Hundreds of people lined up outside Key West High School before 9 a.m. one recent Saturday for a health fair. One of them was Steve Lander, for whom the annual event suffices for his annual checkup, since he doesn't have health insurance.

"If you don't have health insurance it is better than nothing as an option," he said. "I've probably come to the health fair for about eight years. Because I don't have insurance, a dermatology test is $100 at the doctor's, but here it's free."

Lander also gets a free cholesterol check by donating blood about once a month.

"I get a total blood cholesterol count from the bloodmobile," he said, referring to the Community Blood Centers of South Florida. "Insurance would cost me about $600 a month for catastrophic health insurance; it's too expensive. If I get hit by a bus, my house is on the line (for medical costs). They go after your assets."

In these days of joblessness, limited income and lack of health coverage, many of the nearly 333 people who attended the Jan. 23 health fair were there for free medical tests, lifesaving advice and time with a physician because they don't have insurance or money for a doctor, health fair organizers said. This year's fair saw a 39 percent increase in attendees, from 240 in 2009, according to the Florida Keys Area Health Education Centers (AHEC). The Upper Keys health fair in November saw a 41 percent increase, from 203 last year to 287 this year, AHEC said.

"Keys AHEC offers year-round community health services, and the demand for those services has dramatically gone up in populations that historically have not accessed services in the past," CEO Michael Cunningham said. "About 85 percent of the people we saw at the Key West health fair either don't have health insurance or are underinsured."

AHEC, along with the University of Miami's Miller School of Medicine, also sponsored fairs in Marathon and Big Pine Key the same day.

"We'll probably end up helping about 800 people in the Keys today at all our sites," Cunningham said that day.

Health fair director Jacadi Bignami said the medical workers who staff the event have become de facto family doctors.

"People who don't have medical insurance attend every year to get their health checked and save money," said Bignami, a second-year Miller medical student who also staffs the booths with signs designating "pediatrics," "dermatology," "mental health" and more.

Kevin Daugherty attended the health fair in Big Pine Key. The 53-year-old lost his health insurance in his 2001 divorce, so he depends on the health fair for his annual checkup.

"I'm unemployed from landscaping and construction work," Daugherty said. "It's been my annual visit to the doctor."

Though the examinations and doctor's advice is free, attendees pay for lab work, albeit a nominal fee of about $15, Daugherty said. He also is on his own if he's told to get follow-up treatment.

"I've been having headaches for months, so I was told that I needed to get a CAT scan. I'll have to save up for one."

Mark Whitehouse, who lives on a boat near Key West, also depends on health fairs and other free services.

"I'm a cancer survivor by being proactive," said the lanky young man. "I'm surprised more people don't come by here to take advantage of the free services. I'm going to take the gamut of tests."

Pavel Ryslav, an Eastern European trailed by his wife and two kids, was in line at the vision testing room.

"My insurance doesn't cover anything," he said. "I brought my wife and kids along too, and it's a big help for us."

jguerra@keysnews.com