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City of Phoenix public safety comic.jpgHelmet fixation distracts from effective safety strategies says US professor
A fixation on cycle helmets is hampering efforts to improve bicycle safety in the United States, according to a professor from the University of Heidelberg. Streets Blog reports how Gregg Culver is arguing that the helmet occupies a special place within official bicycle safety discourse and that this distracts from more effective strategies to improve safety.
Early on in his paper, published in Applied Mobilities, Culver emphasises that his issue with helmet advocacy is purely one of proportionality: “I wish to make clear that I do not seek to make claims or recommendations on helmet use, one way or the other. Instead, my intention is to interrogate an exaggerated and arguably misplaced fixation with helmets.”
He goes on to say that… “cyclists in the United States are far likelier to wear helmets and yet five times likelier to be killed and about 21 times likelier to be injured than in the Netherlands, where helmet use is a rarity.
“If safe cycling can be achieved without helmets, and if relatively dangerous cycling persists despite helmet use, then basic logic dictates that the helmet simply cannot possibly be the most significant factor of bicyclist safety.”
Culver believes that attitudes to cycling in America, “must ultimately be understood within the larger context of the subordination of the bicycle to the automobile.”
He explains: “Virtually everyone involved in automobility has an understandable inclination to reflexively consider the death of cyclists as tragic accident rather than manslaughter. The helmet fixation redirects attention away from the overarching problem of vehicular violence, assisting in its denial.”
To analyse the attitudes of American public officials to cycling and cycle helmets, Culver conducted analysis of the official bike-related texts posted online by the planning departments of 25 US cities.
What he found was a “fixation” with cycle helmets which he says sees them prioritised over other safety measures in a number of different ways.
Helmet use was typically mentioned either first or among the first safety measures relating to cycling. He also found that ‘admonishments’ about helmet use were given special emphasis via exclamation marks, italics, or similar, whereas other safety measures were not.
He describes one example, from the city of Phoenix, where a strikingly graphic comic was used to illustrate the dangers of not wearing a helmet to children. In it, a cyclist’s head is split open and his brains can be seen by other cyclists.
In many cases, Culver identified an “overtly moralising tone that is largely unique to helmets compared to other elements of bicycle safety.” He said helmet use was presented not as a legitimate personal choice, but as “a moral duty.”
Reflecting on what he perceives to be a disproportionate emphasis on helmet use, he concludes: “Whether they (choose to) wear a helmet or not, cyclists should refuse to acquiesce to vehicular violence, and push for serious bicycle infrastructure investments and policies that safeguard vulnerable traffic participants. Considering that motorists operate fantastically lethal machines, a greater focus on improving motorist awareness for and responsibility toward vulnerable traffic participants should be pursued.”
Alex has written for more cricket publications than the rest of the road.cc team combined. Despite the apparent evidence of this picture, he doesn't especially like cake.
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120 comments
I'm not.
Unless we're talking about cheese. Can we talk about cheese?
I recently tried one of those new-fangled cheese diets as I wanted to cheddar few pounds.
You're absolutely right.
However, helmet skeptics are often treated to abusive comments such as "you'd have to be an idiot to cycle without a helmet" and these comments come from all sections of society. The annoying aspect is that most helmet skeptics have actually done some investigation into the efficacy of helmets and usually the person advocating helmet use for all cyclists (yet not other people for some strange reason) has not done any research and instead declares it "bloody obvious".
Indeed the choice is ours, and long may it remain so. Your anecdote is just that, a story with no supporting data, and I'm sure we've all seen the quote "the plural of anecdote is not data".
Anecdotes are very useful ways of supporting a scientifically proven case, but on their own mean absolutely nothing, and in the case of cycle helmets, the long term, large scale reliable data is precisely opposite.
All neatly summed up here http://www.cyclehelmets.org/1209.html
So there was a crash (cause not given). Your ride partner suffered a serious and distressing head injury as a result. He was wearing a helmet but it just broke in two, giving no protection whatsoever and not preventing the injury. Neurosurgeon is quoted as saying he was 'lucky to be alive', presumably because the injury was so severe (and not illustrating that neurosurgeon's have a strange idea of what 'lucky' means). With you so far: Helmets are a complete distraction because (in this one anecdotal incident, at any rate) they don't prevent serious head injury or possibly death, even in low speed incidents.
Then you say something about saving rehab costs which I don't follow at all. Could you elucidate?
PS I hope your partner is well on the road to recovery.
The obsession with helmets is distracting. But it is an easy win for all the anti-cyclists. "You all don't take minimal precautions for your own safety so why should we spend millions on you safety". And in the propaganda war that simple argument is a flat out winner with the voting public.
Until you all give up and just accept a helmet law you aren't going to get progress on anything else.
Exacly right - all the helmet promoters are essentially acting as tools, deliberately or otherwise, of the motor lobby.
