Beyond "safe": Chilean "Kool" routes to school address social determinants of health

An abundant literature has examined the usefulness of "safe routes to school" programs to increase active transport (mainly walking and cycling) and with it levels of physical activity, hence health. To date, these have been applied mainly in the Global North, where they are supported by national networks and government. Conditions in developing countries differ. While the obesity epidemic is rife, the sustainability trio of walk-bike-bus/Metro account for high percentages (66% or more) of daily travel (LTAA-cademy, Singapore, 2011). In a rapidly urbanizing world, with 90% of its population already living in cities, Chile offers an excellent opportunity to study these issues. Both adults and children in Chile have extremely high rates of sedentarism (over 90%), overweight and obesity. This raises interesting questions about the potential impacts of programs focusing on active transport for school children in the Global South. This research originally sought to explore potential for improving physical activity. Working with teachers, principals, local government and students in one of Chile's most vulnerable municipal jurisdictions, we created a program to raise awareness of sustainable transport impacts on children's health and happiness. As the program advanced, partners requested a broader agenda of participatory planning to transform territories around schools. Findings to date reveal considerable potential for transformation in challenging spheres, including gender roles, gender-related violence and social insecurity, road safety, traffic calming, environmental and civic education. This suggests that, at least in developing countries, cocreating and innovating to achieve suitable adaptations of these programs with local actors should receive careful attention, to mobilize their potential for generating responses to a broader public policy agenda, able to address the social determinants of health.