UK: Attitude is important when it comes to helmets

Although there has been a great deal of effort in the United Kingdom to promote bicycle helmet wearing in children, there has been little success in getting a national law passed to require their compulsory use. In the absence of any law, what factors determine whether or not a child wears a helmet?

Using data from the Health Survey for England (HSE), Iain Lang uses logistic regression techniques to try to tease out some of the factors that influence helmet wearing in children, 8-12 years old. Using a sample of about 9,800 children who participated in this nationally representative health survey, Lang classified the variables into three categories: demographic, socioeconomic, and attitudinal. In addition to a question about whether or not a child wears a helmet, the HSE has six statements about helmets that Lang used as responses to the attitudinal part of the analysis. Examples of the statements are: “Helmets can protect you if you have an accident,” or “Wearing a helmet makes me feel like a proper cyclist.”

First, Lang used a logistic regression model that only included demographic and socioeconomic variables. He observed that age and living in a rural area seemed to be associated with a lower odds of wearing a helmet, while being female tended to have a higher odds. As the social class and income decrease, so did the likelihood of wearing a helmet. For each 10% reduction in household income, there was a 9% reduction in chances of reporting always wearing a helmet. When the logistic regression model included attitudinal data as well as the demographic and socioeconomic variables, the effect of age was no longer statistically significant. Statistically significant variable were all of the attitudinal questions. The largest effect was associated with the statement “Helmets make me feel safer when I ride  bike.” Helmet wearers were 7 times more likely to say yes to this statement.

So what do these findings mean? First, in the absence of legislation, there are demographic, socioeconomic, and attitudinal findings that are associated with whether or not a child who is between 8-12 years old wears a helmet. This is in keeping with other demographic and socioeconomic studies. Second, wearing helmets when cycling is more strongly associated with attitudes than other factors. These attitudinal factors should be considered when mounting campaigns to promote helmets.

Lang IA. Demographic, socioeconomic, and attitudinal associations with children’s cycle helmet use in the absence of legislation. Inj Prev 2007;13:355-358.

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