Effect of a state law on reported bicycle helmet ownership and use
R. A. Schieber, M. J. Kresnow, J. J. Sacks, E. E. Pledger, J. M. O'Neil and K. E. Toomey
Division of Unintentional Injury Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
OBJECTIVE: To evaluate the effect of a state law on reported bicycle helmet
ownership and use. DESIGN: Multistage cluster random-digit-dialing
telephone survey. SETTING: Georgia, June through November 1993.
PARTICIPANTS: Adults who reported the behavior of bicyclists 4 through 15
years old. INTERVENTION: State law mandating helmet use after July 1, 1993,
for all bicyclists aged younger than 16 years. MAIN OUTCOME MEASURES:
Bicycle helmet ownership and use. RESULTS: Reported helmet ownership
increased from 39% before the law took effect to 57% afterward (+ 46%, P =
.06). Reported use increased from 33% before to 52% afterward (+ 58%, P
< .05). About 7% of riders changed from "never-wearing" to
"always-wearing" behavior. After the law took effect, in those households
in which the law was known, 69% of riders owned and 64% used a helmet. By
comparison, in those households in which the law was not known, only 30%
owned and 25% used a helmet (P < .01). Reported ownership and use were
93% concordant, inversely related to rider age, and directly related to
household income. Multivariable analysis indicated that race was an effect
modifier of reported helmet ownership and use. In black riders, knowledge
of the law appeared to be highly associated with both reported helmet
ownership and use but was not significant in white riders. In white riders,
though age and income were significantly associated with reported helmet
ownership and use. CONCLUSIONS: This law appeared important in increasing
reported helmet ownership and use, particularly in black riders. Since
knowledge of the law was associated with increased ownership and use,
additional publicity about the law might further increase helmet use.
Because most riders who owned helmets used them, give-away programs
targeting areas of low ownership may also increase use.
