Constructing a childhood BMI registry: Tracking an epidemic

To validate anecdotal provider reports of a childhood obesity problem, a community health center clinic in south Phoenix, Arizona developed an electronic data registry to track body mass index among its pediatric patients. This facility serves 10,000 low-income, largely Hispanic pediatric patients a year. A working group within the health center assisted in determining the data components of the registry. It was decided that those Pediatrics Department patients ages 4 - 19 years being seen for a "well child" visit would be included in the registry. Data fields included patient name, address, date of birth, gender, race/ethnicity, height, weight, and diagnosis of diabetes, asthma, dyslipidemia, and/or hypertension. A BMI calculation and percentile was generated based on height, weight, gender and date of birth information. Data entry began in August 2007. Through October 2008, 1,471 records have been entered into the registry. By race/ethnicity, 89% of all entrants were Hispanic, 7% African American, and 4% Other. For 4 – 5 year olds, 32% had a BMI higher than the 95th percentile (obese), and 16% had a BMI between the 85th and 94th percentile (overweight). For 6 – 11 year olds, 36% were obese and 22% overweight. For 12 – 19 year olds, 33% were obese and 21% overweight. These rates of obesity are generally twice the national rates (NHANES, 2003 – 2006) and among the highest reported in the medical literature. These data establish a baseline with which this community health center can initiate strategies and programs to intervene in this epidemic.