Raise the Hammer

It's funny that the same authors, in their Coroner's report, had this to say:

The issue of mandatory helmet legislation for all ages is much more controversial, and was the subject of much debate among the members of the Expert Panel. While Expert Panel members were in agreement about promoting helmet use by all cyclists in Ontario, there was disagreement as to whether mandatory legislation was the best way to achieve this goal. There were three general arguments advanced against mandatory helmet legislation.

The first related to the potential for mandatory helmet legislation to decrease the overall number of cyclists. Proponents of this view cited the experience in Australia, where the introduction of mandatory helmet legislation was associated with a drop in cycling activity. Some research exists which suggest that the health benefits of helmets may be outweighed by the detrimental effects on overall health in the population through the decrease in cycling activity in jurisdictions where helmets have been made mandatory.

The second argument against mandatory helmet legislation relates to the view that government may see mandatory helmet legislation as “the answer” to cycling safety, with the result that other measures recommended in this Review (improved infrastructure, legislative review, education and enforcement activities) are de-emphasized or not acted upon.

The third point raised by members of the Expert Panel is that helmets are, indeed, the last line of defence and of value only after a collision has occurred. Instead of mandating the use of helmets, it was argued that efforts should be focussed on preventing the collision (through strategies such as improved infrastructure and expanded public awareness and education programs) – in other words, if one prevents the collision, helmets become unnecessary. In addition, some stakeholders felt that mandatory helmet legislation sent the message that the responsibility for safety rests with the cyclist alone, rather than being a shared responsibility of all road users.

In other words, in their role as public servants, Cass et al take a nuanced view of the benefits (and potential harms) of helmets, and acknowledge the tradeoffs inherent in legislation. In their role as researchers, they exaggerate the importance of an adjusted odds ratio derived from a study with low-quality methodology and loads of potential biases, and argue that poor evidence should dictate public policy. Given the propensity of researchers of all stripes to exaggerate the importance of their own results, I'm not the least bit surprised.