Background Equestrian helmet use remains relatively low despite their proven success in reducing serious head injuries. Societal forces, like mass media, impact the culture of safety practices and what is considered normative behavior. Our objective was to examine how equestrian helmet use is portrayed in movies.
Methods The American Humane on-line database was used to identify movies with horses from 1990–2021. Historical and fantasy films were excluded. 170 films meeting inclusion criteria were available for viewing. All individuals in horse scenes were coded for study variables. Frequencies and statistical analyses were performed.
Results 1376 individuals in 451 scenes were analyzed. Equestrian helmet use was extremely low (13%). Helmet use was higher when riding horses (177/988, 18%) than for off-horse activities (7/388, 2%), p<0.0001. Overall, youth (52/172, 30%) were helmeted in greater proportions than adults (132/1216, 11%), p<0.0001. No one was wearing a helmet during occupational or recreational riding in G-rated movies. A significantly higher proportion of G/PG-rated movies had all children/teenagers depicted unhelmeted during recreational riding (16/19, 84%) as compared to PG-13/R-rated movies (9/21, 43%), p<0.01. There was no increase in equestrian helmet use in movies over time. Of characters falling off horseback, there was no difference in the proportion suffering a head injury by helmet use.
Conclusion and Learning Outcomes The vast majority of characters interacting with horses in movies were unhelmeted, reinforcing an unsafe societal norm. Improvement in mass media equestrian helmet use might help positively shift this paradigm, thereby increasing helmet use and decreasing head injuries.
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