Bicycle helmet campaigns and head injuries among children. Does poverty matter?

J Epidemiol Community Health. 2003 Sep;57(9):668-72. doi: 10.1136/jech.57.9.668.


Objectives: To assess the impact of a community based bicycle helmet programme aimed at children aged 5-12 years (about 140,000) from poor and well off municipalities.

Methods: A quasi-experimental design, including a control group, was used. Changes in the risk of bicycle related head injuries leading to hospitalisation were measured, using rates ratios.

Results: Reductions in bicycle related head injuries were registered in both categories of municipalities. Compared with the pre-programme period, the protective effect of the programme during the post-programme period was as significant among children from poor municipalities (RR= 0.45 95%CI 0.26 to 0.78) as among those from richer municipalities (RR=0.55 95%CI 0.41 to 0.75).

Conclusion: Population based educational programmes may have a favourable impact on injury risks in poor areas despite lower adoption of protective behaviours.

MeSH terms

  • Bicycling / injuries*
  • Child
  • Child, Preschool
  • Craniocerebral Trauma / epidemiology
  • Craniocerebral Trauma / etiology
  • Craniocerebral Trauma / prevention & control*
  • Female
  • Head Protective Devices*
  • Health Promotion / methods*
  • Hospitalization / statistics & numerical data
  • Humans
  • Incidence
  • Male
  • Poverty*
  • Program Evaluation
  • Quebec / epidemiology
  • Risk Assessment