P

ro-helmet activists have launched aggressive efforts in state legislatures across the nation to fend off motorcyclists demanding the right to ride bareheaded.

For two decades, the riders — and their rallying cry of freedom — have often had the upper hand in these battles. Now, though, the public health advocates are gaining traction as more and more evidence emerges that mandating helmet use saves lives.

Coalitions of insurance groups, doctors, and accident survivors have beaten back attempts to loosen helmet laws in 10 states this year, including North Carolina and Missouri. They’ve also helped get bills requiring helmets introduced in six states — an uptick over recent years, according to Advocates for Highway and Auto Safety, which pushes for stronger laws.

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Just one of those bills has actually passed, and even proponents call it just a small victory: Utah’s governor in March signed legislation requiring motorcyclists aged 18, 19, and 20 to wear helmets.

But helmet activists see momentum on their side. “The number of helmet requirement bills that were introduced this year is very affirming that the message that motorcycle helmets save lives and reduce injuries is getting out there,” said Tara Gill, the director of state programs for Advocates for Highway and Auto Safety.

They’ve also notched recent wins in the less fiercely contested territory of mopeds and ATVs. In South Carolina, the governor earlier this month signed a law requiring moped riders under age 21 to wear helmets. Maine earlier this month enacted a similar law for moped riders under 18.

And in Indiana, a new law will go into effect this summer requiring helmets for ATV riders under age 18. The legislation was inspired by the death, from a head injury, of an 11-year-old girl driving an ATV that flipped over. She was not wearing a helmet.

Among those pushing hardest for stronger helmet laws: state lawmakers who double as practicing or retired doctors. In Arizona, a trauma surgeon this year introduced legislation to require motorcyclists to wear helmets — but let them pay to opt out. (It ultimately failed, no surprise for a deep-red, mandate-wary state.)

The loudest — and usually the only — voices lobbying for looser helmet laws are state-level motorcyclist groups. They use the rhetoric of freedom and argue that helmets discourage tourism from motorcycle clubs, while doing nothing to stop deadly crashes from occurring in the first place. And they argue that head injuries to motorcyclists represent a negligible fraction of health care costs and are generally covered by private insurance, so they don’t cost the average taxpayer.

Peter terHorst, a spokesman for the American Motorcyclist Association, called the issue “challenging.” He emphasized that the group strongly supports the voluntary use of helmets, but draws the line when it comes to “mandates.”

Thousands of deaths each year

About 4,500 motorcyclists are killed each year in the US.

The Centers for Disease Control and Prevention calls laws requiring all motorcyclists to wear helmets “the single most effective way for states to save lives and save money” on the issue, a prescription backed by a bevy of public health research.

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Such laws were once the norm in nearly all states. But motorcyclists pushed back, and since 1995, seven states have loosened or repealed those laws.

Today, just 19 states always require helmets, and three states let everyone ride bareheaded. The rest allow some motorcyclists to ride bareheaded, based on how old they are or whether they have certain medical insurance or training. Many helmet advocates say these partial laws are inadequate, because they’re difficult to enforce and haven’t been shown to improve health outcomes following a crash.

Motorcycle helmet laws and fatalities by year and by county

Press play or drag the timeline handle to see motorcycle fatalities in states that have enacted universal helmet law (covers all riders), conditional helmet law (covers only young riders or some adult riders) or have no motorcycle helmet law.

Year

Natalia Bronshtein/STAT Source: CDC WONDER The Multiple Cause of Death data (V20-V29), Highway Loss Data Institute

In 2012, Michigan became the most recent state to weaken its helmet law; the new rules let riders older than 21 go bareheaded if they meet certain insurance or training requirements. The next year, helmet use declined by a quarter — and head injuries increased by 14 percent, researchers found.

Another byproduct of weaker laws: When motorcyclists aren’t required to wear helmets, the supply of donor organs rises.

Stacy Dickert-Conlin, an economist at Michigan State University, recently submitted for peer review a paper estimating that helmet law repeals increase donor supply of kidneys, livers, hearts, and lungs from donors killed in accidents by more than 20 percent. She’s now studying whether such repeals affect where people seeking organ donations register for a transplant.

An emotional argument — and an economic one

Pro-helmet advocates have long made an emotional case for stronger laws, citing statistics about lives saved and bringing in crash victims to testify at public meetings.

Lately, they’ve been raising economic arguments, too. Regional AAA auto clubs fighting helmet law repeal attempts last year in Nebraska and Tennessee commissioned studies that found taxpayers would be on the hook for more health care costs if motorcyclists were allowed to go without helmets.

In North Carolina, meanwhile, helmet advocates gave a lawmakers handouts showing a spike in motorcycle crash injuries and treatment costs in nearby Florida after that state weakened its helmet law in 2000.

Ken Jones, executive director of the Brain Injury Association of North Carolina, thinks the Florida data helped stall the attempt to roll back his state’s helmet law last month.

“The numbers tell the story of lives and money,” Jones said, “and whether you are a person that feels for people or you’re in there to save money for the state, either way it just makes sense to wear the helmet.”

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  • What do you call a motorcyclist or cyclist who doesn’t wear a helmet? An organ donor. A helmet can turn a catastrophic head injury into a story told by the wearer of what might have happen had they not worn a helmet.

  • Helmetless motorcycling is obviously dangerous and irresponsible, but perhaps that is what makes it so attractive to a certain type of person. It is nice to know that there is an upside – more organs available for transplant.

    • The helmet laws probably should be included with seat belt and other motorist safety laws. Separating them out individually makes it confusing for everyone. States need to enter into a multistate system, including all the states, which would be in force on interstate highways, which essentially include all the states. For local and state highways, I could see states having individualized laws, however once on the interstate system, you see license plates from all the different states, Canadian provinces and even Mexico. Trying to have individualized state laws on the interstate system makes no sense when much of the traffic in going from one state to the next on cross country trips or commerce such as truck traffic.

    • There’s a financial impact as well – people getting sued in wrongful death cases. People who choose not to wear helmets should forfeit their right and the right of their estate to sue for wrongful death or other damages associated with not wearing a helmet. The cost of treating/caring for a person with a head injury is incredibly expensive.

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