Spring 2007 Editorial

Commentary: Motorcycle Helmet Laws and Public Health

A recent article in the American Journal of Public Health reviewed America’s up and down relationship with passage and repeal of mandatory helmet laws. It’s an interesting story about public health and individual freedom, and it also tells a little about the American character. Here’s a summary:

For four decades USA helmet law advocates and those opposed to the laws have argued in courts and in state legislatures about the merits and demerits of helmet laws and how they reflect governmental intrusion in the lives of individuals, something Americans call paternalism. Helmet law proponents claim that the effectiveness of helmets in reducing morbidity and mortality and disability is an over-riding societal concern, and helmet wearing, therefore, should be a social issue. In addition, proponents have argued, when an individual is injured in a road traffic crash, at least some of the costs for treatment, rehabilitation, and income support, are paid for by society through government programmes, and therefore the government has a right to mandate an individual’s behaviour, if it will reduce costs.

Those opposed to helmet laws haven’t seriously challenged them on the grounds of effectiveness, but they have raised a case on just how far should government go in protecting individuals. In courts they challenged the constitutionality of mandatory motorcycle helmet laws for two reasons: 1) the laws discriminated against motorcyclists by singling them out with a law directed just towards them, and 2) the laws infringed on the motorcyclist’s liberty and used “excessive” government powers. In almost all cases, the American judicial system has upheld the constitutionality of the laws and found that requiring helmets is a legitimate responsibility of government.

Recently, those opposed to helmet laws, have raised the argument of choice – how much right does the government have to tell an individual what to do? – as a concern. They’ve said that requiring an individual to wear a helmet is governmental paternalism, much like the restrictions on abortion infringes on a woman’s right to choose whether or not to terminate a pregnancy. As one opponent to laws testified:

… We do not want to be forced to wear seat belts or helmets because others think that it is good for us. We do not want to be forced to eat certain diets because some think that it too may be good for us, reduced deaths or medical costs. We do not want to be forced to give up certain pastimes simply because some may feel they entail any amount of unnecessary risk.

This argument has been effective in raising questions about individual liberty. In 1995, the Federal government dropped its requirement that states have mandatory motorcycle helmet laws or risk a 3% reduction in Federal highway funds. Since then, states have been dropping their helmet wearing requirements. Arkansas and Texas were the first to do so (1997), followed by Kentucky, Louisiana, Florida, and Pennsylvania (1998-2000).

Predictably, helmet use in those states has decreased, and deaths and head injuries have increased. Today, 20 states require helmet wearing for all ages of drivers and passengers.

But an interesting development is taking place in some states. Universal helmet wearing laws are being repealed. In their place, however, are new laws that require helmet wearing, but only for certain groups of riders – beginners or those under 18 or 21. And these laws are being suggested by the same groups who have opposed mandatory laws.

For a public health and safety policy maker, this provides a new opportunity. By supporting laws for only certain riders, those who are opposed to universal laws are now tacitly supporting not only helmet effectiveness but the role of the government in requiring helmets for some riders. There seems to be agreement that for some riders, individual decisions to wear or not wear a helmet is secondary to the government’s responsibility to protect riders.

Does this open a potential for advocates of universal laws to push again for mandatory helmets for all?  Perhaps. Laws that require seat-belt use and prohibit tobacco use are designed to protect people from avoidable harm. They have set a precedent.

As the authors of the study observe:

…motorcycle helmet use has dropped to 58% nationwide and
fatalities have risen. Need anything more be said to show that motorcyclists have not been able to make sound safety decisions on their own….?

As ever, we look forward to your comments.

Have a healthy and safe Spring.

-Philip L. Graitcer
Facilitator, WHO Helmet Initiative

Jones, MM  and Bayer R. Paternalism and its discontents: motorcycle helmet laws, Libertarian values, and public health. AJPH 2007;97(2):208-217.

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