Southeast Kansas Casino

Kansas Health Institute

Kansas Health Institute (KHI), in partnership with the University of Kansas School of Medicine, conducted a health impact assessment (HIA) of proposed legislation that would reduce casino development fees in Southeast Kansas. Previous discussions about potential casino development were limited to potential economic benefits and the effects of pathological gambling; the HIA sought to bring additional health considerations to the deliberations.

The HIA found that the two counties that would be most affected by potential casino development, Cherokee and Crawford, are among the least healthy in the state, and currently struggle with high unemployment, poverty, and high rates of premature death, as well as obesity, injuries, and other health problems. The HIA found that a new casino would bring jobs to the Southeast region; more jobs could lead to increased quality of life and life expectancy associated with higher incomes, community stability, and access to health care. The HIA also found significant health risks including a potential increase in pathological gambling, which is connected to nicotine addiction, substance use, depression, and insomnia as well as higher rates of domestic violence, child abuse and neglect, unsafe sex, and divorce.

The HIA made several recommendations to maximize the economic and health benefits of a new casino, including training primary care physicins to screen for problem gambling behaviors at medical homes; eliminating smoking within and around casino buildings; operating a 'safe ride' program for patrons and residents; and using a 'loss limit' strategy to prevent substantial financial losses among casino visitors.


The HIA process gave legislators and community members the opportunity to examine how placement of a casino in the region could affect residents’ health. Ultimately, the legislation did not pass in 2012, nor when it was reintroduced in 2013. The HIA did change the policy discussion to more fully integrate health considerations as it was being debated in 2013.