Use of electronic health record to determine prevalence of and aid in treatment for childhood obesity in integrated rural health system

BACKGROUND: Although < 20% of the US population lives in rural areas, prevalence of obesity in rural adults and children exceed national averages. Investigations of obesity in rural children are needed to guide successful obesity treatment and prevention efforts. PURPOSE: To describe the prevalence of obesity and overweight in rural children < 18 years seen in 2005 or 2006 in the Geisinger Health System 38 clinics servicing 41 counties of central/northeastern Pennsylvania. METHODS: Height, weight, and age were extracted from the electronic health records (EHR) of 75,379 children with at least one height and weight collected at the same visit in 2005-2006. Body mass index (BMI) was calculated and compared to Centers for Disease Control's age specific percentiles. The prevalence of “underweight” (BMI < 5th percentile), “normal weight” (5th percentile< BMI < 85th percentile), “overweight” (85th percentile RESULTS: Overall, 61.7 % of the Geisinger children were “normal” weight, and 3.1% were “underweight”. The prevalence of “overweight” for children was 16.7 % and 19% were obese.

CONCLUSIONS: EHR data reflect higher prevalence of obesity in Geisinger Health Systems' children < age 18 compared to most recent US prevalence of obesity of 17.4% for 3,958 ages 12-19 from 2003-2004 NHANES. Importantly, the EHR will be used to help develop and deliver clinical and research prevention and treatment for childhood obesity to help avoid potential lifelong, devastating and costly consequences associated with obesity.