Moving on income as a social determinant of health: free transit for social assistance recipients in Kingston, Ontario.

settingThe 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.

interventionIn 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.