In Growing Group, More Than Half Are Uninsured
By Donna St. George
Washington Post Staff Writer
Thursday, June 26, 2008; GZ01
Latinos have emerged as the fastest-growing population group in Montgomery County, and more needs to be done to boost their health and well-being, including improving access to medical care and expanding transportation and bilingual services, a new report says.
The report noted that the best estimates, from 2005, suggest that more than 50 percent of Latinos in the county are uninsured, and about half do not have a primary-care doctor. Among Latinos who had not seen a doctor in the past year, the primary reason was the high cost of care.
Some Latinos face other obstacles to good health. In what many see as an anti-immigrant climate, "Latino residents in Montgomery County are all too often forgoing health services because they worry this will lead to their deportation," the report says.
The report, "Blueprint for Latino Health in Montgomery County, Maryland 2008-2012," was released recently as a portrait of the county's Latino community, estimated at more than 128,000, with strategies for improving health care in the most comprehensive sense. It follows a similar report that covered the years 2002 to 2006.
Sonia Mora, manager of the county's Latino Health Initiative program, said there has been progress on many fronts since the original report. "We have indeed advanced in improving the health of Latinos in Montgomery County, and at the same time we still have a long way to go," she said.
For the next five years, she said, "it's going to be critical to continue to get others engaged and involved in this effort," including the private sector, health clinics, hospitals, the county and community groups. "The blueprint provides a road map so that we can all be working in the same direction."
The report was completed by the county Latino Health Initiative in partnership with a panel of 18 community members who make up the Latino Health Steering Committee.
Committee members said they recently set a priority for the year ahead: children.
"We see youth as the future of the county," said committee member Diego Uriburu, deputy executive director of Identity Inc. in Gaithersburg. As it stands, he said, "we don't think the county is doing enough to address the issues facing Latino youth and other youth, African Americans in particular."
The report recommends an array of approaches on broader health issues, starting with improving data collection. Without statistics about health troubles, it is hard to find the right answers or get money to fund them, committee members said.
"Without the data, we don't have the information we need to act," said Olivia Carter-Pokras, an associate professor at the University of Maryland School of Public Health and a member of the steering committee.
National data suggest that the primary health conditions that affect Latinos include asthma, chronic obstructive pulmonary disease, HIV/AIDS, obesity, suicide and liver disease, according to the report.
The county should also expand efforts for those low-income residents who rely on its "safety net" services, such as Montgomery Cares, Care for Kids and Maternity Partnership, the report says. In the most recent analysis, of 2003-04 data, those efforts served about 13,000 Latinos, leaving more than 46,000 uninsured and outside of safety net programs, the report says.
Access to mental health care, counseling and substance abuse treatment was even more difficult than access to standard health services, the report says.
"Access is important for everyone," Mora said. "It is even more important for Latinos, because they tend to be more uninsured" than other ethnic or racial groups.
The report notes that research has shown "those who are uninsured over the long-term experience poorer health and earlier death than the insured population."
The county's bilingual health-care assistance lines have been helpful, the report says, but "demand for these services has outstripped supply." And county health programs need to become more sensitive to cultural and language differences, it says.
Among other recommendations, the report says the county should establish a grant program to expand the capacity of Latino community organizations; develop diverse and creative funding sources for efforts that benefit Latinos; include more Latinos on county boards, committees and commissions; pump up health-care prevention efforts that target Latinos; and attract more Latino health-care providers to the county.
One effort that has been especially successful is a county program to help foreign-trained Latino nurses get their licenses in Maryland, Mora said. Another success has been a Latino health promoters program, which sends lay educators into the community to promote healthful behaviors and ways to access health care.
The report draws on interviews conducted in focus groups of Latino residents, information provided by key county decision makers, census reports, state data and an array of other county studies and research.
These issues should be a concern to the larger community, Carter-Pokras said.
"The people who provide child care for their children, the people who put roofs on their houses . . . the people who cook the food in their restaurants, the people who clean their offices and their homes, these individuals have lives and families, and often they don't have health insurance and they don't have health insurance for their children," she said.
The report quoted national analyses that say immigrants deliver a net economic advantage to their communities, paying more in taxes than they consume in benefits and contributing to Social Security, among other things.