The number of children with medical insurance is increasing across the country, thanks to outreach efforts and streamlining of government eligibility requirements.
But among the millions of uninsured children, many of them African American and Latino, one in three goes an entire year without seeing a doctor, according to a report released yesterday by the Robert Wood Johnson Foundation.
"The number of uninsured children continues to be in the millions. No child should go without health care," said U.S. Surgeon General Richard H. Carmona.
In a Northwest Washington recreation center yesterday, Carmona spoke at the kickoff event for "Covering Kids and Families," the foundation's annual campaign to encourage parents to sign their children up for health insurance.
In the District, 10 percent of children were without insurance in 2002-03, the time covered by the report. Maryland does a little better, with 9 percent of children uninsured. Virginia has worse numbers, with 10.6 percent uninsured.
At the Kennedy Recreation Center at Seventh and P streets NW, an assortment of soccer stars, entertainers, health care officials and politicians joined Carmona for the release of the statistics. At a health fair at the center, activists handed out bananas, pens and Frisbees; doctors gave vaccinations; and counselors offered options.
Sylvia Harris scrapes together $500 a month to keep her four grandchildren on her family's health plan. But she may be eligible for federal or state insurance programs she never considered, a counselor told her. "I always thought that I could never get help," Harris said after hearing the news, as she pushed a stroller and herded her grandchildren through the maze of tables at the health fair.
In Washington, 25 percent of uninsured children did not see a doctor for a year. That is lower than the national average of 33 percent, according to the report. But it is more concentrated in minority populations. Twenty percent of uninsured African American children went a year without a doctor visit, said Risa Lavizzo-Mourey, president and chief executive of the Robert Wood Johnson Foundation. "Inequality in health care is just plain unacceptable in our great country," she said.
The foundation's program tries to make health insurance enrollment a back-to-school priority. The event yesterday was the first of thousands to be held across the country in the next few months, Lavizzo-Mourey said.
With a spicy musical public service announcement recorded by salsa legend Willie Colon, the effort also will target Latino populations. "I grew up in a very poor neighborhood. We didn't go to the doctor -- we went to the emergency room," Colon said of his childhood in a Puerto Rican neighborhood in the Bronx, N.Y., where his uninsured family went to the hospital only if they thought "we really weren't going to make it."
Meredith Josephs sees that kind of thinking daily at La Clinica del Pueblo, where she is medical director at the free clinic. Many patients are eligible, she said. But the language barrier and fear that illegal immigrants will be turned in to authorities often keep Latino families from applying, she said.
In other neighborhoods, the complexity of the system keeps some families from getting insurance. Studies document improvements in coverage once states simplify their qualification process, said Cindy Mann, a research professor at Georgetown University's Health Policy Institute.
Outreach programs such as the foundation's event will not work if families are scared off, she said. "If you build it right, the children will come," Mann said. "It's not the soccer stars alone who can do this."