Equestrian Helmet Use in the Movies: A Lost Opportunity for Injury Prevention?

Leela Strand
Karisa Harland, PhD
Suleimaan Waheed, DO
Charles Jennissen, MD

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 and whether there were any differences in helmet use by age, sex, type of horse interaction, movie rating, or over time. We also wanted to examine if characters experienced injuries from potential injury mechanisms, including falls, and whether there were any differences in head injuries by helmet use.

The American Humane on-line database was used to identify movies with horses from 1990-2021. Historical and fantasy films were excluded (n=325), and 94% (384/409) of remaining films were available for review through Netflix DVD or streaming venues. 170 movies met final inclusion criteria having scenes with people interacting with horses. All individuals in horse scenes were coded for study variables. Potential injury mechanisms and injuries sustained were also coded. Frequencies and statistical analyses including chi-square, Fisher’s exact and logistic regression analyses were performed.

1376 individuals in 451 scenes were analyzed. Equestrian helmet use in movies 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. Females in movies were nearly four times more likely than males to be wearing helmets during recreational riding (OR 3.76, 95% CI 2.19-6.45). Youth (6/48, 13%) had a higher proportion wearing helmets when around but not riding horses than adults (1/340, 0%), P<0.0001. They were also over 4 times more likely to be helmeted than adults during recreational riding (OR 4.32, 95% CI 2.43-7.67). Higher proportions of movies had all youth wearing equestrian helmets when recreationally riding (8/40, 20%) as compared to movies having all adults wearing helmets (7/101 movies, 7%), P=0.033. No one was wearing a helmet during occupational riding in G/PG movies. No individuals doing recreational riding in G movies were wearing a helmet. A significantly higher proportion of G/PG movies had all children/teenagers depicted unhelmeted during recreational riding (16/19, 84%) as compared to PG-13/R movies (9/21, 43%), P<0.01. There was no increase in equestrian helmet use in movies over time. In fact, individuals in movies released from 1990-1999 were over 4 ½ times more likely to have helmets while recreationally riding than movies released from 2010-2019 (OR 4.67, 95% CI 2.35-9.30). Of characters falling off horseback (n=45), 60% experienced no apparent injury while six (13%) had head injuries. There was no difference in the proportion suffering a head injury by helmet use.

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.

1. Participants will be able to share how mass media may have a role in shaping normative safety behavior.
2. They will be able to describe equestrian helmet use in the movies and at least two demographics that are more frequently shown to be wearing helmets.
3. Attendees will be able to state the effect of a movie’s rating and release date on the portrayal of equestrian helmet use.