Promoting Health Equity Through Tax-Funded Zero-Fare Public Transit: A Survey of Voters From Kansas City, MO.

Public transportation has positive impacts for both individual and community health, but funding and scalability are political challenges. Understanding civic processes, such as voting, is key to advancing health equity through large-scale policy change. The purpose of this study is to understand voter support for tax-funded public transportation. This study employed a cross-sectional survey of randomly sampled voters in Kansas City, Missouri, collected from October 2023 to January 2024. Of the 2,577 respondents, 79% participated in the election of interest. Two-sample proportion tests for pairwise comparisons of support for taxes were used to calculate test statistics, p-values, and effect sizes. Most participants supported the current (84.43%, n = 1,719) and potential future (72.45%, n = 1,475) taxes to support public transit. Recent bus use and proximity to a bus stop were significantly associated with current and future tax support. Notably, 48.26% of respondents unaware of the free fares supported the current tax compared to 71.06% of those aware (p < .001, h = 0.47). Free fare public transit may be a motivating factor for funding services among voters. Public health professionals and researchers should work to better understand and leverage the interplay between public policy, institutional legitimacy, and civic engagement to improve the upstream determinants of health.