China: Improper Helmet Use in Provincial Areas

A recent study has shown that there is a huge gap between knowledge and practice when it comes to helmet wearing in two provincial areas of China.  While nearly 90% of motorcycle riders and passengers believed that helmets were effective, only about 32% wore wearing them correctly.

Li-Ping Li and Gong-Li Li surveyed over 75 000 motorcycle operators in the provincial towns of Shantou and Chaozhou (total population about 7.5 million). Their survey also included observing helmet use among motorcycle passengers and conducting an attitudes and knowledge survey among 2300 riders.

Although more than two-thirds of the motorcycle riders were wearing helmets, less than half of them were wearing them correctly (properly strapped). About 29% of the passengers had helmets, but only half of them were wearing them correctly. Helmet wearing tended to be less on the rural roads, compared to the national highways and principal arteries.

While reduced helmet wearing rates are frequently seen in low-income countries, what was surprising in this study was the large gap between knowledge and behaviour when it comes to helmet wearing. While most of the respondents surveyed believed that helmets had a protective effect, the reason that 74% wore helmets was to “cope with the police.” Many of the riders had seen messages about helmet use, and 81% correctly knew that it was against the law not to wear a helmet. But almost all of the riders thought that helmets were only needed on highways. Many riders also complained that helmets were uncomfortable, could block vision, and that police enforcement was no strict enough. 

The authors conclude that stricter enforcement of the law may be necessary in provincial areas, but with limited resources, this is probably impossible to do. They suggest, however, that an economic analysis should be launched to compare the costs of enforcement to the actual costs of injury related to not wearing helmets. With data from such a study, they suggest that an evidence-based policy of enforcement could be developed.

Li LP, Li GL, Cai QE, et al. Improper motorcycle helmet use in provincial areas of a developing country. Accid Anal Prev 2008;40:1937-42.

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