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Dr. Jordan Carlson Receives Funding From NIH to Study Kansas City’s Zero-Fare Bus Transit and Its Possible Impact on Health

STORIES

Dr. Jordan Carlson Receives Funding From NIH to Study Kansas City’s Zero-Fare Bus Transit and Its Possible Impact on Health

Headshot of Jordan A. Carlson, PhD
Jordan A. Carlson, PhD
Director, Community Engaged Research, Center for Children’s Healthy Lifestyles & Nutrition; Associate Professor of Pediatrics, University of Missouri-Kansas City School of Medicine; Research Assistant Professor of Pediatrics, University of Kansas School of Medicine
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Jordan Carlson, PhD, Center for Children’s Healthy Lifestyles & Nutrition, received a $2,665,578 R01 grant from the National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases. Dr. Carlson is Multiple Principal Investigator (MPI) along with Dr. Jannette Berkley-Patton from the University of Missouri – Kansas City. The funding’s project period goes until Jan. 31, 2026. This work is also being supported by the U.S. Environmental Protections Agency through a two-year $200,000 award ending Dec. 31, 2023. The research involves a partnership among Children’s Mercy, the University of Missouri – Kansas City, University Health, BikeWalkKC, Kansas City Public Works, and the Kansas City Area Transportation Authority.

Dr. Carlson’s study, “Health Impacts of City-Wide Zero-Fare Bus Transit: A Natural Experiment,” looks at the new policy that eliminated bus fare citywide in Kansas City, Mo. It evaluates the policy's potential impact on bus ridership and improvements in metabolic health through increased physical activity and healthy eating, as well as reduced economic barriers to health care.

As Dr. Carlson explains, creative and wide-reaching approaches are needed for reducing the high rates of preventable chronic diseases like obesity and diabetes that economically disadvantaged groups disproportionately experience. Active transportation is an underused source of physical activity but can be a major contributor to a person’s overall physical activity and cardiometabolic health. Using public transit is one way to increase active transportation via walking to and from the bus stop. Previous work has shown that transit users engage in about 15 more minutes per day of overall physical activity than non-users and are much more likely to meet the 150+ minutes/week physical activity guideline. Public transit can also support access to healthy eating and health services.

Kansas City, Mo. made national headlines in December 2019 when its city council voted unanimously to become the first major city in the U.S. to make public transit free citywide. The policy aimed to reduce transportation and economic barriers faced by many Kansas City residents.

“Policies like this have promise for supporting health improvements among the families we serve at Children’s Mercy and in our community, so we believed it was critical to conduct a health evaluation,” said Dr. Carlson.

The study, which uses a natural experiment design, will collect bus ridership data before and up to three years after zero-fare bus transit (ZBT) went into effect to compare changes in bus ridership in Kansas City to other cities that charge fares to ride the bus. To investigate health information, study participants will be recruited from local health systems serving economically disadvantaged residents. Patients’ health information will be gathered from the electronic health records before and after the policy was adopted. Researchers will have a subsample complete in-depth assessments about their physical activity, their healthy eating, their thoughts on the ZBT policy and barriers/facilitators to riding the bus. Children’s Mercy’s new Field-Based Physical Activity Measurement Core will employ multiple wearable monitors to capture when a study participant uses public transit and the amount of physical activity associated with each transit trip.

“This work is important because if we can document that the policy is supportive of health without other detrimental consequences, it may be more likely to be continued and expanded in other cities across the U.S. as a way to improve community health and reduce health disparities,” said Dr. Carlson.

Keith Feldman, PhD, and Vincent Staggs, PhD, Health Services and Outcomes Research, serve as co-investigators on the project. At the University of Missouri – Kansas City, Amanda Grimes, PhD, Joey Lightner, PhD, Jenifer Allsworth, PhD, and Betty Drees, MD, also serve as co-investigators.