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Promoting Helmet Use in Equity Emphasis
Low Income Neighborhoods

Summary: This page was written by Steve Meiers, former Safety Educator, Madison (Wisconsin) Department of Transportation. There is good stuff here from a keen observer in the field.

When I started to do bicycle safety programs in 1989 kids wearing bike helmets were commonplace in middle-class neighborhoods but non-existent in poor ones. I raised as much money as I could to buy helmets and gave them out like stickers whenever I did a program in a poor neighborhood. My thinking at the time was that the only reason these kids weren't wearing helmets was because their families couldn't afford them.

Boy was I wrong!

Much to my chagrin kids often had the helmets off before I left the event and helmets weren't anywhere to be seen a few days later.

As Professor Gary Winn, the author of the first study on helmet use and poor kids, remarked

"Anything that is not part of the local culture will die. Same thing with any safety program: if the recipients see that it's one shot, it's DOA.."

I decided to concentrate my efforts on working with schools with high concentrations of poor families. By giving them to a large number of kids in the same area we hoped to create a positive peer pressure to help maintain helmet use. And by getting parents involved we hoped to have another voice reinforcing usage.

Students in the 3rd or 4th grade learned how the brain functioned from medical professionals and what happened when it got damaged from people who had experienced brain trauma themselves. They had to write letters to their parents sharing what they learned in order to get a helmet and pledge to wear it always. Kids were sincere about wanting to get helmets and some were so excited when they got them they would wear them in school and while walking home.

This excitement soon faded and helmets were nowhere to be seen a short time later. This pattern holds true in every study of bike helmet use and poor kids. Enthusiasm and use is high for a days or weeks at best then helmet use fades back to previous levels.

The Madison Safe Kids chapter did focus groups with parents in one of the area's most challenged neighborhoods in order to get a better understanding of why this pattern exists. The results of these discussions along with the ground breaking work done by Anita Brentley at Cincinnati's Children's Hospital, has given me some insights that I'd like to share with you.

Parents in these neighborhoods live with challenges and stressors that those of us in more secure environments can't imagine. Guns are being sold on street corners in the neighborhood where we held the discussions. Parents told of gangs recruiting their 10 year olds. As one parent remarked "You have to choose your battles." And getting kids to wear helmets in light of more real, immediate concerns is not going to be a high priority.

Even if parents talk to their kids about the importance of wearing a helmet it is ultimately up to kids to determine if they are going to wear them. It's common to see middle-class teenagers with helmets on their handlebars. They wear them when they leave home to make their parents happy then ditch them when they get out of sight.

Arguments about the importance of protecting ones brain in a crash aren't credible to a lot of kids or their parents. They don't know of anyone who has had a serious head injury as a result of a bicycle crash. And many kids tell of their own crashes without serious injuries so the notion that one can suffer permanent brain damage in a bicycle crash doesn't resonate with them.

How do we change this around? The key, as Winn suggests, is to look at their culture and try to fit wearing helmets into that.

Ruby Payne, who has written extensively about teaching kids who are growing up in poverty, suggests "If it became a 'cool' thing for gangs to do, you would have a very high compliance rate."

If star athletes endorsed helmets the way they do athletic shoes would kids be drawn to helmets because they are 'cool'? And if so, can we get athletes to endorse helmets in such a way that they won't drive up the cost of helmets to an outrageous amount?

Are there other ways of making helmets acceptable to kids? The Cincinnati Children's Hospital has developed a program working through churches. Few people are more respected in the African American community than ministers or in the Latino community then priests. Will their endorsement make a difference?

We don't have answers but it seems the next step is to look at these kinds of questions. Even if this route shows promise change will be difficult and slow. When I told kids in one neighborhood they had to wear helmets in order to go on a bike ride they were horrified. "Please don't let my friends see me with one on" they begged. Peer pressure is difficult to overcome.

Still there are immediate, concrete steps communities can do to help ensure these kids safety on bikes.

A young boy was killed several years ago when the bike he was riding ran into the side of a bus causing massive brain damage. Witnesses said Jermaine was frantically pedaling backwards trying to stop but couldn't- his brakes didn't work.

I am sure Jermaine wasn't the only kid riding a bike without brakes in that neighborhood. Most bikes in impoverished neighborhoods need repairs and quite a few need extensive work. And there are bikes that are better off in the scrap heap. If you distribute helmets in a poor neighborhood make sure you take a couple of bike mechanics along. They will have plenty of work to do.

On the first day of summer vacation a few years ago a boy crashed into the front of a car when he lost control of his bike and was in a coma for more than a week. Police said the bike the 7 year old was riding was too big for him to control.

There is a shortage of bikes of any sort in poor neighborhoods so kids will ride whatever is available, regardless if they are in poor shape or too big. Some communities have established programs that get good working, properly fitting bikes to kids in needy neighborhoods.

As with any safety program we have to meet the immediate short term needs of a group along with working for the long term changes.

In 2006 Safe Kids invited Steve to address a workshop on this topic at their national conference.

For more background, see the research summary from Steve's original proposal for a study of factors affecting helmet use in poor neighborhoods.

You will also find interesting observations in this British study of helmet use in what they call "deprived areas" and more recently would be called equity emphasis areas.