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Even with Medicaid, many poor children are not receiving the health-care services they need, a new study concludes.

The study, published in last week's issue of the Journal of the American Medical Association, found that about 10 percent of all children, or more than 6 million young people, lacked a routine source for medical care.

Poor children were twice as likely as other children to lack a usual source for either routine or illness-related care, wrote the authors, who are affiliated with the University of California at San Francisco.

The researchers based their study on data from a 1988 federal survey and subsequent interviews with 17,110 children.

Children from low-income families were less likely to receive routine medical care in a physician's office than were middle-class children, going more often instead to community or hospital clinics, the researchers found.

Poor children also were more likely to have different sources for sick care and routine care, the study indicates.

McDonald's Corporation is unveiling a health- and nutrition-education program this week that will advise students to eat only moderate amounts of regular-fat meat and dairy products.

The program, "Healthy Growing Up,'' is a curriculum for students in grades K-3. Principals nationwide will be getting letters from the company this week about the program, which will be offered free of charge.

The curriculum, which is designed to supplement existing health-education programs, will stress self-esteem, exercise, good health, and nutrition.

Students in the 1st grade, for example, will be told that foods can be grouped into the "green,'' "yellow,'' and "red'' categories. "Green'' foods, such as fruits and vegetables, can be eaten frequently, while such "yellow'' foods as regular-fat meat and dairy products should be consumed less frequently.

Students will learn that "red'' foods, such as candy bars, should be eaten only occasionally.

Roughly one out of every five people living in developed countries will die as a result of their use of tobacco, the first study to project tobacco-related deaths in the industrialized world suggests.

Just under 20 percent of all deaths in developed countries can be attributed to tobacco usage, according to the study, which appeared in the May 23 issue of the British science journal, The Lancet.

That percentage will rise, however, the study predicts. It estimates that tobacco will cause about 30 percent of all deaths for those between the ages of 35 and 69 this decade, and 21 million deaths over all in developed countries.--E.F.

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