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Lack of medical insurance is a health risk factor. Underutilization or postponement of medical services, as well as lack of planning for long-term care are common among the uninsured, project was implemented within the framework of the Or Yehuda Intervention Program to assess the health status of children from birth to 17 years of age in 72 families without health insurance. Information on medical status and service utilization was summarized for 169 of the 217 children in these families. These families constituted a substantial burden on the health system, both in the form of hospitalization debt (636 hospital-days owed to a nearby hospital) and as uncompensated primary care clinic visits. Half of the visits were made by 12% of the children, while a quarter of the study children had not visited the clinic at all during the preceding year. Among families uninsured for over 2 years, the trend of underutilization was even more pronounced. Significant morbidity and signs of neglect were found among the study children, nearly 60% of whom suffered from health problems and a similar proportion had been hospitalized. The most common diagnoses were infections, congenital anomalies, and musculoskeletal and hematological problems; a third of the children had 2 or more conditions. Over 40% of the study children were referred for specialist consultation or treatment--about half of them to the pediatric subspecialties and the other half to surgical clinics. Signs of medical neglect were noted in 42.6% of study children and among 60.4% of those with 2 or more medical problems.(ABSTRACT TRUNCATED AT 250 WORDS)