In an ailing economy, the doctor can wait

Dena Lansford, 49, would like to have a cholesterol check, a mammogram and, soon, a colonoscopy.

She hasn't seen a dentist in more than a year. She worries that she might suffer a similar fate as her mother, who had a stroke at 47.

But after losing her job and health insurance last year, the Wildomar woman said, "I'm not doing any preventive care."

As of February, an estimated 3.7 million working-age Americans -- 500,000 in California -- had lost their health insurance since the start of the economic decline, according to a recent report.

People are cutting back on routine screenings and examinations designed to protect their health, Southern California doctors and dentists say.

Those who have health insurance with high deductibles or expensive co-pays also appear to be cutting back on nonessential medical care, doctors say, possibly to save money.

"People are spending less money on everything," said Dr. Howard R. Krauss, president of the Los Angeles County Medical Assn. "If you're feeling well, the easiest thing to save money on is not going in for your mammogram or colonoscopy."

Precise numbers on the recession's effect on preventive care are not yet available, but mammography screenings have declined in recent years, according to the American Cancer Society. They are down about 4% since 2000 and down 7% in women ages 50 to 64, the age group at highest risk for breast cancer.

Local dental practices say business is off 15% to 30% this year. Michael Fulbright, a Redondo Beach dentist, said his hygienists' workloads had declined 15% in the last month.

A survey of Californians released last month by the California HealthCare Foundation found that 43% of people under 50 said they had postponed care for a chronic health condition because of cost.

Doctors in hospital emergency rooms say they are seeing signs that people are cutting back on routine care.

"People are coming in sicker, often with a chronic disease which had been under control but has gone out of control," said Dr. Brian Johnston, medical director of the emergency department at White Memorial Medical Center in East Los Angeles. "Emergency rooms all over L.A. are reporting that patients are coming in, and they just can't get to them fast enough."

Preventive care includes examinations and tests to detect illness early and keep chronic health conditions -- such as asthma, diabetes, thyroid or blood pressure problems -- under control.