Health disparities found for Baltimore Latinos

Many Latinos in Baltimore lack medical coverage, which contributes to problems such as fewer mothers getting prenatal care, according to a new report that takes the first comprehensive look at the group's health.

The report, released Thursday by the city Health Department, compiled data from the U.S. Census, state health records and a survey of Latino residents to assess the needs of a rapidly growing group that is often left out of the health system.

The study found Latinos, with limited access to medical care, often rely on community clinics. The Highlandtown Community Health Center, for example, provides preventive care and treatment to the growing Latino community in Southeast Baltimore, and offers a bilingual staff and reduced rates.

Still, the report shows that more must be done, as Latinos were twice as likely as other city residents to say they were in poor or fair health.

Health officials and advocacy groups hope that identifying the health issues will lead to better care for Latinos and can be used to secure additional funding to create programs to help them. Health problems in one segment of the city can put pressure on the health system, raising the cost of care for everyone, officials said.

"By improving the health of various communities, we hope to improve the overall health and vitality of the city," said Baltimore's health commissioner, Dr. Oxiris Barbot.

Latinos are the fastest-growing ethnicity or race in the city, surging by more than 50 percent from 1990 to 2008, while Baltimore's population as a whole declined 13 percent. Census data show about 17,000 Latinos in the city in 2008, or 3 percent of the population.

Officials say the number could be closer to 25,000 or 35,000, as Latinos often go uncounted because of language barriers and immigration fears.

Hispanic enclaves can be found mostly in Southeast Baltimore — in Fells Point, Highlandtown, Patterson Park and Canton. The Hispanic residents hail from countries that include Mexico, Puerto Rico and the Dominican Republic and other parts of Central and South America. They are recent arrivals without deep roots in the community.

Angelo Solera, a longtime community advocate, said the Health Department report is long overdue — and is a first step toward closing the gap in health disparities affecting Latinos.

"I don't think it is going to fix all the ills of our society, but it is a good step for moving forward," said Solera, president of Latino Providers Network, which works with groups that offer services to Latinos. "The community is growing. It can't be ignored."

Language and cultural barriers have played a role in limiting access to health care for Baltimore Latinos, the study found. But cost is the main reason that many, who often live in poverty, do not have health insurance. In 2007, the median income for Baltimore residents was $36,949; it was $33,890 for Hispanics.

Nearly three-quarters of the survey respondents said they did not have Medicare, Medicaid or private health coverage during the past 12 months, and 46 percent said the costs are too high.

About 43 percent feared asking for coverage because of their immigration status, while others said they couldn't find providers who spoke Spanish. Latinos in Baltimore were more likely than Latinos in the rest of the nation to be born in another country and speak mostly Spanish. About 84 percent speak only or mostly Spanish.

Community health clinics are filling some of the need. About 40 percent of the patients seen at the Highlandtown Community Health Center are Latinos. The center, part of a network of six clinics owned by Baltimore Medical System, has found much of its Latino clientele through word of mouth.

The Highlandtown facility is able to offer care at lower cost because it is a designated center that receives federal money, and bigger Medicare and Medicaid reimbursements because it serves disadvantaged communities.

Jay Wolvovsky, president and CEO of Baltimore Medical System, said he hoped the city's report would help his company create programs and serve as a tool to win additional funding.

"It gives us a better target to shoot for in terms of developing our programs," he said.

The city has also responded with bilingual brochures and staff at its clinics. But health officials say more could be done.

Some Latinos are skipping care and pushing through illnesses on their own. The report found that among Latinos living in Southeast Baltimore, 20 percent did not get the care they needed. Nearly three-quarters said they had not talked to a doctor, nurse or pharmacist in two years.

Many of the study results mirrored national trends among Latinos.

Barbot said she would like to see further study on some topics. For instance, accidents and unintentional injuries were the third-leading causing of death among Latinos from 2005 to 2007, and the fifth-leading cause among all Baltimore residents. Barbot said data should be collected to see what kinds of accidents were killing people.

In Southeast Baltimore, more than 40 percent of Latino men reported binge drinking, having five or more drinks in one sitting in the past 30 days.

Latina mothers were less likely to receive prenatal care in the first trimester than other mothers in Baltimore. Some did not receive prenatal care, which helps prevents birth defects, during their pregnancy.

Still, Latina mothers had lower rates of low birthweight and preterm babies than other mothers in the city, though the study noted it was still a problem.

Latinos in Baltimore

•Accidents accounted for 11 percent of deaths compared with 2 percent for all residents in 2006.

•40 percent of Latino men in Southeast Baltimore reported binge drinking.

•67 percent of Latina mothers got first trimester prenatal care compared with 74 percent of other mothers.

•The Latino poverty rate was 17 percent compared with 20 percent of all city residents.

•Three-quarters of Latinos in Southeast Baltimore did not have health coverage in the past 12 months.

•20 percent of Southeast Baltimore Latinos said they didn't receive the care they needed.

•16 percent of Southeast Baltimore residents said they smoked.

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