jschumann-AAAS-photo1John Henning Schumann, a writer and doctor in Tulsa, runs the Internal Medicine residency at the University of Oklahoma School of Community Medicine. An earlier version of this post ran on his Glass Hospital blog. He is on Twitter @GlassHospital

Like a lot of preventive health ideas, we have beaten the importance of bike helmets into (onto?) everyone’s head. Overall, this is probably a good thing.

I was lucky in my previous job (in Chicago) to be able to walk or ride my bike to work. Let me repeat that, fellow Oklahomans: WALK. OR RIDE MY BIKE. TO WORK. [What will it take for us to do that here, in a land of little to no snow and moderate winter and spring temperatures? As for summer, that raises other issues. But I digress…]

On the few occasions I failed to wear a helmet, I was castigated by my children, my wife, and even passers-by on the street. When you’re a doctor, there’s higher pressure to practice what you preach. [Hey, nobody ever said role modeling is easy.]

Like seat belts before them, helmets have become so routine that riding a bike without one makes me feel naked.

But what is the cost?

We can calculate real and theoretical costs of head injuries due to bike accidents. There are sobering stats: 91 percent of those killed while biking in 2009 were not wearing helmets. So the danger is real. But what about people choosing not to ride a bike because of mandatory helmet laws?

A recent New York Times article compares cities that have bike sharing programs, where people pay very little (or nothing) to borrow city-maintained bicycles and use them as a healthy, non-polluting transportation source. (Tulsa provides free bike rentals at four locations along the Riverparks Trails System, while Oklahoma City has a downtown bike share program, Spokies, for which you pay a daily, monthly or annual charge.)

Author Elizabeth Rosenthal, anticipating New York City’s inauguration of a bike sharing program, compared cities that required helmets with those that didn’t. Perhaps unsurprisingly, cities requiring helmets had much less ‘uptake’ of bikes than cities that don’t. Example:

  • Melbourne: Climate: Temperate—–Helmets: Required——Uptake: 150 rides per day
  • Dublin: Climate:  Rainy—–Helmets: NOT required—–Uptake: 5000 rides per day
  • [editor’s conclusion]:  Happiness: Dublin

An expert that Rosenthal interviewed summed up the thinking this way (with some U.S. counterpoint):

“Pushing helmets really kills cycling and bike-sharing in particular because it promotes a sense of danger that just isn’t justified — in fact, cycling has many health benefits,” says Piet de Jong, a professor in the department of applied finance and actuarial studies at Macquarie University in Sydney. He studied the issue with mathematical modeling, and concludes that the benefits may outweigh the risks by 20 to 1. [emphasis added]

He adds: “Statistically, if we wear helmets for cycling, maybe we should wear helmets when we climb ladders or get into a bath, because there are lots more injuries during those activities.” The European Cyclists’ Federation says that bicyclists in its domain have the same risk of serious injury as pedestrians per mile traveled.

Yet the United States National Highway Traffic Safety Administration recommends that “all cyclists wear helmets, no matter where they ride,” said…an agency official.

Here in Oklahoma, there’s a small but vibrant group of urban cyclists (unequivocally helmeted) who ride  during the longer daylight months. They hew toward the more serious fitness buffs, who enjoy long rides and competition. What I’d love to see is collaboration amongst them, public health folks, and civic planners to create more bike lanes on our city streets. We have a culture of drivers and rising obesity–we can turn the tides by pushing for more bike lanes and bike sharing. They are low cost, ‘low hanging-fruit’ public health interventions.

Footnote: there’s an ironic (but happy-ending) twist to this story: Three days after the article ran, former Boston Red Sox manager Bobby Valentine was riding his bike in New York’s Central Park. He made the unwise choice of reading a text while biking, then flipped over his handlebars, injuring his knees and hips.

Said Valentine (per the LA Times story): “I shouldn’t have been reading a text while I was riding. That’s the wrong thing to do. But at least I was wearing my helmet.”

Two days after that, Red Sox management fired Valentine for leading the team to their worst record in 47 years. Unclear if helmets were involved.

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