​For Winston-Salem residents without the means or ability to drive, the bus system plays a critical role in determining their ability to reach jobs, education, medical care, child care, public benefits, and community activities. The Business 40 infrastructure improvement project presents an opportunity to consider the mobility of all Winston-Salem residents and to focus on how the bus system can be used to advance health equity in our community.

The NC DOT has designated funds to expand bus service during the Business 40 closure.

• Both the Piedmont Authority for Regional Transit (PART) and Winston-Salem Transit Authority (WSTA) will receive funds to increase bus services to mitigate the impact of the Business 40 closure on local transportation and traffic.
• WSTA will receive more than $7 million in grant funds to expand bus services.
• The Business 40 closure presents an opportunity to conduct a “natural experiment” to determine the impact of such improvements on the ability to access health resources (Downtown Health Plaza and Novant Health).

​Harm reduction models use a variety of strategies to eliminate the harmful consequences associated with substance abuse. These strategies seek to reduce morbidity and mortality associated with substance abuse for those who are not ready to quit all together. Such programs resemble a stepping stone process and allow persons who inject drugs to make gradual progress to overcome their addiction. According to the Rural Health Information Hub, “The goal of harm reduction models is to reduce at-risk, moderate and high-risk behaviors often associated with substance abuse.”
 
One of the key principles of harm reduction practice from the Harm Reduction Coalition is, “Accepts, for better and or worse, that licit and illicit drug use is part of our world and chooses to work to minimize its harmful effects rather than simply ignore or condemn them.” This principle highlights the knowledge and acceptance that the programs put into place are not direct solutions but help assist people in taking steps towards ending their addiction.
 
Syringe exchange programs allow persons who inject drugs to exchange used needles for new, sterile needles and syringes to reduce the risk of spreading human immunodeficiency virus (HIV).  These programs also provide counselling, HIV and hepatitis B and C testing, and referrals to treatment centers. The hope of these programs is to reduce to spread of HIV and hepatitis B and C while also providing education, counseling and testing to persons who inject drugs.
 
Even though these programs are controversial, they have drastically reduced the rate of HIV transmission and risk of hepatitis infections among injection drug users without increasing the rate of the illegal drug use.  According to the Centers for Disease Control and Prevention (CDC), the use of these programs has increased during the past decade. The service provided by these programs have been misinterpreted as enabling drug users by giving them easy access to clean needles.  However, the goal of these programs is to reduce the transmission of HIV and hepatitis B and C.