THURSDAY, Oct. 29 (HealthDay News) -- An estimated 17,000 children in the United States might have died unnecessarily over nearly two decades because they didn't have health insurance, according to a report from researchers at Johns Hopkins Children's Center in Baltimore.

They found that kids who lacked health insurance were 60 percent more likely to die in the hospital than were kids who had insurance. After adjusting for such differences as race and gender, uninsured kids were still 37.8 percent more likely to die than kids with insurance coverage.

David C. Chang, co-director of the pediatric surgery outcomes research group at Hopkins and a study co-author, said he could not think of a medical treatment that has such a dramatic impact on health outcomes as health insurance seemingly does.

"This is actually something we as a society ... can choose to do something about," he said. "It's literally with the stroke of somebody's pen, this could be changed."

The article was published online Oct. 30 in the Journal of Public Health.

Bruce Lesley, president of First Focus, a bipartisan child and family advocacy group, noted that data from the U.S. Institute of Medicine have shown that people who are uninsured have a higher mortality rate.

"You knew that it existed, you knew that there were cases [of child deaths related to lack of insurance], but I think this data is pretty shocking and really points to the need for national health reform," Lesley said.

In one of his first acts after taking office in January, President Barack Obama signed legislation reauthorizing the Children's Health Insurance Program (CHIP). The measure also provided funding for states to add several million more children to the rolls though 2013.

"CHIP has really worked and been very important and insures about 7 million kids in the country," Lesley said. Still, he said, roughly 6.5 million children who are eligible for Medicaid or CHIP remain uninsured -- for whatever reason.

Enrollment barriers are part of the problem, explained Lesley, whose organization endorses legislative proposals to move toward a "default enrollment" system. "The presumption should be the kid's enrolled, and let's figure out what program they're in," he said.

The Johns Hopkins team looked at the relationship between insurance status and kids' mortality to better inform the CHIP debate.

Using records from two large databases, lead author Dr. Fizan Abdullah, Chang and colleagues examined more than 23 million hospitalizations of people younger than 18.

Over an 18-year period though 2005, 117 million children were hospitalized. Nearly 6 million kids were uninsured at the time of admission. In all, 38,649 children died while hospitalized.

Uninsured kids were 1.6 times more likely to die than children who had insurance.

Assuming that the insured and uninsured populations are identical, the difference in risk of mortality was 60 percent. The authors' actual predicted mortality is lower, however, because factors such as age, race and gender are associated with risks that affect outcomes, Chang explained.

"The 60 percent is the theoretical difference, and the 37 percent is the actual difference that you see in real life," he said. "Our extrapolation is based on that more conservative number."

The study includes some data from the period before CHIP was enacted in 1997. Though fewer kids are uninsured today than two decades ago, Chang said, that would not skew the risk of death from lack of insurance.

And though the study does not prove that being uninsured boosts a child's mortality risk, it does suggest a strong association between insurance status and odds of dying.

"I think the message is insurance is a choice we can make as a society, and this is something that we should consider," Chang said.

More information

The U.S. Centers for Medicare & Medicaid Services has more on the Children's Health Insurance Program.

WEDNESDAY, Oct. 28 (HealthDay News) -- Smoking just one cigarette stiffens the arteries of young adults by 25 percent, says a new study.

The stiffer a person's arteries, the greater their risk for heart disease or stroke, noted researcher Dr. Stella Daskalopoulou, an internal medicine and vascular medicine specialist at McGill University Health Center in Montreal.

She measured arterial stiffness in smokers and non-smokers, ages 18 to 30, at rest and after exercise. To establish a baseline measurement, the smokers, who smoked five to six cigarettes a day, were asked to refrain from having a cigarette for 12 hours before their first exercise test. Before the second exercise test, smokers were allowed to have one cigarette. Before the final test, they were asked to chew a piece of nicotine gum.

After exercise, arterial stiffness in non-smokers decreased 3.6 percent. But the smokers' arterial stiffness increased 2.2 percent after exercise. In smokers, arterial stiffness increased 12.6 percent after they chewed nicotine gum and 24.5 percent after they had one cigarette.

There was no difference in arterial stiffness between smokers and non-smokers at rest.

"Our results are significant because they suggest that smoking just a few cigarettes a day impacts the health of the arteries," Daskalopoulou said in a news release from the Heart and Stroke Foundation of Canada. "This was revealed very clearly when these young people were placed under physical stress, such as exercise."

