Last month, I was in Barcelona for a conference. I noticed that everyone on a motorcycle wore a helmet. In stark contrast, practically no one on a bicycle wore a helmet.
Spain has a universal helmet use law for two-wheeled motorized vehicles. Everyone, regardless of age, must wear a helmet when riding a motorcycle or moped. A study conducted in Spain a few years after the law was passed showed that deaths among motorcycle riders, especially those involving traumatic brain injuries, dropped substantially.
For bicyclists, however, Spain does not have helmet use policies. And by my observations, helmet use among people on bikes is nearly nonexistent.
So, how about in the United States?
We have laws requiring motorcycle helmet use, but the specifics of these laws vary from state to state. As the laws vary, so does helmet use. In states requiring all motorcyclists to wear a helmet, nearly 100% do. Conversely, in states in which helmet use is optional or required only of minors, use is much lower.
States enacting universal helmet use laws have seen impressive decreases in motorcycle deaths and serious head injuries. As expected, states that have repealed universal helmet use laws have seen a rise in motorcycle-related brain injuries and deaths.
The laws for bicycle helmet use across the United States are as variable as the laws for motorcyclists, even though legislation has been recommended by CDC as a means to increase helmet use.
In public health, the focus is often on sharing information about risks and encouraging healthier alternatives. That’s enough to get some people to make healthy choices. But others need more of a “push.” We cannot underestimate the power of policy as impetus for change, especially when paired with programs to educate and raise awareness.
Where else might we explore the use of policies that require healthy behaviors or prohibit unhealthy ones? We welcome your ideas.