Tremendous growth moved San Bernardino County officials to act 

By Les Gura

A 20-year growth boom that saw some communities double or even triple in size in San Bernardino County in Southern California led to unexpected fallout — public health.

Dora Barilla, assistant vice pesident for strategy and innovations for Loma Linda University Health, says the incredible population growth became a problem, especially when the recession hit in 2007 and 2008, and funding dried up for services and infrastructure to meet the demands of larger populations.

“We didn’t have the robust system to meet population growth,” she says. “But things actually thrived because people said ‘No one’s coming to help and we’ve got to take ownership of our local communities.'”

With statistics showing downward public health trends (rise in cases of obesity and diabetes for example), leaders throughout the county across several sectors–government, business, health, nonprofit–began meeting to figure out how to reverse course. Their discussions led to creation of the Healthy San Bernardino County Healthy Places Coalition, an initiative in which different cities within the county each tackled the unique problems they were facing in their own ways, with the help of health providers, transportation and grant agencies willing to support such efforts.

“We wanted to improve relationships among all sectors and bring an increased awareness on health in all policy,” Barilla says. Different city agencies began to plan efforts to create community gardens, bicycle and pedestrian trails, all of which might help reduce chronic conditions such as obesity, diabetes and heart disease. “They looked at the question ‘What are the principles that promote health and connectivity in the planning of a city?’”

Reaching neighborhoods

The city of Rancho Cucamonga, population 170,000, in San Bernardino County quickly embraced concepts raised by the Healthy San Bernardino Healthy Places Coalition. The city council backed the idea and in 2008 created a multidepartment team to discuss what such a plan could look like.

Erika Lewis-Huntley, the Healthy Rancho Cucamonga project director, says the idea confused some employees in departments such as public works and engineering, who didn’t understand what their work had to do with public health.

“Well, public works maintains parks, and if the parks are not well maintained and a place where people feel safe, then people don’t go and get physical activity as a family,’’ she says. Once concepts such as those were laid out, representatives from every department began to understand how the entire city is responsible for building a healthier place. “There were a lot of a-ha moments.’’

Statistics showed that certain areas of the city specifically faced health risks, such as two neighborhoods in southwest that were part of areas annexed over the years by Rancho Cucamonga. As former unincorporated areas, the Los Amigos and Northtown neighborhoods lacked infrastructure such as sidewalks, bicycle lanes and gutters, Lewis-Huntley says. In addition, the population of the two neighborhoods was largely Hispanic, with lower income and education levels. Adults were at high health risk, as were children in schools in that area, for chronic diseases, including obesity, asthma and diabetes.

Leaders of the Healthy Rancho Cucamonga project reached out to the community, holding meetings in the neighborhood both to educate the residents about their intent and to listen to their suggestions on ideas such as promoting family meals. They brought translators so that meetings could be held in Spanish, the native language of many residents.

At the meetings, residents including children and teenagers (each of which met in their own groups) mapped out amenities that exist in the neighborhoods and city. They discussed how to take better advantage of the city’s amenities, as well as suggest things they would like to be able to access.

“We knew there was something magical there. They wanted to stay involved and were saying ‘Well, what’s next?’’’ Lewis-Huntley says. “Residents who have not been traditionally involved—they couldn’t tell you who the mayor was or where city hall was—wanted to stay involved.’’

Targeting an entire county

Today in Rancho Cucamonga, Lewis-Huntley points to the connections made in the Los Amigos and Northtown neighborhoods for helping promote better health among the residents in various ways.

More residents are now aware of and using city facilities such as an outdoor trail connecting five neighborhoods, as well as the Community Center. In addition, many are taking advantage of a Community Champions program that provide bilingual classes that teach them about government and understanding how resources are allocated.

“We’re empowering them to be as involved as possible in local governments,’’ Lewis-Huntley says. Residents from the neighborhoods already have done park assessments and walkability assessments, for example, that helped Rancho Cucamonga apply for grants to create sidewalks and bike lanes where needed.

“Now kids are walking safely to school,’’ she says.

Residents in the neighborhoods also are working on a healthy store initiative to promote better eating options to be sold at a neighborhood store, she says. And many also take advantage of a new farmer’s market just outside their neighborhoods.

On a broader scale, 21 out of San Bernardino’s 24 cities are now participating in the Healthy San Bernardino Healthy Places Coalition. Barilla says the goal is for every city to be part of the coalition by the end of 2015 to promote a healthier Inland Empire.

Photos from City of Rancho Cucamonga: Children on the playground; Mapping healthy eating and active living opportunties at the Healthy RC Kids Forum; Bikers take the Cucamonga Challenge.