Many Latinos lack a regular source of health care and health information other than hospital emergency rooms, a trend that threatens to worsen their health outcomes, according a new report by the Pew Hispanic Center and the Robert Wood Johnson Foundation.

The report, released Wednesday, found that 27 percent of Hispanics in the United States do not have a usual place they go for medical care, a number that is twice that among African Americans and three times the percentage among non-Hispanic whites.

Having a usual place for care, such as a primary care physician or outpatient clinic, is strongly associated with preventative care, which in turn correlates to better long-term health outcomes, according to researchers. “Among Hispanics with a regular health care provider, 86 percent report a blood pressure check in the past two years, while only 62 percent of those lacking a provider report this,” the study said.

The report is designed to address what Ed Howard of the Alliance for Health Reform called the “sleeper issue” in the on-going debate on the prospect of a major health overhaul in the United States - the health disparities facing the Latino community. At an Alliance briefing Wednesday to discuss the study and its context, Howard pointed out that Hispanics are the largest minority in the United States and growing rapidly with some projections predicting that they will make up 29 percent of the U.S. population by 2050.

“Any thoughtful reform that gets proposed is going to have to take into account the ‘Hispanic factor’ in a variety of ways,” Howard said.

Researchers said immigration and assimilation factors such as language barriers and cultural differences are chief contributors to health care disparities for Latinos. They also cited education-level and insurance as central factors in whether a Latino has a regular source of care, but cautioned that many of the study’s participants have health insurance and a high school or even a college-level education but do not have a usual place where they receive medical care.

“Of those without a usual source of health care, 45 percent have health insurance” and 50 percent “have at least a high school diploma,” the report said.

Elena Rios, president and CEO of the National Hispanic Medical Association, noted that measures designed to reduce health care disparities for Latinos could not merely focus on increasing coverage. “You can’t just have insurance - you have to have education for the population,” she said.

Within Latino communities approaches to health care split along the same divides as they do in the general population. In addition to the less educated and those without health insurance, men and young people were less likely than their counterparts to have one place where they received most of their care. Thirty-six percent of males and 37 percent of individuals ages 18 to 29 lacked a usual source of care, compared with 17 percent for females and 13 percent for seniors.

In addition researchers found that U.S.-born Hispanics were more likely than those born abroad to seek care from one consistent source.

Of all the participants that lack a usual health care provider, 41 percent, a plurality, said they were seldom sick and so seldom required medical attention. Although diabetes and obesity rates are high in Latino communities, Hispanics are significantly less likely to suffer from other chronic diseases such as cancer, heart disease, hypertension and asthma than non-Hispanic whites and blacks, according to the report.

But William Vega of the UCLA School of Medicine, pointed to a different reason that Latinos cite generally good health as the central factor in the decision to forgo primary care: Many Hispanics in the United States are young working-age men who are, in fact, generally healthy, he said.

Other study participants listed a lack of insurance, the high cost of medical care and an aversion to doctors as reasons for forgoing primary care.

The trend away from use of primary care sparked questions among researchers about where Latinos get medical information if not from their doctor, and the study found that many Hispanics use non-medical sources to inform themselves on health. While 71 percent of participants reported having obtained information about health and health care from a doctor or other medical source in the past year, 83 percent said they had used a branch of the media, predominately television, for the same purpose.

The report contained no qualitative analysis on whether health information obtained through the media was beneficial to consumers, or whether it came in the form of advertisements, public service announcements or news media.

But several panelists at Wednesday’s event noted a strong interest in health disparities among the Hispanic press. Sumi Sousa, health care advisor to California Assembly Speaker Karen Bass, said that during California’s recent attempt at a state health care overhaul, which contained sweeping provisions to reduce minority disparities, the presence of Spanish-language news outlets such as La Opinion and Telemundo was noticeably greater than that of English-language venues.

“We had probably the greatest participation by the Spanish-speaking press,” she said.

• Pew/RWJF Report (pdf)