Aaron Wernham, director of the Health Impact Project discusses the benefits of health impact assessments in this edition of Governing.More info
New HIA Identifies Possible Health Effects of Casino Development in Southeast Kansas
Health Impact Project Grantee Identifies Possible Health Benefits and Risks of Proposed Casino Development and Legislation
TOPEKA — A new report on a health impact assessment (HIA) by the Kansas Health Institute highlights the potential positive and negative health effects of developing a casino in southeast Kansas. While previous discussions about casino development have been limited to potential economic benefit and pathological gambling, the HIA sought to bring additional health effects to the table.
The HIA uncovered potential health benefits—such as increased quality of life and life expectancy associated with new jobs—and health risks —including chronic fatigue and injury associated with pathological gambling—that were not part of previous discussions about gaming. These benefits and risks are outlined in the report, Potential Health Effects of Casino Development in Southeast Kansas (PDF).
KHI and its research partner, the University of Kansas School of Medicine–Wichita, conducted the HIA to inform members of the Kansas Legislature as they considered proposals to reduce the development fee for a casino in the Southeast Kansas Gaming Zone, a state-designated area that comprises Cherokee and Crawford counties. During the first part of the 2012 legislative session, three casino-related bills received a hearing with a Senate committee, but no action was taken on these bills and they died in the committee. At the beginning of the veto session, these three bills were repackaged into a Senate bill that also did not advance.
By providing evidence-based information to policymakers, HIAs aim to maximize the health benefits of a project while minimizing potential risks to community health. Because so many things can affect health, HIAs often bring issues that otherwise might not have been discussed to the attention of policymakers.
“Health impact assessment is a natural extension of our work in Health in All Policies,” said Robert F. St. Peter, M.D., CEO and president of KHI. “Our first HIA intended to inform the discussion of potential casino development in southeast Kansas. In many cases, issues like this may seem not to have direct connections to health, making them a good fit for health impact assessment. We hope that the HIA findings will be a valuable resource for policymakers and will stimulate discussions of the many issues that affect the health of Kansans.”
The HIA results suggest that even after accounting for effects from existing casinos in the region, residents of Cherokee and Crawford counties likely would experience some added positive and negative impacts from a new casino. The potential positive health effects relate to creation of jobs, particularly for the leisure and hospitality industry. However, the project also identified several potential negative health consequences, which will mostly result from increased access to a casino. Specifically, the region could experience increases in pathological gambling. Adverse health consequences of pathological gambling include nicotine dependence, substance use, depression and insomnia. Pathological gambling also has been associated with higher rates of child abuse and neglect, domestic violence, unsafe sex and divorce.
Concerns about the economy and health are not new for southeast Kansas residents. More than 27 percent of Cherokee and Crawford County children live in poverty, compared to 18 percent of all Kansas children. The region’s teen birth rate is higher than the state’s. And the percentages of Crawford and Cherokee County residents who are overweight and inactive are both significantly higher than the state averages. As the 2012 County Health Rankings show, Crawford and Cherokee counties lag behind many other Kansas counties. The result is that many residents are sicker during their lifetimes and die younger than their counterparts in other parts of the state.
To maximize the economic and health benefits offered by a new southeast Kansas casino, the HIA included several recommendations. Among them are suggestions to:
- Train primary care physicians to screen for problem gambling behaviors at medical homes.
- Eliminate smoking within and around casino buildings.
- Strengthen local services to treat and prevent gambling addictions and related conditions.
- Enhance traffic enforcement on well-traveled roads to patrol for drivers under the influence.
- Operate a “safe ride” program for patrons and residents.Use a “loss limit” strategy to prevent substantial financial losses among casino visitors.
“The health impact assessment process helped to identify some hidden connections between casino development and health, such as the potential effect of population growth on access to health care services,” said Tatiana Lin, KHI senior analyst and strategy team leader, who directed the casino HIA project. “In addition, the HIA allowed our research team to incorporate public input into findings and recommendations, making them more relevant to the local community. We hope policymakers and community members will find this Kansas-specific information useful.”
The HIA was funded by a grant from the Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts. HIAs are part of a fast-growing field in the United States. In 2007, there were only 27 such studies. Today, roughly 200 HIAs have been completed or are ongoing. KHI plans to conduct additional HIA projects as part of its mission to inform policymakers by identifying, producing, analyzing and communicating information that is timely, relevant and objective. A related KHI issue brief, Health Impact Assessments Help Link Policy Decisions With Effects On Public Well-Being, provides more information about HIAs and the casino project.
KHI is an independent, nonprofit health policy and research organization based in Topeka. It was established in 1995 with a multiyear grant from the Kansas Health Foundation.
The Health Impact Project announced eight new grant recipients that will receive funding to conduct health impact assessments, or HIAs. The projects will bring health considerations into upcoming decisions on topics including education, sanitation infrastructure, and energy. The grantees were selected based on their response to a national call for proposals.More info
The city of Greenville, South Carolina recently completed a yearlong health impact assessment with support from Pew's Health Impact Project.More info
The Health Impact Project announces a request for proposals (RFP) that will fund three grants of up to $100,000 each to identify and address potential health impacts of an upcoming decision in each of their communities or state through the use of health impact assessments (HIA).More info
The New York Times interviews Aaron Wernham, project director for the Health Impact Project, about the growing field of health impact assessments.More info
Minnesota organizations are invited to participate in an in-person training to learn about health impact assessments (HIAs). An HIA can help improve the well-being of local communities by incorporating health into decisions in other sectors.More info
"A new report from the Pew Charitable Trusts and the Robert Wood Johnson Foundation concludes that getting rid of junk food at school boosts kids’ health and doesn’t hurt schools financially. Even many snack food companies are on board."More info
"'The evidence is clear and compelling,' said Jessica Donze Black, director of the Kids’ Safe & Healthful Foods Project in a press release. 'Implementing strong national nutrition standards to make the snacks and beverages our children consume healthier is something that schools and districts can afford. The USDA should do all it can to finalize and help implement strong standards.'"More info
Aaron Wernham, director of the Health Impact Project, explains how by systematically assessing the health risks of development decisions upfront, health impact assessments can prevent costly and harmful mistakes.More info
"A study released late last month delivers the message: Make competitive foods offered in schools healthier, too. The study was a collaboration between the Pew Charitable Trusts and the Robert Wood Johnson Foundation and came from two projects, the Kids’ Safe and Healthful Foods Project – the director, Jessica Donze Black, is a University of Delaware graduate – and the Health Impact Project."More info
The Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts, announced a call for proposals for grants to conduct health impact assessments (HIAs). HIAs identify and address the health impacts of decisions in other sectors, such as planning roads, passing agriculture legislation, or siting schools.More info
Pew and the Robert Wood Johnson Foundation collaborate to examine impact of updated USDA standards for snack and a la carte foods and beverages sold in schools.More info
"A recent study has reaffirmed what local school officials already knew: Student health and school budgets can both benefit from higher nutrition standards."More info