"In effect, this means that even light smoking in otherwise young healthy people can damage the arteries, compromising the ability of their bodies to cope with physical stress, such as climbing a set of stairs or running to catch a bus," she said. "It seems that this compromise to respond to physical stress occurs first, before the damage of the arteries becomes evident at rest."

The study was to be presented Oct. 27 at the Canadian Cardiovascular Congress 2009.

More information

The U.S. Centers for Disease Control and Prevention has more about the health effects of smoking.

WEDNESDAY, Oct. 28 (HealthDay News) -- Letting children sleep late on weekends and holidays might help them avoid becoming overweight or obese, a new study suggests.

Researchers in Hong Kong found that children who got less sleep tended to be heavier (as measured by body mass index, or BMI) than children who slept more. But among children who slept less than eight hours a night, those who compensated for their weekday sleep deficit by sleeping late on weekends or holidays were significantly less likely to be overweight or obese.

The study, which confirmed previous research linking sleep deficits to obesity in children, also found that, on average, children slept significantly longer on weekends and holidays than on school weekdays. However, the overweight children tended to get less weekend/holiday sleep than their normal-weight peers.

The researchers didn't determine why obese and overweight children were less likely to sleep late on holidays or weekends, but noted that they tended to spend more time doing homework and watching TV than their normal-weight peers.

Biological factors might also play a role in the compressed sleep cycle, they said.

"There's a lot of evidence linking short sleep duration to higher body mass," said Kristen Knutson, assistant professor of medicine at the University of Chicago, who was not involved in the study. "What's unique about this study is that it's the first to show that extending sleep on weekends may help with avoiding weight gain."

Still, the researchers urged caution in the interpretation of their findings, acknowledging that "an irregular sleep-wake schedule and insufficient sleep among school-aged children and adolescents has been documented with a variety of serious repercussions, including increased daytime sleepiness, academic difficulties, and mood and behavioral problems."

The precise nature of the link between short sleep duration and obesity remains unclear, said Mary A. Carskadon, professor of psychiatry and human behavior at Brown University's Alpert Medical School in Providence, R.I., and director of chronobiology at Bradley Hospital in East Providence.

"Evidence has shown that there are changes in satiety and in levels of the hunger hormones leptin and ghrelin," Carskadon said. "But there's also evidence that kids who are not getting enough sleep get less physical activity, perhaps simply because they're too tired. It's just not cut-and-dried."

The study authors noted that "reduced sleep duration has become a hallmark of modern society, with people generally sleeping one to two hours less than a few decades ago."

Experts say that adolescents and pre-pubertal children generally do best with 9.5 to 10 hours of sleep a night, younger children a bit more.

The one-year study, led by Yun Kwok Wing of The Chinese University of Hong Kong, used questionnaires to track the sleep habits, lifestyle, height and weight of 5,159 local children aged 5 to 15 years.

The findings, published in the November issue of Pediatrics, could be helpful in preventing and managing childhood obesity, the authors noted.

For now, parents should take note of their children's wake-sleep cycles in light of other behavioral and environmental factors, the researchers advised.

More information

For more on children's sleep problems, see the Nemours Foundation  .

FRIDAY, Oct. 23 (HealthDay News) -- Children as young as 5 months old are able to tell the difference between human speech and monkey calls, a new study has found.

Researchers showed 5-month-old infants from English- and French-speaking homes pictures of human faces and rhesus monkey faces paired with either human speech or monkey calls. The infants looked longer at pictures of human faces when human speech was presented and longer at monkey faces when monkey calls were played.

However, the babies weren't able to match human non-speech sounds, such as laughter, to photos of human faces. This suggests that infants are especially attuned at an early age to some of the functional properties of speech, said the researchers from New York University and McGill University in Montreal.

In another experiment, human speech, monkey calls and duck sounds were played for the infants while they were shown human and duck faces. The infants didn't look longer at the duck face when they heard a duck sound, which suggests they're unable to match ducks' faces with their sounds.

The researchers concluded that "infants' expectations about the sources of vocalizations seem not to be based on a simple association between faces and voices and extend beyond their specific experiences," according to a news release from NYU. "This ability may help infants identify their conspecifics even when they are out of view and allow them to identify the human-produced speech sounds that are relevant for language acquisition."

The study was published recently in the Proceedings of the National Academy of Sciences.

More information

The U.S. National Institute on Deafness and Other Communication Disorders has more about voice, speech and language.