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Saturday
Dec052009

Monkey see, monkey do? Images, media and public health

In today's Ottawa Citizen, Leonard Stern wrote an editorial called Parental guidance. In it, he discussed the reaction of the paper's readers to a number of parenting related articles that the newspaper had run. This included one by Kate Heartfield saying that the crib recall was pretty obvious (anyone could see that those cribs are not safe) and one by Ottawa physician Barry Dworkin way back in 2002 suggesting that combination feeding (breast/bottle) was okay in some cases.

Those are certainly hot buttons and I can imagine that they got a lot of letters about them. I haven't read the articles  or the letters myself, so I can't comment on the validity or outrageousness of either the articles or the letters received in response. However, the other hot button that Leonard Stern mentioned did get me riled up and made me question the original author's judgment, Leonard Stern's judgment and the judgment of the newspaper's editorial team and policies.

Outrage over helmetless kids


In his editorial, Stern writes:
Last fall, [Kate] Jaimet took her two young daughters on a cycling tour of Quebec's Eastern Townships. Jaimet wrote a lovely article about the adventure for the Citizen's Travel section, accompanied by photos of the girls. Except the children were not wearing helmets. Uh oh.

Stern goes on to explain that the paper received no shortage of feedback from readers who "did not hesitate to lecture Jaimet on her dereliction of maternal duty". He then explained that people who work with Kate know that she is a great mom and she even writes children's books in her spare time (not sure what that has to do with keeping your kids safe, but okay).

Stern asked Jaimet what it was like to hear from readers who thought she was a bad parent. Stern wrote:
"People should just chill a little bit" she e-mailed me. She notes that the controversial photos of her children were taken on dedicated bike paths. When it comes to biking on the street, however, her children always wear helmets.

Stern concludes by saying that he hates receiving parenting advice from strangers and that despite his own urge to be a busybody and butt in when he sees bad parenting, he just shuts up. He doesn't want them to think that he is judging them, but admits he probably is.

Bicycle helmet safety


In her e-mail to Stern, Jaimet assured him (and readers) that they weren't travelling on the street that day. They were on a dedicated bike path. Unfortunately, not all accidents are caused by cars. Debris on the bike path, a malfunction of something on the bicycle, misuse of the brakes, turning to look at something interesting, other careless cyclists, are all things that can cause an accident even on a dedicated bike path. When I was in high school, a friend of mine had some part of his bike come loose and get caught between the spokes, causing him to go flying over the handlebars and land head first on the pavement. Jaimet may not have been breaking any laws that day because (a) they were not on the street and (b) they were not in Ontario. But that doesn't mean it was a responsible decision. Bike helmets are important and not just on the street.

The power of imagery


They say a picture is worth a thousand words. Whether it is a picture of a baby being bottlefed instead of one being breastfed, a picture of a child sleeping on its stomach instead of on its back, or a picture of a teenager lighting up a cigarette, these images can undo a lot of important public health related advocacy work.

I don't think people consciously make parenting decisions based on the images that they see, but we do internalize images and  make decisions about what is good and bad, right and wrong, normal and abnormal based on what is prevalent in our society.

While perhaps a dozen or so people saw Jaimet and her kids cycling without their helmets that day, when the picture appeared in the paper, it would have been seen by more than 100,000 people. That is an awful lot of helmet imagery that bike safety advocates have to get out there now to battle Jaimet's helmet free picture.

The responsibility of the media


No parent is perfect. We all make mistakes. We all make decisions that are less than ideal. Some people write about those mistakes or bad decisions as a way of saying, "I'm human, we're all human, it's okay to not be perfect." As long as it doesn't go to the point of glorifying bad decisions, I think that type of writing is useful both to the writer and to others who can see that there are other parents out there who don't get it right all of the time.

But this article wasn't about parenting. It wasn't a confession that she had forgotten the helmets at home, but decided to risk cycling without the helmets so that they wouldn't have to miss out on their special plans. It was an article about the beautiful cycling trails of Western Quebec nonchalantly paired with a picture of her two daughters having a glorious helmet-free day.

The Canadian Association of Journalists Statement of Principles includes a clause that says:
Defending the public’s interest includes promoting the free flow of information; exposing crime or wrongdoing, protecting public health and safety and preventing the public from being misled. [emphasis mine]

I think the media has a responsibility to think carefully about the images they use to accompany their articles and how those might be interpreted or internalized by readers. Just as I've called on the media to lay off the bottle imagery and told Elizabeth Pantley that I don't like the unsafe co-sleeping images in her books, I think it is important for publishers like the Ottawa Citizen to think carefully about whether the images they are showing could be working counter to important public health advocacy messages.

Ultimately, as much as we pretend to be superior beings capable of higher reasoning, there is still an awful lot of monkey see, monkey do out there. So when it comes to important public health and safety issues,  let's be sure that the monkey sees the safe choice.

Like this:



Image credit: istargazer on flickr
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Reader Comments (14)

Definitely not a parent. Definitely won't be for another few years. But as a public health employee and someone who wants children, this has given me a lot to think about.

December 5, 2009 | Unregistered CommenterKaitlin

Bike helmets is a tough one-- I see so many kids who don't wear them, and those who do are often wearing them wrong (like the strap hanging loosely a good inch or 2 below their chin, or the girl on the far right in the picture above whose helmet is tilted too far back off her forehead). We just bought our son a balance bike, and I noticed how the instructions specified to NEVER let a child ride it without a helmet... while every single picture on the box and instructions showed helmet-less kids on the bikes. =/

I was pleased to see an article in Parents magazine a couple months ago on bike helmet safety, including a diagram showing keys to proper fit, which I saved for future reference. I think a lot of people just do't bother to think about how important helmets are and what a difference they really make.

