June 24, 2010

Gap In Preventive Care Exists Among Latinos

Addressing the disparity could help reduce health care costs

"Prevention" is the new buzzword for health professionals and the new emphasis for containing future health care costs. Yet Latinos, who currently represent about 15 percent of the U.S. population, have the lowest level of preventive care of all racial and ethnic groups in the nation.

And prevention counts. Without it, many conditions that could be treated easily early on end up leading to more costly and invasive procedures. But to address this situation, and to provide proper outreach and education, it's necessary to know which specific groups within the larger Latino population are vulnerable.

Researchers at UCLA have now pinpointed which groups within that population are at risk. Reporting in the current online edition of the American Journal of Preventive Medicine, lead author Arturo Vargas Bustamante, an assistant professor in the department of health services at the UCLA School of Public Health, and his colleagues report that within this broader population, Latinos from Central and South America and those from Mexico consistently report using preventive services at a much lower level than non-Latino whites.

Further, compared with non-Latino whites, all Latino subgroups are significantly less likely to receive basic preventive tests such as colorectal cancer screening, blood pressure screening and influenza vaccinations.

The study compared preventive care utilization among seven groups of U.S. adults aged 18 and older between 2000 and 2006. The groups included non-Latino whites and Mexicans, Puerto Ricans, Cubans, Dominicans, Central and South Americans, and other U.S. Latinos. Information on these groups was drawn from two large national databases: the Medical Expenditure Panel Survey (MEPS) and the National Health Interview Survey (NHIS).

The authors compared various bundles of common preventive care interventions among the different subgroups.

"While Latinos currently makeup about 15 percent of the population, it's estimated that by 2050 they will comprise a quarter of the U.S. population," Bustamante said. "So it is a critical group to reach."

But Bustamante said Latinos continue to experience the lowest level of preventive care utilization among racial and ethnic groups in the U.S., which could potentially impact future health care costs.

"Reduced utilization of preventive services is likely to lead to more costly and invasive health care procedures as long as easily preventable conditions progress unchecked and people remain unaware of lifestyle changes that can prevent the onset of medical problems," he said.

The primary reasons for this disparity, Bustamante said, are, in order: a lack of health insurance, having a regular doctor, level of education, age and citizenship status.

Because almost half of current Latinos have immigrated to the U.S. recently and the majority of them are first- or second-generation immigrants, cultural attitudes toward preventive care may also play a role.

Basic screening and health care information can play a large role in keeping costs down "” "just the basics," Bustamante said, "measures like colorectal cancer screening, flu vaccination, and advice and help in quitting smoking."

"By expanding health insurance coverage and integrating Latinos into primary care practices, we can substantially reduce the disparities in the receipt of preventive care services," he said. "We hope this analysis of the use of preventive health care will prove useful to decision-makers interested in targeting cost-effective interventions to the most disadvantaged populations," he said.


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