Reducing injuries is important but not at expense of public health: Provincial Coroner's helmet recommendation misguided
The Provincial Coroner came out with his long-anticipated recommendations for reducing cycling deaths today. Alongside recommendations asking for a provincial cycling plan, complete streets, education and sideguards for trucks, he also recommended mandatory helmets for all age groups. His mandatory helmet recommendation is outdated, misguided and overshadows is otherwise (though somewhat broad) set of recommendations. The media has latched onto the helmet recommendation like it is the magical talisman that will solve all that harms cyclists. Drivers won't have to change anything, it's all up to the cyclists! Almost every headline is: "Ontario Coroner calls for mandatory helmets for cyclists..."
The limitation of this coroner's review is that it only looked at a relatively narrow perspective, that of deaths
and injuries while cycling. The Coroner never considered were the broader public health implications. Nor did he consider, it seems, whether other jurisdictions saw a reduction in injuries and deaths. Nor how it is that some jurisdictions such as the Netherlands as pictured above can be very safe while most cyclists young and old don't wear helmets. When it comes to mandatory helmet legislation, it is widely considered by experts now to have either no impact or a negative impact on public health. I spelled out the broad issue yesterday. It is one thing to promote helmet use while still leaving the option open for people, but it has been shown that once you try to enforce helmet use many people just decide not to bother. The experts have shown that the health benefit of cycling is much greater than the risk of injury or death.
Even the Toronto Coroner's report on cycling fatalities in 1999 recognized that mandatory helmet use could backfire:
...helmet use is not a panacea for drastically reducing cycling related fatalities or serious head injuries. Stricter bicycle helmet legislation and mass helmet usage in other countries (U.S.A., Australia, and New Zealand) have failed to produce any statistically significant reduction in the rates of fatalities and head injuries, despite optimistic projections. In addition, compulsory helmet use may result in reduced bicycle usage.
Did you get that? Mandatory helmet legislation showed NO statistical evidence that it reduced fatalities and head injuries!
One could ask too why there is so much of an emphasis on helmets for cyclists when drivers and pedestrians also suffer head injuries that could be prevented with helmets? I personally have suffered a head injury sustained in a car crash. But I'm sure requiring helmets for drivers and passengers would create a loud outcry.
It's not clear if the Coroner took any consideration of the impact of this on the public bikesharing initiatives such as BIXI Toronto or Capital Bikes in Ottawa. Bikesharing in Melbourne, Australia is struggling because of mandatory helmets and Vancouver is having trouble launching its own service because of mandatory helmets there.
A bicycle helmet law came into effect in Ontario in 1995. It was originally meant to be applied to all ages but was amended by regulation to exempt adults. Helmet usage among children increased after the legislation but eventually dropped off because of a lack of enforcement.
I wish the Coroner had considered the public health aspect of his review before making any recommendation, but instead he had decided to forge ahead with a misguided recommendation. If the Liberal government takes up this recommendation I believe that it will put a big dent in cycling promotion in this province and put us even further behind. If Australia is any indication then we could see reductions in cycling by 20 to 40%! That is a hugely negative impact on public health, especially considering how Toronto celebrates when the number of cyclists increased by 6% in the decade from 1999 to 2009. Maybe the reductions won't be as large here, but even a small drop would likely overshadow any positive impact.