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What the report found Key findings from the Snohomish Health District's "Access to Care" report: Access to timely and adequate health care plays an important role in preventing and treating disease. People without insurance and people living in poverty are most affected by lack of access to health care. Pregnancy & Birth From 2003 to 2005, 14 percent of women giving birth in Snohomish County received inadequate prenatal care. Women receiving inadequate prenatal care were more likely to have a premature birth or a low birth-weight infant. Children In 2006, more than 55 percent of uninsured children in the Puget Sound region may have been eligible for public insurance programs. For children in Sno­homish County, asthma was the leading cause of hospitalizations that can be avoided through timely primary care. Hospitalizations for avoidable conditions accounted for 17 percent of all nonchildbirth hospitalizations for children in Snohomish County. Adults Nearly 15 percent of Snohomish County adults ages 18 to 64 reported not having any form of insurance. Fourteen percent reported not seeking medical care in the previous 12 months because of cost. Adults without insurance were less likely to receive recommended clinical preventive services, such as a mammogram in the past two years, a Pap test in the past three years and a flu shot in the past year. Adults 65 and up Although most elderly adults have health insurance through Medicare, many do not receive recommended clinical preventive services, such as a mammogram or a colonoscopy or sigmoidoscopy. The full report is available at www.snohd.org/snoHealthStats/accessReport.htm.

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Robert Frank, City Editor frank@heraldnet.com

Many in Snohomish County get too little medical care, report finds

By Sharon Salyer, Herald Writer

EVERETT -- Nearly 15 percent of adults in Snohomish County are going without health insurance, and lack of money often means they delay getting medical care.

Too many moms aren't getting enough prenatal care during their pregnancies, which can lead to premature births and babies with low birth weights.

And too many seniors, even though they're insured through Medicare, aren't getting regular health screenings, such as mammograms.

These are some of the findings included in a Snohomish Health District report released Monday, documenting problems local children and adults face in getting medical care.

It's the first time in five years that the public health agency has done this type of report card on the problems people face in getting access to health care, said Dr. Gary Goldbaum, health officer for the Snohomish Health District.

Information was analyzed from a number of sources to define the extent of the problems that limit people's ability to get medical care, he said.

"What we take out of this is that it's pretty clear that there are a significant number of Snohomish County residents who are either uninsured or if they are insured, are still having trouble accessing (medical) care," Goldbaum said.

Some of the indicators the study found of these problems:

n From 2003 to 2005, 14 percent of women giving birth in Snoho­mish County received inadequate prenatal care.

n In 2006, more than 55 percent of uninsured children in the Puget Sound region may have been eligible for public insurance programs.

n Adults without insurance were less likely to receive recommended clinical preventive services, such as a mammogram in the past two years, a Pap test in the past three years and a flu shot in the past year.

The Everett Clinic, Group Health and nonprofit health organizations such as the Community Health Center of Snohomish County and Sea Mar are among those who will work with the Snohomish Health District to try to find ways to ensure more people get medical care.

Representatives of these and other health care organizations from throughout the county met with Goldbaum on Monday. They learned of a program in King County called Project Access that was launched about a year ago. Its goal is to try to find ways to ensure that more people can get medical care, said Mark Mantei, chief operating officer of The Everett Clinic.

In King County, physicians have banded together to donate time to help treat the uninsured, he said.

"If everybody does a little, it makes a big difference," he said.

Mark Judy, chief executive of Valley General Hospital in Monroe, said he was surprised by the health district's finding on the number of women giving birth in Snohomish County who didn't get the recommended number of prenatal checkups.

He said it reminded him of similar findings in Snohomish County in the 1980s. "I was surprised that the access questions and the number of prenatal visits was becoming an increasing problem again," Judy said.

Some relief will be provided soon to people living in the Skykomish Valley, he said.

Sea Mar will open a new medical clinic in Monroe in late April or early May, he said.

Providing health care for those without insurance is a complicated problem, he said, caused by a shortage of primary care physicians and nurse practitioners, coupled with the large number of people without health insurance.

Ken Green, director of the Community Health Center of Snohomish County, agreed, adding that his organization is now trying to recruit eight physicians and two physician assistants or nurse practitioners.

Both uninsured and Medicaid patients have particular trouble finding specialty doctors, such as orthopedists, or those who specialize in bone and joint problems, he said.

Monday's meeting was an important first step in trying to find ways more people can get health care, Green said. But it will probably take six months or more to come up with specific suggestions on what steps can be taken locally, he added.

Reporter Sharon Salyer: 425-339-3486 or salyer@heraldnet.com.