Abstract
Setting
The public health intervention setting is the City of Kingston, Ontario, Canada. The authors were involved in various stages of development of the intervention, including advocacy, design, implementation, and evaluation.
Intervention
In early 2017, the City of Kingston launched a pilot program to offer all recipients of social assistance a pass that would provide unlimited access to transit. The 1-year pilot program showed promise in terms of the objectives of the two departments involved, Housing and Social Services and Kingston Transit, as it reduced barriers to transportation and increased ridership in the city. The pilot was adopted as an ongoing program, The Ontario Works Universal Transit Pass, upon completion of the pilot. The program was funded by redirecting provincial means-tested and discretionary employment benefits from the Housing and Social Services budget to the Kingston Transit budget in order to purchase transit in bulk for Ontario Works (OW) recipients.
Outcomes
The program provided greater access to essential services, increased household budgets, reduced stigma, and increased ridership. The improved social and economic opportunities that the program facilitated demonstrate the potential of addressing social determinants of health through transportation.
Implications
The program illustrates an effective model for addressing income as a social determinant of health through transportation policy. Moreover, it demonstrates the potential for creative, cooperative approaches to inter/intra-government operations—like the transfer of funds from Housing and Social Services to Kingston Transit—which simultaneously promotes both greater efficacy of public services and health equity.
Résumé
Cadre
Le cadre de l’intervention en santé publique est la ville de Kingston, Ontario, Canada. Les auteurs étaient impliqués pendant les étapes variées d’intervention, y compris faire la promotion, la conception, la mise en œuvre, et l’évaluation.
L’intervention
Au début de 2017, la ville de Kingston a lancé un projet pilote pour offrir à tous les bénéficiaires de l’aide sociale un laissez-passer qui fournirait l’accès illimité aux transports en commun. Le projet pilote dura un an et se montrait prometteur en termes des objectifs des deux services impliqués—Housing and Social Services (logement et services sociaux) et Kingston Transit (transports Kingston)—parce qu’il réduisait les barrières au transport et augmentait le nombre d’usagers de transports en commun en ville. Le projet a été adopté comme un projet continu, appelé le laissez-passer universel de transport en commun de L’Ontario au travail, dès l’achèvement du projet pilote. Le programme était financé en redirigeant les bénéfices d’emploi provincial disponibles avec l’évaluation des revenus, qui font parties du budget pour le service logement et services sociaux, vers le budget du service de transports au Kingston. Les finances étaient utilisées pour acheter les laissez-passer de transport en gros pour les bénéficiaires de L’Ontario au travail.
Résultats
Le programme fournissait un meilleur accès au services essentiels, augmentait les budgets famille, réduisait la stigmatisation, et augmentait le nombre d’usagers de transports en commun. Les opportunités économiques et sociales améliorées que le programme avait facilitées illustre le potentiel de s’occuper des facteurs déterminants sociaux de la santé à travers les transports en commun.
Conséquences
Le programme démontre un modèle efficace pour s’occuper de revenu comme un facteur déterminant social de la santé à travers la politique des transports. En outre, il illustre le potentiel pour les approches créatives et coopératives aux opérations entre les niveaux gouvernementaux—comme le transfert des finances du service de logement et services sociaux vers le budget du service de transport au Kingston—qui provoque simultanément une efficacité plus grande des services publics ainsi que l’équité de la santé.
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Notes
The provision of transportation benefits is included as an OW Discretionary Employment Benefit and, as such, it is the responsibility of the Housing and Social Services department to determine funding allocations. Eligible benefits are cost-shared with the province in accordance with the prescribed provincial cost-sharing formulae. City of Kingston, Report to Council, Report Number 16–368, Universal Kingston Transit Pass 1-Year Pilot Program – Ontario Works, November 15, 2016. https://www.cityofkingston.ca/documents/10180/16556902/COU_A2816-16368.pdf.
A series of developments to increase ridership among high school students led to expanded free transit for all youth and children in the City of Kingston as of 2017. Transit Fares and Passes, City of Kingston. https://www.cityofkingston.ca/residents/transit/fares.
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Material preparation, data collection, and analysis were performed by Authors 1, 2, 3, and 4. The first draft of the manuscript was written by Author 1. All authors read and approved the final manuscript.
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Authors 1, 2, and 3 have received employment income from the City of Kingston and Author 4 has received employment income from KFL&A Public Health for their contributions to the article.
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Holland, M.R., Noordegraaf, R., DaCosta, J. et al. Moving on income as a social determinant of health: free transit for social assistance recipients in Kingston, Ontario. Can J Public Health 115, 111–116 (2024). https://doi.org/10.17269/s41997-023-00816-y
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DOI: https://doi.org/10.17269/s41997-023-00816-y