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WASHINGTON — Millions of Americans aren't following the adage: Prevention is the best medicine.

The nation's minorities, poor and uninsured especially are missing out on the preventive screening and counseling they need, according to government reports Thursday.

Overall, the quality of the U.S. health-care system continues to improve at a modest pace. When it comes to preventive care, though, the rate of improvement lags.

Americans as a whole largely are not getting the tests, exams and advice from doctors that can lessen the burden from asthma, cancer, diabetes and obesity, according to the fourth annual national health-care quality and disparities reports.

"It's encouraging to learn that overall quality continues to improve," said Dr. Carolyn Clancy, director of the federal Agency for Healthcare Research and Quality, which issued the two reports.

"At the same time, the message is clear: Much more can be done to prevent illness from occurring or progressing."

There also continues to be a wide split in access to health care, with poor and minority patients generally receiving poorer care, according to the reports. The uninsured, however, fare the worst when it comes to access to and quality of health care.

Finding ways to reduce the numbers of the uninsured will be a hot topic during the current Congress. Lawmakers, physician groups, insurers and others have put forth plans to cut their ranks.

The disparity findings of the congressionally mandated reports are consistent with previous editions. That divide is especially stark when it comes to preventive care, according to the new reports.

Obese blacks and Mexican-Americans, for example, are less likely to be told by a doctor that they are overweight than are white patients.

Anyone who's obese — that's about one-third of all American adults — faces an increased risk of diabetes, high blood pressure, stroke, heart disease and other serious conditions.

Identifying disparities is an important step, but closing the gaps remains a challenge, said Andrea Kabcenell, an executive director with the nonprofit Institute for Healthcare Improvement.

"It isn't we don't know what to do, it's we don't know how to do it," said Kabcenell, whose institution has pushed hospitals to put into place lifesaving strategies shown to work.

"If we can show health-care organizations how to do the things that reduce disparities, they will jump on them. Nobody wants these disparities," she added.

Among other disparities, blacks with asthma are less likely to receive medications to control their condition.

And colorectal screening rates are lower for blacks and Asians when compared with whites, according to the reports.

Overall, only about 52 percent of American adults reported receiving a colorectal screening as recommended, according to the reports.

Each year, there are about 150,000 new cases of colorectal cancer and 56,000 deaths.

Federal health officials urge adults 50 and older to get an initial screening.

The American Cancer Society estimates wider screenings could cut colorectal cancer cases and deaths in half.

"The news is encouraging in that we seem to be increasing screening rates for many populations," said Dr. Durado Brooks, director of colorectal cancer for the society.

"But there's still a tremendous amount of work to be done and far too many people are dying of this disease."