More than one-fourth of Hispanics in the United States don't have a regular doctor, and an even larger number reported they received no health care information from qualified medical personnel in the past year, a troubling statistic for those with chronic medical conditions, those who might suddenly become ill, or those who could benefit from early detection and continued monitoring of a medical condition.

"Nearly a fourth of Latinos have diabetes, whether they know it or not," said Dr. Olveen Carrasquillo, co-founder of Latinos for National Health Insurance and an associate professor of Medicine and Health at Columbia University. "You see asthma a lot among young Latinos, and as they get older diabetes becomes much more prevalent among this population. These are serious health issues that need constant observation and treatment."

These troubling findings are the result of a May 13 report by the Pew Hispanic Center, in conjunction with the Robert Wood Johnson Foundation, titled "Hispanics and Health Care in the United States: Access, Information and Knowledge."

"Foreign-born Latinos, Spanish speakers and recent arrivals are more likely to lack a provider," said Gretchen Livingston, senior researcher on the report, which was based on a bilingual telephone survey of a nationally representative sample of more than 4,000 Hispanics adults from July 16, 2007, to Sept. 23, 2007.

According to previous reports by the U.S. Centers for Disease Control and Prevention, Hispanics are about twice as likely as blacks, and three times as likely as whites, to lack a regular health care provider.

"When asked why they didn't have a regular provider, the most common answer was that people felt they just didn't need one." Livingston said.

Fifty percent of those surveyed said they were high school graduates, 30 percent were born in the United States and 45 percent responded that they did have health insurance.

So then why such a pronounced "disconnect" between

Hispanics and the medical community?

There is no concrete cause or factor to point to as the culprit; rather, there are numerous reasons - socially, economically, culturally - within the Hispanic community as to why this is so.

Interestingly, 83 percent of Latinos said that they received medical advice from the media - with TV being the most commonly cited source - in the past year; 79 percent of this group said they acted on that information, compared with only 71 percent who consulted a doctor or other qualified medical personnel in the past year. Another 71 percent responded that they also received health care information through social networks - family, friends, church and community groups.

But there is no question that lack of health insurance - or what is known as health care disparity, lack of access to adequate health care due to racial, ethnic and socioeconomic factors - also plays a significant role.

Latinos constitute 10 percent of Connecticut's population, but amount to 40 percent of its uninsured.

U.S. Sen. Christopher Dodd has been a vocal proponent of universal healthcare over the years, and again emphasized the topic when he spoke at a summit on May 3 at the Sheraton Four Points in Meriden organized by Latinos for National Health Insurance and the Universal Health Care Foundation of Connecticut.

Dodd stressed the importance of quality healthcare for all, not just those that can afford it, in his remarks May 3, and when asked to comment on the Pew Center's findings the senator replied by e-mail Thursday afternoon: "The findings of the Pew Hispanic Center study paint a dismal picture for the future of our nation's current health care system unless we act now to implement real reforms. Leading experts have repeated the warnings: unless we act, today's generation of children may be the first in the modern era to live shorter, less healthy lives than their parents. I am heartened by the growing chorus of voices, Republican and Democratic, that are calling for health care reform."

But even representatives from the Universal Health Care Foundation of Connecticut acknowledged that, although certainly a step in the right direction, universal health care alone would not solve all issues of medical disparity.

"Health care equity must be a centerpiece of universal health care reform," said Janet Davenport, spokeswoman for the Universal Health Care Foundation of Connecticut. "Universal health care in and of itself won't close that gap."

The report found that 23 percent of Latinos who received medical treatment in the past five years thought the quality of the treatment they received was poor - 31 percent attributed this to financial limitations, 29 to race or ethnicity and 23 to a language barrier.

"Many (Hispanics) are not comfortable in the system, so they would rather seek services within their known comfort zone," said Eloise Hazelwood, director of the Wallingford Health Department.

Locally, there are a number of locations that Hispanics who don't feel comfortable or catered to by the medical community can go to receive assistance with finding compatible health care.

The Spanish Community of Wallingford provides Hispanics with a list of area doctors who are Hispanic themselves or fluent in Spanish; should a specialist be sought, or the language barrier prove particularly difficult, SCOW representatives will interpret, or even accompany, those who need assistance to the doctor's office.

At the Department of Health and Human Services in Meriden, whenever a child is brought in for immunization, staff members ask the parent or guardian who the child's primary care provider is. If there is none, the department assists the parent or guardian in finding one that is a comfortable fit.

"There's no reason on earth why a child doesn't have health insurance," said Beth Vumbaco, director of health and human services.

The Community Health Center on State Street in Meriden, a non-profit agency committed to providing health care and social services to all, regardless of income, insurance, or ability to pay, estimates that about 30 percent of the patients it services are Hispanic.

Chief Medical Officer Dr. J. Nwando Olayiwola said that the majority of the CHC's six doctors and two nurse practitioners are bilingual, and each exam room has a "language line," a phone that the doctor or nurse can pick up and connect with an interpreter should communication with a patient prove too difficult.

"Forty-four percent of our patients speak a language other than English," Olayiwola said. "We know that it is critically important that we communicate with our patients to provide quality medical treatment."

Julissa Muniz said she feels comfortable with the care she receives at the Community Health Center. Muniz, a Meriden resident, has been coming to the center since she first moved to the area from Puerto Rico 15 years ago; she now brings her two children here too.

"Since I moved here from Puerto Rico this is the only place I've been coming to. I don't like to change, and now I bring my children here," Muniz said. "The only thing is that there's a lot of people who come here and sometimes it's kind of slow."

Steps are being taken at the state level to combat health disparity as well. The Connecticut Association of Directors of Health recently announced a three million dollar grant it received from the W.K. Kellogg Foundation to develop the Health Equity Index, a statewide initiative designed to identify, and ultimately eliminate, many of the problems brought about by health disparity.

"Tackling health inequities requires broadening our view and looking at how the conditions in which a person works and lives influence his or her wellbeing," Richard Matheny, president of the Connecticut Association of Directors of Health, said in a press release. "This grant will allow us to continue examining these factors in our local communities and effectively advocate for policy change."

Still, many legislators and health care professionals feel progress isn't coming quickly in addressing the growing health disparity in the United States. Among them is Dr. Bruce Gould, who splits his time between duties as the associate dean for primary care at the UConn Health Center and the Burgdorf/Fleet Health Center in the north end of Hartford, which estimated that about 40 percent of the patients it services are Latino.

"Right now, everyone claims that we have the best health care system in the world, what we have in actuality is the most advanced health care system in the world, but it is available to only those who can pay," Gould said. "It's unconscionable that in a country as wealthy as the United States that we do not feel as a people more of a responsibility for others."

dmoran@record-journal.com

(203) 317-2224

Percent of Hispanic Adults Lacking A Primary Health Care Provider 27

Male 36

Female 17

Insured 19

Uninsured 42

Less than a high school diploma 32

High school diploma 27

Some college or more 19

Native born 22

Foreign born 30

Source: "Hispanics and Health Care in the United States: Access, information and knowledge" by the Pew Hispanic Center and the Robert Wood Johnson Foundation