December 6, 2009 | Unregistered CommenterMarcy

In case anyone wants it, here's that diagram showing proper bike helmet fit:

http://farm3.static.flickr.com/2492/4162302974_93f45cbf89_b.jpg

December 6, 2009 | Unregistered CommenterMarcy

Helmet laws have stopped a lot of people cycling and have done nothing for head injury rates, see http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=16565131 (Robinson's work uses the best scientific methods, all available control groups and so on.) And the only known connection between helmets and death is that helmets have strangled a few young children who were wearing helmets while playing off their bicycles, see http://en.wikipedia.org/wiki/Bicycle_helmet for an incomplete list.

In real accidents bike helmets don't seem to crush as designed, they break instead. The senior engineer of Bell Sports, the market leader in cycle helmets, has written: “Another source of field experience is our experience with damaged helmets returned to customer service... I collected damaged infant/toddler helmets for several months in 1995. Not only did I not see bottomed out helmets, I didn’t see any helmet showing signs of crushing on the inside.” In 1987, the Australian Federal Office of Road Safety found that in real accidents "very little crushing of the liner foam was usually evident... What in fact happens in a real crash impact is that the human head deforms elastically on impact. The standard impact attenuation test making use of a solid headform does not consider the effect of human head deformation with the result that all acceleration attenuation occurs in compression of the liner. Since the solid headform is more capable of crushing helmet padding, manufacturers have had to provide relatively stiff foam in the helmet so that it would pass the impact attenuation test..." A broken helmet has simply failed, and the widespread anecdotes on the theme of "a helmet saved my life" seem to owe more to wishful thinking than to science.

My children and I do not wear helmets but we do use bikes a lot. Kate Jaimet is making a thoroughly sensible choice. It's great to see helmetless children on bikes; personally I'd like to hear that they are getting appropriate education, that their brakes and steering work, and that their parents are campaigning for safer streets. But if they're safe on bikes, they're safe without helmets.

December 6, 2009 | Unregistered CommenterRichard Keatinge

Interesting point. Looking back, I loved to ride my bike until it 'became' (california helmet law) dangerous to do so when I was around 10 years old. Then it was either be 'living on the edge' or feel choked while riding down our quiet country road, so I took up swimming instead. I wonder how little children first learning can balance at all while being so top heavy. Something I'll be looking into more before my children start riding bikes.

December 6, 2009 | Unregistered CommenterCara

I agree Marcy - telling people to wear helmets is not enough. We need to teach them how to use them properly. I also agree about ensuring the imagery on the package of bikes enforces the safety message inside.

December 6, 2009 | Unregistered Commenterphdinparenting

From the study:

"This contradiction may be due to risk compensation, incorrect helmet wearing, reduced safety in numbers, or incorrect adjustment for confounders in case-control studies"

From reading through the study, it sounds to me like the answer might not necessarily be to simply not bother with helmets, but to figure out how to make them more effective. If 90%+ of people are wearing helmets wrong (and that may very well have a HUGE impact on how well they protect cyclists) then we need to a) educate people on how to wear them correctly and b) look into re-designing helmets so they're easier to wear correctly.

As for the helmets breaking on impact, maybe I'm missing something but my basic understanding of physics leads me to believe that if I fall off a bike and my helmet hits the ground and breaks, it is still absorbing quite a bit of impact (enough to break it) that instead would have hit directly on my skull. That seems worth something.

December 6, 2009 | Unregistered CommenterMarcy

@Marcy:

I tend to agree. A large portion of people use child seats incorrectly too. That doesn't mean that they do not prevent injuries and save lives when used correctly.

December 6, 2009 | Unregistered Commenterphdinparenting

I have to think that the helmet breaking helps prevent injuries. My mother's boyfriend does a lot of bike riding, and the day he was hit by a car his helmet broke. His head was fine. It's hard to not consider the two associated.

December 6, 2009 | Unregistered CommenterStephanie

a child's bike helmet is only around 250 grams (9 oz) so they are not *that* top heavy.

December 7, 2009 | Unregistered CommenterRob A

My kids always wear helmets. I was glad of this on the day my son fell off his bike, while riding on the sidewalk, nowhere near traffic, and landed on his head. Doctor friends who have done ER rotations swear that helmets save lives. After Natasha Richardson died from a seemingly harmless bump on the head, I thought more people would realize that even a small fall can cause a serious head injury.

There is a bike helmet law here, but it's not enforced, I routinely have to brake because kids on bikes with no helmets ride out into the street in front of me.

December 7, 2009 | Unregistered CommenterKayris

Children aren't raised in a vaccuum ... it takes whole community. As such, we absolutely have a right to comment (respectfully) on the manner in which others parent their children, most especially when it comes to questions of safety.

December 8, 2009 | Unregistered CommenterMarianne

[...] PhD in Parenting weighs in on an interesting controversy over helmets and the responsibility of the media to portray bike safety. [...]

Hi! We loved your post over at KiwiLog and decided to feature it as part of our parent blog round-up. Thanks!

December 14, 2009 | Unregistered CommenterKiwiLog

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