Boston Public Health Commission Didn’t Listen To The Experts When Crafting It’s Helmet Safety Campaign

I know I just keep chewing at this bloody billboard campaign by the BPHC, but it just bothers me how incredibly shady the whole thing seems to be.

If you go to the BPHC Helmet Campaign page you will see this:

“The city of Boston, supported by BPHC and a coalition including emergency department doctors and other hospital staff, cycling advocates, and community leaders, has taken a comprehensive approach to promoting safe bike riding in the city.”

“BPHC works with community-based organizations to ensure that free and low cost helmets are available in Boston neighborhoods.”

(emphasis added)

They tout their involvement with community and advocacy groups, making it seem like these groups had a lot of input into the campaign.

But if you read the latest post by the BCU you see a different picture:

Boston’s bike community will be the first to tell you that helmets are a good idea. Over the last few weeks, however, a large part of that community, including virtually all of its leaders, is up in arms over an advertisement that is meant to get more people wearing helmets.

Seem odd?

The ads are meant to scare people (they are meant to be targeted at young men in particular) into wearing a helmet, but it seems obvious to most observers that the ad will likely scare people away from bicycling altogether. And that would be bad, given that physical activity would really help out with the Mayor’s Million Pound Challenge—one of the city’s key prevention strategies this year. www.BostonMovesForHealth.org

The truth is that the Boston Public Health Commission—which paid around $50,000 for a month’s worth of bus stop posters depicting bloodied young cyclists—did ask for the Bike Union’s involvement on the campaign beginning back in May. The problem, however, is that they didn’t value our or other advocacy groups’ advice when we came to the table.

At that first meeting, the Union, MassBike, Livable Streets Alliance and others made it very clear to the various city agencies and health professionals in the room that the bike community would be open to just about anything but a scare campaign for the simple reason that we, thousands of Bostonians who support bike advocacy and volunteer in many ways, and the City of Boston itself have worked very hard to increase the cycling rate. We want to preserve those numbers, and get more people riding for the health benefits and other good things that it brings.

Given the clarity and unity on that message, the presentation at a second BPHC meeting on the proposed helmet ad campaign in August came as a shock. The worst fears, the things the advocacy community had specifically asked not to have, were there on the screen in bloody triplicate. Gasps filled the room. The Union asked if the ads had been tested to see if they might discourage biking. The BPHC responded that they had done focus groups and had asked that question. But when the Union requested and received the focus group results, it was clear that the question had not been addressed.

Instead, the “focus groups” actually comprised of only one focus group of a “men’s health” group, an online poll of 21 people (only one of whom did not wear a helmet), and three comments from “college/grad students.” The online poll participants suggested many positive ad ideas, the men’s health group asked for more shock value, and the “college/grad students” appeared to be studying health-related fields (thus having a clear bias).

These findings, to the Union’s leadership, did not seem like a thorough investigation of potential effects of a negative ad campaign. Moreover, it seemed at various times during our conversations with the BPHC, that increasing or at least maintaining the cycling rate was not one of the directives of this campaign. And if that was the case, why would one branch of government be allowed to run the risk of working against the work of another branch of government, in this case, Boston Bikes?

Additionally, it is not clear that focusing on the use of helmets has a significant effect on rider safety. A study of bicycle-related injury data from all nine Boston Emergency Rooms was projected at that first meeting about the helmet ads, and city officials, bike advocates and ER doctors in the room saw that only 2.2 percent of the 1,411 bike crash victims the ERs saw in 2010 had head injuries. Only a third of those people, 11 in total, had injuries serious enough to be admitted to the hospital after the ER. This number is dwarfed by hospitalizations for injuries of other kinds.

Another statistic from that meeting showed that 28 percent of bike crash victims in 2010 had fractures or dislocations, and over a quarter of those were admitted for a longer hospital visit (82 people). Overall, 58 percent of all hospital admissions (post-ER) for bike related incidents in 2010 were for fractures or dislocations, compared to 8 percent for head injuries. So why not focus on the prevention of the crashes in the first place?

The ER study is one of the only products of a BPHC investigation into bike and ped crash data that has now spanned two years, and it does not mention helmets as part of its conclusion. Instead it highlights the need for prevention through education and outreach, access to information on the “environmental context” of injuries (such as location and cause from police and ambulance data), and identifying crash hot spots.

All of this is in line with what the Bike Union has been recommending for the last three years: data-driven safety efforts. Better crash data, we believe, will help make the argument for better infrastructure and policies and inform strategies for prevention through targeted safety education and outreach.

For the $50,000 spent on this ad campaign, or a fraction of it, the city could have paid an expert to compile and redact private information from the police reports that tell us all about the cause of crashes. Then, that data could be matched with valuable ER information, allowing us to see how the most serious crashes are happening, and make all of the findings available to the transportation department, advocacy groups, and to the health department. This would allow the city to build better bike infrastructure in smarter ways, encourage targeted bike safety programming from other organizations, and maybe even some put out some ads that hit the target and actually make biking safer.

And if you read MassBike’s Twitter feed you will see the following:

We’re disappointed that Boston chose to promote helmet use in a way that might discourage people from biking.

(link to tweet)

If you check out Livable Streets Blog Steve Miller writes:

But scaring people about the dangers of bicycling without a helmet may undermine the larger benefit of getting more people to cycle. Already, the primary reason people give for not bicycling is that it seems dangerous – mostly because of the proximity of cars. Maybe we should be trying to increase the fear of dangerous behaviors among car drivers rather than bicyclists!

It would seem that the “advocacy community” the BPHC reached out to, all said the same thing. DON’T DO THIS! While $50,000 isn’t going to buy a lot of infrastructure, it could have been used for much nicer ad’s.

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