Health Care

Health impact assessments leading to changes for Wichita bus system

Soon, smoking won’t be allowed outside the Wichita Transit Center. (March 13, 2014)
Soon, smoking won’t be allowed outside the Wichita Transit Center. (March 13, 2014) The Wichita Eagle

There soon will be a lot less cigarette smoke in the outdoor waiting areas at the downtown Wichita Transit Center.

And the transit system has stopped enforcing a rule against carrying more than two bags of groceries on the bus, pending action to do away with that rule entirely.

Banning smoking outside the bus depot and relaxing the two-bag rule are two of several changes to spring from a health impact assessment by the Topeka-based Kansas Health Institute, which studied how changes in the bus system can affect the overall health of the community.

The study marked the second time that the institute has taken an in-depth look at how a proposed government action can affect community health – the other being a study of proposals to make it easier to expand gambling in southeastern Kansas.

Now the institute also is looking into the potential health impact of a bill before the Legislature that would allow the sale of full-strength beer, wine and liquor in grocery and convenience stores and another bill that would allow expanded ownership of Kansas farms and farmland by out-of-state corporations.

Long term, the institute is hoping that health assessments will take a place in everyday government consideration of policies and projects alongside the environmental- and fiscal-impact assessments commonly used today.

While most people think in terms of hospitals and doctors’ offices when considering the health of a community, it can also hinge on less-noticeable factors such as good sidewalks, placement of grocery stores, clean water and housing conditions, said Duane Goossen, vice president for health and financial policy for the institute.

“These considerations are not always part of our decision-making process,” said Goossen, a former state budget director and legislator.

Wichita is still working on what its bus system should look like going forward, but already the recommendations from the institute study are having an effect where the rubber of bus tires literally meets the road.

For example, the study pointed out that people who ride the bus are generally less exposed to second-hand cigarette smoke because smoking isn’t allowed on buses. The study estimated as many as 1 in 5 children are exposed to high concentrations of second-hand smoke riding in cars with drivers who smoke.

But the study also found that the benefit of riding the bus is offset somewhat by being exposed to second-hand smoke in the outdoor waiting areas at the transit station, where people line up to get on the buses.

Stephen Spade, the director of Wichita Transit, said he is working with the city Law Department on how to restrict outdoor smoking at the station without running afoul of the state’s smoking law.

“We think we’ve got it figured out,” he said, adding that the expanded smoking ban will probably take effect in a couple of weeks.

He said his department and the lawyers don’t think that change will have to go to the City Council for approval.

“We can just do that as an agency action, at least that’s my assumption at this point,” he said.

The institute also is recommending that Wichita Transit spend some of its advertising and media efforts to inform motorists about the negative health impact of second-hand smoke exposure in cars.

Another notable change stemming from the study is the demise of the two-bag rule on groceries.

One of the biggest health issues for lower-income people who ride the bus is diet, the institute study found.

Many bus riders will make a once-a-week trip to the grocery store but can’t get a week’s worth of food in the two bags they are allowed to bring on a bus.

As a result, they supplement their diet with less-healthy food from a local convenience store or fast-food outlet during the week.

The hope is that doing away with the two-bag rule will change that, resulting in a better all-around diet and correspondingly better health outcomes, officials said.

In the same vein, Spade said the transit system found a gap in service to Barney’s Deep Discount Drugs, a west-side store that sells a variety of fresh meat and produce along with pharmacy and health supplies.

Only one woman brought that up during a community meeting on bus routes, but further research discovered other consumers who prefer to shop at Barney’s rather than taking a longer ride to a bigger grocery store farther west.

“We found that was their neighborhood grocery store,” Spade said.

As a result, the transit system changed one of its west-side routes to include a stop at Barney’s.

Without the health assessment and its focus on food access, “we probably would have blown right by that,” Spade said. “We were sensitized to that issue after the health impact analysis.”

Another health-related change at Wichita Transit came up after Via Christi Health built a major west-side clinic on 21st Street North, just outside the city limits.

The transit system offers curb-to-curb van service for people with disabilities, but a longtime rule has been that the destination had to be within the city limits.

When the medical group moved outside the city, people who used the transit system were cut off and faced the prospect of having to change their medical providers.

As a result, Spade said, “we’re going to bend our rules to make sure our Wichita citizens can get to their medical facilities.”

Institute officials say a health assessment isn’t a universal cure. Often, other considerations such as cost or jobs can override health concerns.

But even then, information from the health impact assessment can be used to “minimize the risks and maximize the potential health benefits,” said Tatiana Lin, a senior analyst at the institute.

A health impact assessment “doesn’t say health should be the only consideration … but it should be one of the considerations,” she said.

Wichita City Council member Janet Miller said the health assessment has given the council credible data to guide decisions rather than members just going with gut feelings and e-mails and letters from individual constituents.

As government decision makers, “you’re always hoping you’re doing something that will help,” she said. “But if you do that in a vacuum and you do it only on hunches and anecdotal information, those are not our proudest moments.”

Having actual data “gave credibility to the outcome” of city decisions on the bus system, she said.

She said the institute’s assessment provided the council with a lot of information on how to improve the bus service.

The problem now is how to pay for it.

“Unfortunately, it hasn’t helped us solve that problem, dang it,” she said.

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