law?

To answer this question it is necessary to consider the purpose and role of these groups and who they represent. Even though the BTA deals with problems in Oregon and SW Washington, they also participate in national advocacy work, so the issue becomes somewhat complicated.

The survey asks the BTA members for feedback, but this feedback only represents a group of cyclists who have chosen to join the organization. And the vast majority are located in Oregon or Washington. How does asking a local, self-selected group of avid cyclists represent the views of cyclists as a whole? It doesn’t.

What, then, does it represent? Essentially, asking a local group of cyclists for feedback opens a dialog.

One place this dialog began was on a blog where the BTA survey was discussed. The usual anti-helmet comments were made about how if a car hit a cyclist then a helmet wouldn’t save him or her. That’s true. But getting hit by a car isn’t what the helmet is for. It’s for preventing a serious head injury when hitting your head against the ground, or other hard object, during a crash.

To illustrate this, one blog commenter shared an anecdote describing the consequences of a slow speed fall, without a helmet.

 

“jeff October 21, 2011 at 12:26 pm

My neighbor used to ride daily to work. Never had a helmet on when I saw him.
About 3 months ago, a car pulled in front of him at slow speed when he was riding on a sidewalk. Wife tells me witnesses said he was maybe doing 6-8 mph…got knocked over…slow speed accident…hit his head on the sidewalk…is still in the ICU at Providence with brain damage as I write this.
wear what you want…enjoy the consequences.”

 

Another commenter, of the helmet-less-rider’s-burden-on-society camp, outlined penalties for people who sustained head injuries when not wearing a helmet.

 

“q`Tzal October 21, 2011 at 12:27 pm

Practical, cold-hearted, freedom of choice related suggestion:
Allow people on bicycles AND motorcycles to ride without helmets IF:
(1) they notify their health and insurance policy holders of said decision and,
(2) they legally waive any claims to government monetary coverage for any damages that would have been prevented by a helmet.

People would still have the right to ride without a helmet but they would also be required to bear the FULL monetary burden of their decision.”

 

This type of thinking unnecessarily singles out cyclists as a group who should bear the financial burden of their own injuries. Many activities carry the risk of injury. When people get hurt during these activities, we refer to it as an accident, and expect their health insurance to pay for it. Further, it is impossible to determine the extent to which their injuries were the result of not wearing a helmet. No one should ever be required to waive their right to health insurance coverage or compensation for injuries sustained during an accident.

After the suggestion about cyclists waiving their rights, the debate took another turn. To antagonize the pro-helmet group, someone raised the frequent, but ridiculous, issue of wearing helmets at all times.

 

“John Mulvey October 21, 2011 at 12:50 pm

My question for helmet fans: Why do you ever take it off? If it’s incrementally better at saving your noggin from unforeseen fluke accidents while biking, then it’s also incrementally safer while walking, going to the supermarket, or sitting in your cubicle at work. You’d have to be a fool to *ever* take the thing off your head, right?”

 

And, as expected, someone on the other side of the argument had to make a witty reply.

 

“Paul Johnson October 21, 2011 at 1:45 pm

It’s a matter of risk. Sitting in an office and sitting in traffic on a bike are two different things. Kind of like how playing tennis on a sunny day and golfing in a thunderstorm are two different things.”

 

Sometimes the anti-bicycle fanatics go overboard with their venom towards helmet use.

 

“John Mulvey October 21, 2011 at 2:06 pm

Ahh, but that’s not the argument that pro-helmet people make, is it? I keep hearing that ANYthing that helps make you more likely to survive that freak accident that’s waiting around the next corner ought to be done. You’re a fool to do otherwise, I hear.

So I hope everyone who thinks that’s true will consider the benefits of helmets while in bed at night. You never know when the roof might fall in!”

 

Mocking the opposition, as in the quote above, is a frequent tactic used by those who can’t present a substantive argument.

More than once in this thread, the issue of walking, as a source of more brain injuries than cycling, came up.

 

“wsbob October 25, 2011 at 12:35 pm

‘…Statistically, you are more likely to suffer a traumatic brain injury from walking than biking. …’ Donna

The insurance issue aside, I just want to interject that the reason people that walk aren’t advised to wear bike helmets or any kind of helmet, is that the dynamics of the act of walking and where in the public way walking mostly occurs itself don’t particularly call for wearing a helmet while walking.

