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Despite Eligibility, Millions of Adolescents Still Uninsured

Of the more than 3 million uninsured adolescents in the United States, at least 2 million are eligible for Medicaid or the newer Children's Health Insurance Program, known as chip, says a study released last week.

While those federal programs help young people obtain health coverage, many states fail to take steps to help adolescents get it, according to the study by the Center for Adolescent Health and the Law in Chapel Hill, N.C.

"Medicaid and CHIP offer states an unprecedented opportunity to meet the health needs of America's teenagers," said Abigail English, the lead author of the study and the director of the center.

The major health problems faced by the young have been described as preventable health conditions, the study says. "This group has a pressing need for a wide variety of health care and related services," it says, "but adolescents are less likely than any other age group to have health insurance."

In 1997, CHIP made available $48 billion in federal aid over 10 years to help states expand health-insurance coverage for low-income children and youths whose parents earn too much to qualify for Medicaid but too little to pay for private insurance coverage. An array of state laws are designed to expand health coverage and increase the likelihood that eligible teenagers will enroll in the programs.

But, Ms. English said, "there is a lot of work that needs to be done to make sure these benefits reach young people."

Getting schools more involved in outreach was one suggestion she offered.

Adolescent Dieting: Dieting and exercise may not be the best way for adolescent girls to lose weight.

A study published in a recent Journal of Consulting and Clinical Psychology says that dieting may actually promote weight gain because it leads to binge eating and increased calorie absorption.

The four-year study followed 692 9th grade girls in Northern California. They were assessed at the beginning of the study, then annually for the next three years. Participants underwent a clinical interview along with height and weight measurements. The students also filled out annual self-report questionnaires.

Researchers found that the use of appetite suppressants and laxatives, bulimic behavior or vomiting to control weight, and binge eating were all weight-gain predictors. Of the girls who were not obese—defined as a body-mass index, or weight divided by height, exceeding 25—at the start of the study, 63, or close to 11 percent, had become obese by the study's end.

The "most striking finding," the researchers say, is that elevated dieting and radical weight-loss efforts predicted greater relative weight gain and increased the risk for obesity.

Weight control requires a permanent lifestyle change, said Eric Stice, a professor of psychology at the University of Texas at Austin and the lead author of the study.

Youth Hockey Injuries: As a way to reduce serious injuries, the American Academy of Pediatricians has called for a limit to "checking" in organized ice hockey games for players 15 or younger.

Hockey is classified as a collision sport by the AAP because of the intentional body contact, called body checking, that occurs. In recent years, an increase in the number of serious head and neck injuries stemming from the practice has alarmed hockey officials and players and led to a reassessment of the role of body checking in youth hockey, according to the physicians' organization.

One study the academy cites found that checking accounted for 86 percent of all reported injuries to players in the 9- to 15-year-old age range.

Advocates of checking say it is a big part of the game, and that players need to learn the proper way to give and take checks at an early age.

Checking is "just like any other skill," said Chuck Menke, a spokesman for USA Hockey, the national governing body for the sport. "We want to make sure players can properly take and perform body checks. If you wait until players are 16, it would be difficult because they are much bigger and stronger, and the risk for injury is much higher," he said.

Most young hockey players are introduced to the sport at age of 5 or 6, according to Mr. Menke. USA Hockey prohibits checking before age 12.

Short Takes:

Family Planning Perspectives: "Adolescent Pregnancy and Childbearing: Levels and Trends in Developed Countries." Adolescent pregnancy occurs in all societies, but the rate of teenage pregnancy and childbearing varies from country to country. Web site: urnals/3201400.html.

International Conference of Developmental Psychopathology: "Adolescent Alcohol Dependence May Damage Brain Function." Heavy use of alcohol can impair brain function in adolescents. Web site: ilk/niaaa1/releases/adoles.htm.

—Adrienne D. Coles

Vol. 19, Issue 28, Page 12

Published in Print: March 22, 2000, as Health Update
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