Disparities in helmet use among New York City children ages 6-12: Results from the Health Department's 2009 Child Health Survey

Background: Research clearly demonstrates that wearing helmets while using non-motorized vehicles (NMVs, i.e., bicycles, scooters, skateboards, roller skates, and roller blades) significantly reduces head injury risk. New York City (NYC) and State laws mandate children under 14 years old wear helmets while using NMVs. To estimate the proportion of children who wear helmets while using NMVs, 2009 NYC Community Health Survey-Child Supplement (CHS-CS) data were analyzed. Methods: The dual-framed, random-digit dial CHS-CS of 3,002 households included an injury module administered to adult respondents living in households with children 6-12 years old. Responses determined frequency of NMV and helmet use. Results: Survey results estimated that 574,000 NYC children, or 78%, rode NMVs. Among these, 46% always wore helmets (N=264,000) and 22% never wore helmets (N=127,000). Hispanic children (29%) and children who were rarely physically active (35%) were more likely to never wear helmets than white, non-Hispanic children (17%) and children who were frequently physically active (21%), respectively. The proportion of children who never wore helmets did not significantly differ when comparing boys (24%) to girls (20%). Discussion/Conclusion: Helmet use varies by subpopulation among NYC's children, with significant differences existing by race/ethnicity and frequency of physical activity. Physical activity promotion programs should incorporate helmet safety messaging, since the least active children are most likely to never wear helmets. Finally, helmet safety messaging must emphasize the importance of always wearing helmets with NMV use, as legally mandated; a single NMV crash can cause permanently debilitating head injuries.