O’Malley let's talk about three important things: jobs, jobs and jobs

Community leaders hope the effort will reduce rates of obesity and hypertension and in turn lower hospital admissions and healthcare costs.

As federal officials continue to roll out elements of the healthcare package, local governments throughout the nation are engaged in efforts such as those in the beach cities that they say could have an even greater effect on people's health. Cities are working to add bike lanes, redo restaurant menus, create neighborhood gardens and make school lunches healthier — changes that health workers say will keep people out of doctors' offices and hospitals. They are driven by a basic principle: Preventing disease is less expensive than treating it.

"We need to change the built environment so when [residents] go out to restaurants, there are decent choices, and when they step out of their homes and they want to exercise, there are sidewalks and the bike paths are big enough," said Susan Burden, chief executive of the Beach Cities Health District, a government agency that provides preventive health services in the communities.

Although more cities are trying to increase residents' physical activity and improve their diets, the ones with the worst health problems are not usually among them, said Susan Babey, a research scientist at the UCLA Center for Health Policy Research. "The cities that are struggling the most don't have the resources to go out and compete for grants," she said. "They miss out on some opportunities that they could potentially really benefit from."