We definitely need an emoji on here for a Wolfie Smith style revolutionary raised fist!
When helmet wearing was increasing in NY they found that the incident/injury rates went UP not down. Same in Canada, same in Australia, ridiculously so in NZ and it's the same in the UK and everywhere else in the worldd, not to mention the pro/amateur raacing scene.
When will these people wake the fuck up and actually take notice of facts #Winstonisnotascientist
Actually, if you look at real, statistically sound, peer-reviewed studies such as you can find in PubMed and other legit resources, you will find the opposite. Head injuries went down in US, Canada, and Australia. Read Culver's article; here's a direct quote:
After years of debate on the basic question of the efficacy of bicycle helmets (e.g. Attewell, Glase, and McFadden 2001Attewell, R.G., K. Glase, and M.McFadden. 2001. Bicycle helmet efficacy: A meta-analysis. Accident Analysis & Prevention 33, no. 3: 345–52.10.1016/S0001-4575(00)00048-8[Crossref], [PubMed], [Web of Science ®], [Google Scholar]; Elvik 2013Elvik, Rune. 2013. Corrigendum to: “Publication bias and time-trend bias in meta-analysis of bicycle helmet efficacy: A re-analysis of Attewell, Glase and McFadden, 2001”. [Accid. Anal. Prev. 43 (2011) 1245–1251] Accident Analysis and Prevention 60: 245–53.10.1016/j.aap.2012.12.003[Crossref], [PubMed], [Web of Science ®], [Google Scholar]; Thompson, Rivara, and Thompson 1989Thompson, Robert S., Frederick P.Rivara, and Diane C. Thompson. 1989. A Case-control study of the effectiveness of bicycle safety helmets. New England Journal of Medicine 320, no. 21: 1361–67.10.1056/NEJM198905253202101[Crossref], [PubMed], [Web of Science ®], [Google Scholar]), there appears to be consensus that, all else equal, bicycle helmets do provide protection against head injuries (Olivier and Radun 2017Olivier, Jake, and Igor Radun. 2017. Bicycle helmet effectiveness is not overstated. Traffic Injury Prevention18, no. 7: 755–60.10.1080/15389588.2017.1298748[Taylor & Francis Online], [Web of Science ®], [Google Scholar]).
I think you missed an important word in BTBS's post; he said injury *rates* went up. The most quoted study I've seen is from Australia, where they saw reduction in head injuries after a mandatory helmet law went into effect. However, some people reviewed the data and saw that overall cycling #'s plummeted, so of course overall head injuries went down. They seemed to find that the # of head injuries per cyclist (injury rate) was higher, though.
I think most on here would agree that helmets do provide some protection against head injuries (I know not everyone, but most). The bigger issue they have is the amount of protection claimed, and the fact that it's paraded around as the single most important element of cycle safety. Because of this, much more significant elements get overlooked or ignored. That brings about a lot of the vitriol towards helmet evangelists.
Injury rates in isolation don't necessarily tell us anything.
Some types of cycling are higher risk than others. If a mandatory helmet law dissuaded low risk cyclists to a greater extent than it dissuaded high risk cyclists you may see an increase in the injury rate on a national level without any increase at the individual level.
FWIW I do believe that helmets provide some protection from head injuries but am opposed to mandatory helmet laws.
Very true. I don't know for certain, but I would guess that many of those higher-risk cyclists were already wearing helmets before any mandatory helmet laws, so their participation #'s may have been less affected. Which, if that's the case, reinforces the idea that helmet laws are a net negative as they reduce overall cycling participation, reducing the "safety-in-numbers" effect that many believe is much more important to cycling safety than helmets.
Oh dear, where to start. Okay, let's go with the fact you mentioned the bent as a nine bob note Jake Olivier in reference.
The guy is sponsored by the worst state government in the world with respect to cycling, uses flawed methodology already denounced by peers and others, he uses cut lips as head injuries in the data to help prove his/NSW states point (Yes, that really happened) and even ignores his own advice on meta analysis.
The guy fawns over the paper from Thompson Riveira and Thompson (their much maligned load of bollocks paper) in his meta analysis and kyboshes others that come into conflict with his very clear bias/agenda.
That alone is enough for me to know you're talking a load of cack, I can't even be bothered to wade through the rest of your worthless bilge.
As others have already said, claiming that your research is statistically sound while quoting Thompson, Rivara and Thompson is an exercise in total and utter logic-defying hypocrisy. As one professor said, "I could use the TRT paper to demonstrate to my students how not to do research."
When someone demonstrates a causative link between helmet wearing and the statistics you mention. The rise of autism and increase in popularity of farmersmarkets align almost spookily. A causative link is yet to be established, so no-one takes the correlation seriously. For 60 years a reduced fat intake was thought to be insturmental in reduced mortality, a paradigm that our dietary advice was based on for 40 years. It turns out that although linked, there is many confounding factors, and no causative link, which informed a dietary approach which is almost certainly responsible for a decrease in heart disease, but with an overwhelming rise in obesity and diabetes, at far higher 'cost' than the original heart disease.
