TitleElectronic health records and community health surveillance of childhood obesity.
Publication TypeJournal Article
Year of Publication2015
AuthorsFlood, TL, Zhao, Y-Q, Tomayko, EJ, Tandias, A, Carrel, AL, Hanrahan, LP
JournalAm J Prev Med
Date Published02/2015
KeywordsAdolescent, Child, Child, Preschool, Continental Population Groups, Electronic Health Records, Feasibility Studies, Female, Health Status Disparities, Humans, Male, Pediatric Obesity, Population Surveillance, Wisconsin, Young Adult

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.

Alternate JournalAm J Prev Med
PubMed ID25599907
PubMed Central IDPMC4435797
Grant List5T32DK007665-21 / DK / NIDDK NIH HHS / United States
UL1 TR000427 / TR / NCATS NIH HHS / United States
UL1RR025011/DHHS/NCRR / RR / NCRR NIH HHS / United States
UL1 RR025011 / RR / NCRR NIH HHS / United States
T32 DK007665 / DK / NIDDK NIH HHS / United States