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Friday, November 29, 2013

Helmets a Plenty

Posted on Fri, Nov 29, 2013 at 3:41 PM

The reason people cycle less here - the reason cycling dropped 65% after the passage of our helmet law - is that people now view cycling as a "dangerous activity" like skydiving or race car driving - and stay away from it in droves. I'm not making a value judgement on this, but this IS human nature we are talking about here.

On a good day 700 intrepid bicyclists make their way over the bridge on a busy workday... That is not great "market penetration". Some of this is because we don't have a lot of cycling infrastructure, some of this because we don't have a great climate... but the government has effectively put a cap on the number of cyclists we will have in this city, and have capped the amount they will have to spend on it as a result.

People have a perception of cycling as road warrior-esque struggle with cars now, that's what I gleam from popular media. This pitting of one road user against another really started in earnest around the time of the helmet law.

If people didn't have to wear a helmet they would be safer - look at any city in the world that has instituted mass bike sharing programs, and have made a real substantive effort to get more people cycling - you know what they ALL have in common?

None of them have helmet laws. They have a critical mass of cyclists that have normalized cycling and with more cyclists on the roads, they are given more leeway by motorists, and they have enough clout with their large numbers to push for real infrastructure. We will never get there with our helmet regime.

Some interesting research has been done into how automobile drivers treat cyclists with helmets as well - it turns out when a driver sees a bicyclist without a helmet, they are given more leeway and consideration vs. one that has a helmet. Psychology abounds all around with this helmet use issue.

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This is the study Doctors NS and the Police champion as the reason for our helmet law ( Attewell, Glase and McFadden, 2001): http://goo.gl/HwCH9i

Unfortunately this study suffers from:

Time-trend bias
(Due to technological innovation, safety measures usually become more effective over time. However, this does not appear to have been the case with bicycle helmets. Recent studies show significantly smaller benefits of cycle helmets than older studies. Attewell, Glase and McFadden, 2001 do not acknowledge this effect and therefore give a too optimistic impression of new helmets.)

Zero-count bias
(Attewell, Glase and McFadden, 2001 included studies in which one of the four numbers used to calculate the odds ratio was zero. This suggests a larger effect for bicycle helmets than is justified.)

Conflict of interest
(some studies have more restrictive inclusion criteria than Attewell, Glase and McFadden, 2001. 4 of the 7 recent studies on the efficacy of helmet use included in their review had been undertaken by the authors themselves, thus judging their own work to be worthy of inclusion but not 8 other studies in which they had not been involved.)

A great disparity between research and helmet law outcomes
(While, on the one hand, studies have predicted large benefits from the use of cycle helmets, large increases in helmet use brought about by helmet laws have not always shown a clear decline in head injuries to cyclists. This could be due to selective recruitment – that the most cautious and safety-minded cyclists with a lower rate of accident involvement are the first to start wearing helmets – or because of behavioral adaptation (or risk compensation), whereby helmeted cyclists feel safer and thereby ride less safely.)

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Doctors NS are smart people, so they must be aware of how flawed the research is that they hold in such high regard - it's ludicrous how much control they want over every one of us - and it isn't even remotely justified - in fact, they are doing much more harm by reducing the amount of people cycling and criminalizing exercise then they could ever hope to accomplish "reducing" head injuries.

And before anyone tells me the reason they want me wearing a helmet is because this isn't America and they don't want to be paying my medical bills in case of an accident - The American health care system is about 50% public, paid by tax dollars (Medicare, Medicaid), while Canada's is 70% - so this whole "if you're in America, you can do what you want but you're in Canada" thing is false all around.

Then there is this: http://goo.gl/zTgHze (page 6)
A comparison of Active Transportation and Obesity Rates in Various Countries: In the USA 5% of people utilize walking/transit/bicycling to get to their destination, with a 25% obesity rate - in Switzerland 65% utilize walking/transit/bicycling to get to their destination, their obesity rate? About 7%. Canada is at the bottom of the pack after the USA and Australia.

If Doctors NS is in fact advocating for people's health, they should be advocating for increased bicycling. With their helmet policy they advocate, they are standing in the way of a healthier populace. Does Halifax want more people riding bicycles? Does Halifax want a way to deal with it's obesity epidemic? Does Doctors NS want to make a positive difference instead of acting as ignoramus in chief? Get off the helmet soapbox, and get people active, repeal the helmet law! —MM

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