In many types of bike riding, wearing a bike helmet does make sense, because the person riding can while balancing on the bike, be traveling at speeds of 12mph and faster, entirely on the street surrounded by motor vehicles.

Even a slight, unexpected nudge can sometimes cause a person on a bike to be pitched off the bike, falling to the ground with a resulting impact to the head, from which the bike helmet would be able to offer some help in reducing injury.”

 

It’s hard to believe that walking is inherently more dangerous than cycling. Could the higher incidence of traumatic brain injuries sustained while walking reflect the fact that virtually everyone walks —  irrespective of coordination level or health status? Difficulty with balance, or walking problems created by another disability, could increase the likelihood of a fall resulting in injury.

No discussion is complete without at least one person bringing up the view of most Emergency Room doctors who treat bicycle accident patients.

 

“Goretex Guy October 21, 2011 at 1:08 pm

I work at Harborview Hospital in Seattle the ‘go to’ Emergency Room for the Seattle Metropolitan area. Many of the doctors from the ER use our bike locker and it seems they all use helmets. I’ve discussed it with them. They call cyclists without helmets ‘organ donors.’”

 

Every doctor I’ve ever spoken to about helmet use has said the same thing because helmets reduce the severity of injury in many cases. A cyclist never knows when a fall might result in one of those impacts where a helmet could improve the outcome of their injuries.

One other thing is worth considering: bicycle helmet technology is advancing. In the not-too-distant future, newly designed helmets will protect cyclists from a broader range of injuries. At that time, the benefits of helmet use may become more obvious to the anti-helmet proponents and bring the two sides closer together. In the meantime, bicycling advocacy groups will have to walk a fine line between advocating for safety and limiting individual rights.

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3 Responses to Bicycling Advocacy Groups and Helmet Use

  1. Rebecca says:

    In the USA we have an epidemic with 112,00 people dying yearly from factors caused by being overweight or obese. Under 700 people in the US die yearly in bicycle accidents. If the goal is to keep more people alive we should work on improving riding conditions which would make everyone feel safe about bicycling. That would mean no door zone bike lanes and more separation between bicycles and moving traffic. Overall getting more people on bicycles and increasing the journeys on bicycles from the current 1% to 27% of journeys by bicycle which are what is made in the Netherlands would make our population healthier and live longer, helmet or no helmet. The Netherlands has the highest cycling rate in the world, with a low mortality rate. The Dutch government’s policy is to discourage bicycle helmets which they believe will cause a decrease in the cycling rate. Instead they are continually working on improving the bicycling infrastructure. David Hembrow in his blog A View From The Cycle Path has written several postings about the Dutch attitude towards helmets. http://hembrow.blogspot.com/search/label/helmets

    • I agree about the obesity epidemic. Getting people to add exercise into their daily lives would improve our population’s health. I also agree that improving riding conditions encourages ridership. However, I disagree with the Dutch position of discouraging helmet use for the sole purpose of encouraging people to ride.

      I visited David Hembrow’s blog and read about the Dutch attitude towards helmets. I agree with him, to an extent, about making cycling appear “safe” to encourage average people to ride. But, his “evidence” for how and why cycling is “safe” is not sound.

      He uses statistics in the form of comparisons to head injuries obtained in other activities and head injuries per km as “proof” of the safety of cycling. This doesn’t prove anything. If you have a single serious head injury, it doesn’t matter whether you sustained it after riding 1 km or after riding 100,000 km. Nor does this prove the odds of sustaining a head injury, since there is no correlation between miles ridden and the circumstances under which a cyclist would crash. He also confuses head injury with head injury deaths – as if non-fatal head injuries have no consequences. Such use of statistics shows a lack of understanding about how head injuries occur and what their consequences are.

      Helmets have protective value. It comes down to the degree of risk a cyclist is willing to take. The real question is whether cyclists should be forced – through the use of mandatory bicycle helmet laws – to wear helmets, or whether this should be a personal choice.

  2. matt says:

    I tend to trust the doctors more than the hipsters re: helmets.

    That said, bike riding is not going to fix the obesity problem. It may help somewhat, but food consumption is the real problem.

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