Bicycle helmet-wearing variation and associated factors in Ontario teenagers and adults

Background: The incidence of bicycle helmet use and the factors associated with helmet use in Ontario are presented in this study. The Ontario Health Survey (1996), a population-based survey of Ontario residents, was used as the data source. Methods: As the factors associated with helmet use were found to differ between adults and teens, a separate analysis was performed for each age grouping. A logistic regression model (with Bootstrap confidence intervals - 95%) was used and adjusted odds ratios (OR) are reported. Results: Of the 7,693 respondents, 41.1% reported wearing their helmets on a regular basis when riding a bicycle. Helmet use was greatest among 12-14 year olds (71.7%) and lowest among those 15-18 years old (33.3%). In teenagers, drinking alcohol (OR: 2.8) and smoking (OR: 4.4) were strongly associated with helmet non-use. In the adult group, female gender (OR: 1.26), higher income (OR: 1.43), higher education (OR: 1.68), nonsmoking status (OR: 2.0) and abstinence from alcohol (1.27) were associated with helmet use. Living in a rural area was also associated with helmet use in the multi-variable analysis. Conclusion: This study indicates that bicycle helmet non-use is a multifaceted problem and thus any strategy for increasing helmet-wearing rates requires multi-dimensional interventions. The results of this study are discussed within the context of other studies and related to their public health implications.