Studies have shown wearing a helmet while riding a bicycle reduces one's risk of death by more than 50 percent, yet every three days, a child in the United States is killed while riding a bicycle, and every day at least 100 children are treated in emergency rooms due to bicycle-related head injuries.

A report released today by the University of Michigan C.S. Mott Children's Hospital National Poll on Children's Health reveals that in areas where no bicycle helmet laws exist, nearly one-half of children, ages 4-17, never wear a helmet.

"These statistics underscore the importance of helmet laws to help prevent death and injury from children not wearing helmets while riding their bikes," says Matthew Davis, M.D., director of the National Poll on Children's Health. "Yet only twenty one states have helmet use laws for children."

Data from the National Highway Traffic Safety Administration indicate universal bicycle helmet use by children, ages 4-15, would prevent about 40,000 head injuries and about 50,000 scalp and face injuries every year.

While the poll shows helmet use is better in areas where helmet laws exist (54 percent of parents report their children always wear a helmet while riding a bike), the poll also measured adults' awareness of helmet laws in their communities and whether or not they would support new laws if none existed.

Forty-one percent of parents said they were unsure about helmet use laws in their communities. Overall, 86 percent of respondents would support helmet laws for children in their communities.

The poll also shows that other barriers to helmet use exist for some parents whether or not laws exist in their areas. Among parents who report their child never wears a helmet, 32 percent believe they are too expensive. One in two children in the lowest income families making less than $30,000 per year never wear a helmet.

As children age, self concept and image may play a role in their decisions about whether or not they will wear a helmet. Among children who never use helmets, 59 percent of parents report that their children do not like wearing helmets.

"Wearing a bicycle helmet is essentially a health behavior," Davis says. "It is not yet a fashion statement. For many kids -- especially older kids -- there is a tension between this healthy behavior and being seen as cool or acceptable by their peers. There is a challenge here for health care providers and public health officials to communicate that wearing a helmet is actually the cool thing to do besides being the healthy thing to do."

The poll also finds:

- 78 percent of parents report children ages 4-17 ride bicycles.

- 27 percent never wear their helmets while riding their bikes.

- Among children ages 4-11, 53 percent always wear helmet while riding bikes, while only 29 percent of children ages 12-17 always wear helmets while riding bikes.

- In states and communities that have bicycle laws, 54 percent of children 14-17 always wear a helmet, while only 24 percent of children always wear a helmet in places without a bicycle helmet law for children.

"To try to increase helmet use across the country, there are at least three ways we can proceed. One way is to pass more helmet laws," Davis says. "There is also a group of parents out there who really want their children to wear helmets but can't afford them. We should be better at sharing information about the very successful state and local programs that provide free or cheap helmets for kids. The third opportunity here is to change how families view helmets in terms of how important it is to use them regularly. That is going to be perhaps the toughest because it involves communicating the benefits of the health behavior and really trying to make a longstanding difference in the attitudes of parents and in the communities that may not yet be on board with the use of bicycle helmets."