Nutrition surveillance data are useful in planning, targeting, and evaluating nutrition programs and policies. Aggregation of these data provides an opportunity to monitor the nutritional status of the population served.
We collected data retrospectively from electronic medical records of all children enrolled in Harvard Community Health Plan (now Harvard Vanguard Medical Associates), a staff model HMO in Massachusetts, from 1980 to 1998. In this period there were over 400,000 visits by over 100,000 children aged 0-59 months. The member population was predominantly non-poor, employed, and Caucasian. However, approximately 6% of subjects were on Medicaid, and nearly 20% were African American.
We identified participants by encounters coded as well-child visits in the HMO's electronic medical record. Using CDC's Pediatric Nutrition Surveillance System abstraction form, we extracted weight and height from the visit record, linked them to demographic information from enrollment data, and then obtained hemoglobin and hematocrit concentrations from laboratory records. From 1980 to 1996 the prevalence of overweight (weight-for-height Z-score >1.65) among children ages 36 to 59.9 months increased from 4.4% to 10.2%. In 1998, the prevalence of anemia (hemoglobin <11.0 g/dL) among children ages 6 to 23.9 months was 15.1%, higher than any year since 1985. Anemia prevalence was higher in children who were younger, on Medicaid, and African American.
Future use of this database may include monitoring breast feeding trends and nutritional status of older children. This project demonstrates that an HMO provides a feasible setting to gather ongoing nutrition surveillance data from a large, diverse population.
Learning Objectives: To describe the use of data obtained from an HMO for nutritional surveillance and monitoring.
Keywords: Child Health, Health Care Managed Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.