Background Childhood obesity remains a public health concern, and tracking local progress may require local surveillance systems. Electronic health record data may provide a cost-effective solution. Purpose To demonstrate the feasibility of estimating childhood obesity rates using de-identified electronic health records for the purpose of public health surveillance and health promotion. Methods Data were extracted from the Public Health Information Exchange (PHINEX) database. PHINEX contains de-identified electronic health records from patients primarily in south central Wisconsin. Data on children and adolescents (aged 2–19 years, 2011–2012, n=93,130) were transformed in a two-step procedure that adjusted for missing data and weighted for a national population distribution. Weighted and adjusted obesity rates were compared to the 2011–2012 National Health and Nutrition Examination Survey (NHANES). Data were analyzed in 2014. Results The weighted and adjusted obesity rate was 16.1% (95% CI=15.8, 16.4). Non-Hispanic white children and adolescents (11.8%, 95% CI=11.5, 12.1) had lower obesity rates compared to non-Hispanic black (22.0%, 95% CI=20.7, 23.2) and Hispanic (23.8%, 95% CI=22.4, 25.1) patients. Overall, electronic health record–derived point estimates were comparable to NHANES, revealing disparities from preschool onward. Conclusions Electronic health records that are weighted and adjusted to account for intrinsic bias may create an opportunity for comparing regional disparities with precision. In PHINEX patients, childhood obesity disparities were measurable from a young age, highlighting the need for early intervention for at-risk children. The electronic health record is a cost-effective, promising tool for local obesity prevention efforts.

Summary Background Environmental and socioeconomic factors should be considered along with individual characteristics when determining risk for childhood obesity. Objective To assess relationships and interactions among economic hardship index and race/ethnicity, age, and sex in regards to childhood obesity rates in Wisconsin children using an electronic health record dataset. Methods Data were collected using the University of Wisconsin Public Health Information Exchange (PHINEX) database, which links electronic health records with census-derived community-level data. Records from 53,775 children seen at UW clinics from 2007–2012 were included. Mixed effects modeling was used to determine obesity rates and the interaction of EHI with covariates (race/ethnicity, age, sex). When significant interactions were determined, linear regression analyses were performed for each subgroup (e.g., by age groups). Results The overall obesity rate was 11.7%, and significant racial/ethnic disparities were detected. Childhood obesity was significantly associated with EHI at the community level (r=0.62, p<0.0001). A significant interaction was determined between EHI and both race/ethnicity and age on obesity rates. Conclusions Reducing economic disparities and improving environmental conditions may influence childhood obesity risk in some, but not all, races and ethnicities. Furthermore, the impact of EHI on obesity may be compounded over time. Our findings demonstrate the utility of linking electronic health information with census data to rapidly identify community-specific risk factors in a cost-effective manner.

No abstract

No abstract

Centered Research and Reviews (JPCRR) is a peer-reviewed scientific journal whose mission is to communicate clinical and bench research findings, with the goal of improving the quality of human health, the care of the individual patient, and the care of populations.