The Inland Empire has been a leader in the state and the nation in population and economic growth over the past several years. Unfortunately, the area also has dubious distinctions, including bad fine-particle air pollution and significantly high death rates among its 4 million residents from coronary artery disease and other chronic conditions.

Some might say that fighting against chronic disease is a losing battle, but before you give up hope and chomp another bite of your donut, take a moment to learn about the Inland Empire's innovative efforts and leadership to boost health.

Over the past few years, Riverside and San Bernardino Counties have begun actively investing in prevention with a long-range vision toward creating healthier communities in which residents can optimally work, play, breathe and recreate.

In 2003, the Riverside County Department of Public Health added "Creating More Livable Communities" as one of its strategic planning goals. Because of this focus, many of the Livable Communities' activities encourage changes in the built environment and impact community planning. Bringing health to the forefront of planning, public health staff work with non-traditional partners including county planning officials, transportation departments, parks services, economic development agencies, county fire departments, associations of governments, and real estate developers.

A Walkable Community Workshop in the City of Riverside led to the development of a model pedestrian master plan for incorporation into the city's general plan and a walking guide that identified 46 walking routes and trails for the city's 250,000 residents. Walkable Community Workshops have been completed in three other cities with the goal of enhancing pedestrian awareness and safety and improving the cities' general plans.

East of Palm Springs in the City of Coachella, the workshop became the impetus for a new general plan that will incorporate smart growth/livable community principles. Public health staff are now part of local governments' "Healthy Living by Design" CalTrans grant that will incorporate transportation, planning and land use design standards that affect health into a nine-city plan in the Coachella Valley.

While the Riverside County movement was taking shape, discussions about preventing obesity and chronic disease began between the San Bernardino County Department of Public Health, a nationally recognized developer, county supervisors and staff, and key local stakeholders. After several crucial meetings, the ground was laid for the Healthy Communities Program that was approved by the San Bernardino County Board of Supervisors in April 2006.

To tackle this daunting issue without narrowing efforts artificially, the program has one goal: to improve the health and well-being of county residents. The county recognized that the concept of "Healthy Communities" requires an infrastructure to support collaborative efforts. This centralized program coordinates healthy planning/development, provides technical assistance for civic planning and promotes enhanced access to health services. Collaboration continues to build among healthcare systems, government stakeholders, high-risk populations, schools, faith-based organizations, academia, and planning and development agencies.

Like the Riverside County initiative, the Healthy Communities team actively engages cities in their efforts to become healthier. The growing cities of Chino, Chino Hills and Fontana lead the charge on getting local neighborhoods to become more active and eat healthier. Other cities including Rancho Cucamonga, San Bern-ardino, Rialto and Ontario are also developing their own healthy initiatives. The Kids Fitness Challenge, a high-profile event scheduled for April 28 at the California Speedway in Fontana, challenges children to become more physically fit.

While the two counties' public health departments have a long history of collaboration, especially around nutrition efforts, they intend to leverage one another's progress to improve their collective efforts. One specific activity being planned is a workshop for professionals in land use, transportation, economic development and planning, to begin including health issues from a regional perspective. This should impact the future of all communities in the growing Inland Empire.

The obesity epidemic will not be stopped by local public health departments; nor will it be stopped by practicing clinicians. However, clinicians can strengthen their presence in the community by being local champions of planning efforts. Since physicians are well respected, no profession is better equipped to talk about and advocate for improved health. Whether through local professional organizations and medical groups or as individuals, each physician can be a powerful force toward making the community healthier.

Eric Frykman, MD, MPH, MBA, is director/public health officer of the Riverside County Community Health Agency. He can be reached at 951/358-5058 or efrykman@co.riverside.ca.us.