Objectives To test a new approach to characterise accessibility to tertiary care emergency health services in urban Cali and assess the links between accessibility and sociodemographic factors relevant to health equity. Design The impact of traffic congestion on accessibility to tertiary care emergency departments was studied with an equity perspective, using a web-based digital platform that integrated publicly available digital data, including sociodemographic characteristics of the population and places of residence with travel times. Setting and participants Cali, Colombia (population 2.258 million in 2020) using geographic and sociodemographic data. The study used predicted travel times downloaded for a week in July 2020 and a week in November 2020. Primary and secondary outcomes The share of the population within a 15 min journey by car from the place of residence to the tertiary care emergency department with the shortest journey (ie, 15 min accessibility rate (15mAR)) at peak-traffic congestion hours. Sociodemographic characteristics were disaggregated for equity analyses. A time-series bivariate analysis explored accessibility rates versus housing stratification. Results Traffic congestion sharply reduces accessibility to tertiary emergency care (eg, 15mAR was 36.8% during peak-traffic hours vs 84.4% during free-flow hours for the week of 6–12 July 2020). Traffic congestion sharply reduces accessibility to tertiary emergency care. The greatest impact fell on specific ethnic groups, people with less educational attainment and those living in low-income households or on the periphery of Cali (15mAR: 8.1% peak traffic vs 51% free-flow traffic). These populations face longer average travel times to health services than the average population. Conclusions These findings suggest that health services and land use planning should prioritise travel times over travel distance and integrate them into urban planning. Existing technology and data can reveal inequities by integrating sociodemographic data with accurate travel times to health services estimates, providing the basis for valuable indicators.

This study's goal was to evaluate the pilot exclusive lane for motorcycles (Motovía) in Cali, Colombia, from the perception of its users in 2012–2013. A cross-sectional study using roadside surveys plus a qualitative component of individual semi-structured interviews was carried out. Road users' perceptions were investigated before and after implementation of lane dividers (LD) and were compared with other roads in the city. Perceptions were compared using chi-square tests. In the study, 293 motorcyclists, 111 cyclists, and 115 automobile drivers were interviewed. Following the installation of the LD, the majority of motorcyclists and cyclists reported that LD made easier the driving maneuvers and decreased travel time, in contrast to perceptions of automobile drivers (p < 0.001). For most motorcyclists, the Motovia was considered as safe and effective, approving its continuity and replication. Half of automobile drivers and cyclists did not approve the installation of the Motovia due to travel time (drivers) and security issues (cyclists). Motovia is an option to enhance motorcyclists' safety on the road. It must, however, offer clear circulation alternatives for automobile drivers. According to users' perception, it is not safe for bicycles and other human-powered vehicles to share lanes with motorcycles. Further research about vulnerable road users' infrastructure is required.

The mobility plan and the road infrastructure works implemented, together with the Bus Rapid Transit (BRT) connected bus system in its first two phases, generated optimistic expectations about the reduction of lethal crashes in the city. This research studies the relationship between investments in transportation infrastructure in the city and the distribution of traffic fatalities. Although it is not strictly speaking an impact assessment, the approach we propose performs geostatistical contrasts between intervened and non-intervened areas, using a geographically weighted model that attempts to model the spatial variability of the factors associated with the intra-urban road traffic crash rate, controlling for infrastructure interventions and some proxy indicators of urban structure. The findings reveal that fatalities decreased in areas both with and without intervention. Despite the expectation of reducing fatal injuries, the differential effects of the interventions were relatively small. The risk of road traffic crashes was even increased in critical points of the city with recurrent lethal crashes. The effects of road interventions on fatal road traffic crashes in Cali did not correspond to the high social and economic costs involved in the BRT system and the work plan.