Ask the Expert: Q&A with Dr. Olga Sarmiento | Changing transportation to improve health in Bogotá

Olga_Sarmiento_webWelcome to our Place & Health blog series! Today’s expert is Dr. Olga Sarmiento, an Associate Professor of the Department of Public Health at the School of Medicine at Universidad de los Andes in Bogotá, Colombia. Her research interests include physical activity, nutrition and built environment among children and adults in Latin America.

Dr. Sarmiento will be joining other leading experts as a speaker at ICUH 2016 in San Francisco on April 3rd, sharing learnings on the panel called “Lessons Learned from LMICs for Advancing a Culture of Health in the US.”

We recently had the opportunity to chat with her about the intersection of transportation and health in her hometown of Bogotá, in an interview on March 2, 2016.


Tell us a little bit about your work.
My research focuses on evaluating the built environment, namely transportation, parks, and community programs. I investigate how the various factors that make up the built environment are associated with physical activity behaviors and nutrition. I look specifically at community programs in Bogotá.

Can you give us an example of one such program and how it is working or not working?
One example is the Ciclovía program. Each Sunday and public holiday, which adds up to about 75 days each year, the main streets of Bogotá are blocked off to cars for runners, skaters, and bicyclists from 7 am until 2 pm. At the same time, stages are set up in the city’s parks for aerobic classes, yoga, and other types of performances to encourage activity and participation. This is an incredibly successful program. Approximately 1 million people attend each of Bogotá’s ciclovías. The city is currently conducting multiple community outreach activities to promote various modes of sustainable transportation like biking among women and children. Our studies have shown that biking during leisure time increases uptake of biking for transport, which is a very positive externality.

What do you see as the major challenges in helping people to understand the relationship between how transportation systems are organized and health outcomes, specifically in physical activity and nutrition?
There is still an education component when it comes to helping people understand the connection between transportation and health outcomes. In addition, there are issues of choice and need. In Bogotá there are several problems when it comes to scaling sustainable transportation like bus rapid transit (BRT), namely that there are not enough buses and crime on and around the BRT system is high.

It really boils down to quality issues. Many in Bogotá use public transit out of need not choice. As a result, there have been periods of time where quality improvements to the system were not a priority. We can do better to highlight the health benefits of public transportation to the people. Choice is a good thing in this case. With more people choosing walking, BRT, or biking, we minimize cars and car-dependency and normalize other forms of transportation.

How do we overcome these challenges? What has worked in Bogotá?
BRT is a scalable model of transportation. Almost 200 major cities worldwide have adopted BRT. Among those, Bogotá is one of the most successful examples. So far, our system has been evaluated in terms of air pollution, accidents, and environmental outcomes and performed well. With that said, we still struggle with the aforementioned quality issues. The new government has a ten-year plan in place to improve the number of buses and increase the number of lanes in order to make BRT a better option than cars.

Another major challenge is that Colombia has high rates of inequities. In Bogotá, the problem is even worse. It has a long history as a highly segregated city, socioeconomically speaking. Back in the late 1990s and early 2000s, we had visionary local leaders who believed that providing programs for the community, including access to transportation would help to decrease inequities. As a result, the BRT system was routed to all parts of the city to meet the needs of all citizens. Major strides were made with the launch of the BRT system, but there is still room to improve.

What would say are some cutting edge innovations in transportation that can be adopted globally?
I think multimodal transportation, using multiple travel options several times or more per week, is most important. This allows for flexibility via a mix of sustainable modes of transportation, but its success requires that multiple modes are available to the average person. This is where the role for cities and strong leadership comes into play. We need to model from cities that have implemented multimodal transportation successfully. We need to study how we can adapt those strategies within our own city and other cities around the world. We need to understand how many minutes we use for biking versus walking versus mass transit in order to make all of those real usable options for people.

What makes you optimistic about the future of transportation in urban settings and its role in improving health?
The long-term success of the Ciclovía program makes me optimistic. People see value and find enjoyment in getting out of cars and onto the streets. The data from Bogotá shows people take advantage of this opportunity when it is provided. We need to work to find more ways to provide such opportunities and encourage biking and walking habits adopted for recreation are also adopted for transport.

What do you consider your call to action from your ICUH 2016 presentation?
There is a clear relationship between transportation and leisure time. I think the disconnect before was that we were working too much in the health sector — and the other sectors didn’t think about health. If we want to promote physical activity, we have to study this interaction to determine how to best leverage that relationship. My message is that we need to look outside of the health sector and work with other sectors in order to promote physical activity and health behaviors on a large scale.