When will people wake the fuck up and realise that public medical policy, while prompted by statistics and correlations, should only be informed by established causative links. Like helmets can, and do, prevent some head injuries, while it is certainly not well established that helmets themselves are responsible for greater injuries.
Mandated helmets = reduced cycling. Surely that's established.
For me, it's not a huge leap from there, to
'encouraged helmetting = less uptake in cycling'. Much less established.
So it comes down to doing what this bloke has done and looking at what countries that have high cycling uptake and low helmet wearing are about. Turns out we have a couple that are geographically and culturally close by. And what those countries are about is stuff like grown-up separate infrastructure, strict liability, less 'car is king' and also less cyclist KSIs.
The logical conclusion then is 'stop fixating on helmets - there is much bigger shit'. Which is this guy's message, and St Chris's message.
The real debating point should be the wider *harm* that encouraging helmet wearing (schools, BC, sportives etc) does through possible reduction of uptake, because that encouragement is based on ideology at the moment. My own take is that that encouragement overall is harmful, but I can't prove how much, so my own position is ideological too.
'We're all safer if more people cycle.
Encouraging cycle helmets stymies participation.
Discuss.'
Can I like this twice?
Hang on, helmets were introduced without any evidence of working, they were legislated on the back of no evidence and are continually pushed on the back of no evidence of working. I suggest that those wanting to push for helmet use have the burden of proof, so far after decades there is precisely diddly squat to support their effectiveness.
The burden is for proponents, not those that want to carry on as before, being unecumbered as the law allows.
You assertion that bike helmets have no evidence of working is absolute tosh. Bike helmets demonstrably prevent or reduce the severity of some head injuries. You could demonstrate this for your self by putting a bike helmet on and throwing yourself off your bike head first at a lamp-post at 25 kph. Then do the same without your helmet. Testing and empirical evidence ably demonstrate that bike helmets prevent or reduce the severity of some head injuries. They certainly don't save cyclist from injury, and it is possible that wearing them increases the risk of other injury . However we dont mandate against smoking on the basis that it reduces mortality from all causes, only that it reduces mortality from those directly associated causes in those individuals.
This is spurious logic. There's not even the slightest suggestion that smoking reduces mortality from other causes, not to a degere that comes anywhere close to matching the well-established incresse due to smoking-related diseases. There's no comparison whatsoever between the two issues, it's a dishonest analogy.
And so what if testing demonstrates that helmets 'prevent or reduce the severity of some head injuries'? Why does that logic ony apply to cycling, why not to all other forms of movement?
Yup: we definitely need those five point harnesses and formula one helmets for all drivers...
And madcarew's just argued for it, haven't they?
"Medical policy"? What's that got to do with the topic?
Anyway, your point here is a major argument against compulsory helmet laws. There are no established causitative links between more helmet use, still less compulosry use, and improved public health.
(I'm not sure whether that's what you were trying to say or not.)
(I'm actually not at all clear at this point what the truth is about sat fat and health, every other report seems to contradict the previous one...but nobody's seriously suggested making saturated fat either compulsory or illegal, so I don't see it's that relevant to the current argument)
It isn't just the USA, this seems to apply to a lot of countries, and certainly the UK, where the fixation with helmets can be observed daily, with lots of organised rides having a helmet rule, and frequent demands for a helmet law.
As the good professor points out, this obsession with helmets is counter-productive, merely distracting from measures which do make cycling safer, and giving the motoring lobby a quick and easy way to attack cyclists, and blame them for not protecting themselves from their bloody awful driving. I wonder if there was some way to make BHIT and RoSPA and the helmet zealots and misguided MPs read this report?
cyclists in the United States are far likelier to wear helmets and yet five times likelier to be killed and about 21 times likelier to be injured than in the Netherlands, where helmet use is a rarity”
“far likelier to wear helmets” isn’t exactly a stat and the US isn’t really the same as the Netherlands. Kinda like comparing apple (pie) and oranges. So apart from mixing stats and opinion with two different situations it’s fantastic analysis.
that is the point. There are much more effective interventions that actually make things safer for cyclists than helmets. They implement them in Holland, but not in the US (or indeed the U.K.). And when they do, helmet wearing becomes a statistical irrelevance...
I think the whole point is that the dutch approach, segregation, low speed limits tolerant drives DOES improve cycoist safety, meanwhile the US approach of wear helmets you little people does not.
The point is not that wearing helmets ios more dangerous than not wearing helmets
this seems to be lost on you, just as it is lost on legislation makes in America (and the UK)
In other news: bears make use of the woods, Pope a catholic, yada yada yada...
This man speaks a lot of sense; what will it take for governments to listen?
A forklift fuckload of evidence-free ideology. Or lobbying $$$$.
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