Axel Hernandez / Hispanic/Latino Health Coalition of Elkhart County

People line up outside last year's health fair provided by the nonprofit Hispanic/Latino Health Coalition of Elkhart County.

Liliana Quintero knows that it's hard enough in tough economic times to pay for health care when you're sick, let alone when you feel OK.

But prevention practices like health screenings, reliable monitoring and behavior changes can keep a small problem from escalating into a crisis, said Quintero, the director of the Hispanic/Latino Health Coalition of Elkhart County. The nonprofit agency aims to provide such early detection and health education for thousands of Elkhart County residents hit hard by the lingering downturn.

"If we create awareness of the importance of health at early ages, we will save money and heartaches for those who will be forced to care for us in the future, should we be one of the unlucky ones," she said.

For five years, Quintero, 37, and her husband, Roger Carlson, 39, have worked to provide access to health information and services to a largely Hispanic audience. (Click here to read a recent story about how the Hispanic community has been hard hit by the recession.)

It's been important in a community and a country where minorities are disproportionately affected by key health issues such as obesity, diabetes and heart disease.

But as the economic crisis has worsened, people of all ethnicities are turning to the agency, particularly to an annual health fair that last year provided more than 7,300 screenings to a racially mixed crowd of more than 1,600.

"It's open to everyone, not just Hispanics," Quintero said.

The outreach recently has become even more personal for Carlson, who stepped up his work with his wife after losing his job as an electrical engineering manager at Monaco Coach Corp., which announced it was closing its doors here last summer.

Reaching out to others has given Carlson a meaningful focus in an increasingly bleak job market.

"It's hard to see the light at the end of the tunnel, at least for a year or two," he said.

One bright spot, however, may be this year's health fair. The couple expects up to 2,000 people on Sept. 12 to show up for free medical screenings that measure important health markers from blood pressure to body mass index and cholesterol to kidney function. Screenings for lead poisoning in children, osteoporosis in older women and blood glucose levels in the population at large also are offered.

It's a potentially life-saving service at a time when growing numbers of Americans are cutting back on health care costs. A survey this spring by the American Cancer Society's Cancer Action Network found that one in five women said that they or a family member had postponed cancer screening in the last year because of cost.

One third of Americans with incomes less than $35,000 put off screenings such as mammograms or colonoscopies because they couldn't afford them, according to the survey of more than 1,000 people conducted in April.

That comes on the heels of reports that Americans are cutting back on prescription drugs and putting off office visits to physicians. After more than a decade of significant steady rises, U.S. pharmaceutical sales slowed to an overall growth of 1.3 percent in 2008, fueled in part by two quarters of decline, according to IMS Health, which tracks sales.

Visits to doctors dropped by 1.2 percent between July 2007 and July 2008, according to IMS. Industry experts say they've probably fallen even more; new data is expected in August.

A free screening offered by Quintero's program likely saved the life of Nohelia Gonzalez, a 37-year-old Goshen factory worker who had postponed annual gynecological exams. She was a volunteer at a 2006 Pap-a-thon, a Pap smear screening fair for women, when a client missed a scheduled appointment.

Carissa Ray / msnbc.com

Nohelia Gonzalez, 37, of Goshen, Ind., was diagnosed with life-threatening cervical cancer after a screening at a health fair offered by the Hispanic/Latino Health Coalition of Elkhart County.

Gonzalez agreed to take her place, and was stunned when the test showed signs of abnormality. Within days, she confirmed the worst with her doctor: cervical cancer. Within weeks, she was in the hospital preparing for surgery.

"It was really bad," Gonzalez said. "Probably, maybe, I could have died from it."

Three years later, she's an even stronger advocate than before for health screening.

"Do not wait," she said. "Do the exams every year. Don't put your life at risk."

That's a message echoed by Quintero and Carlson, who run their program on a shoestring budget of a little more than $102,000 a year, according to tax records.

"Most of us can drastically improve our chances at a healthy life by taking care of our bodies, eating healthy and exercising," Quintero said.

Click here to see more of the Elkhart Project: Struggle and Recovery in America