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Bicycle helmet laws

Evidence Rating

Scientifically Supported

Health Factors

Decision Makers

Bicycle helmet laws require bicyclists to wear helmets. Such laws may be established locally or statewide, and may apply to children or to all bicyclists. Penalties for violators vary, but are generally very minor (). Many bicyclists do not wear helmets; in a 2012 national survey, 46% of respondents over the age of 15 reported never wearing a helmet. Respondents also reported that 18% of household children never wear a helmet (NHTSA-Schroeder 2013).

Expected Beneficial Outcomes (Rated)

  • Increased helmet use

Other Potential Beneficial Outcomes

  • Reduced fatal and non-fatal injuries

Evidence of Effectiveness

There is strong evidence that bicycle helmet laws increase helmet use (, Karkhaneh 2006, ). Bicycle helmet laws also appear to reduce head injury in the short-term (Karkhaneh 2006, , , ) and long-term ().

Laws that require children to wear helmets appear to reduce bicycling-related deaths among children (, ). Statewide laws may increase children’s helmet use more than local laws (). Laws requiring children to wear helmets may increase helmet use among children more than laws for all ages affect helmet use among the broader population (Karkhaneh 2006). However, adult role modeling of helmet use may lead to increased use by children (). Some researchers suggest that laws that focused on children’s use may lead to reduced bicycling among youth ().

Overall, helmet laws appear to increase helmet use more in areas with low helmet use than areas with higher use. Effects may also be stronger in lower income areas than higher income areas (Karkhaneh 2006).

Impact on Disparities

Likely to decrease disparities

Implementation Examples

Nationally, 21 states have child-targeted helmet laws. No state requires adults to wear bicycle helmets (IIHS-Bicycle laws). In a 2012 national survey, 87% of respondents favored laws requiring children to wear helmets, and 63% supported such laws for adults (NHTSA-Schroeder 2013).

Implementation Resources

BHSI-Laws - Bicycle Helmet Safety Institute (BHSI). Mandatory helmet laws.

Citations - Evidence

* Journal subscription may be required for access.

Cochrane-Macpherson 2010* - Macpherson A, Spinks A. Bicycle helmet legislation for the uptake of helmet use and prevention of head injuries. Cochrane Database of Systematic Reviews. 2008;(3):CD005401.

Karkhaneh 2006 - Karkhaneh M, Kalenga J, Hagel B, Rowe B. Effectiveness of bicycle helmet legislation to increase helmet use: A systematic review. Injury Prevention. 2006;12(2):76–82.

Carpenter 2011* - Carpenter CS, Stehr M, Journal S, May N. Intended and unintended consequences of youth bicycle helmet laws. Journal of Law and Economics. 2011;54(2):305–24.

Olivier 2013* - Olivier J, Walter SR, Grzebieta RH. Long term bicycle related head injury trends for New South Wales, Australia following mandatory helmet legislation. Accident Analysis & Prevention. 2013;50:1128–34.

Walter 2011* - Walter SR, Olivier J, Churches T, Grzebieta R. The impact of compulsory cycle helmet legislation on cyclist head injuries in New South Wales, Australia. Accident Analysis & Prevention. 2011;43(6):2064–71.

Markowitz 2013* - Markowitz S, Chatterji P. Effects of bicycle helmet laws on children’s injuries. Health Economics. 2013:Epub.

Dellinger 2010* - Dellinger AM, Kresnow M. Bicycle helmet use among children in the United States: The effects of legislation, personal and household factors. Journal of Safety Research. 2010;41(4):375–80.

Wesson 2008* - Wesson DE, Stephens DS, Lam K, et al. Trends in pediatric and adult bicycling deaths before and after passage of a bicycle helmet law. Pediatrics. 2008;122(3):605-610.

Citations - Implementation Examples

* Journal subscription may be required for access.

NHTSA-Schroeder 2013 - Schroeder P, Wilbur M. 2012 National survey of bicyclist and pedestrian attitudes and behavior, volume 2: Findings report (Report No. DOT HS 811 841 B). Washington, DC: National Highway Traffic Safety Administration (NHTSA); 2013.

IIHS-Bicycle laws - Insurance Institute for Highway Safety (IIHS). Bicycle helmet use.

Date Last Updated

Mar 6, 2015