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Linking electronic health records with community-level data to understand childhood obesity risk.

ABSTRACT: Environmental and socioeconomic factors should be considered along with individual characteristics when determining risk for childhood obesity.To assess relationships and interactions among the economic hardship index (EHI) and race/ethnicity, age and sex in regard to childhood obesity rates in Wisconsin children using an electronic health record dataset.Data were collected using the University of Wisconsin (UW) Public Health Information Exchange database, which links electronic health records with census-derived community-level data. Records from 53,775 children seen at UW clinics from 2007 to 2012 were included. Mixed-effects modelling 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).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?

SUBMITTER: Tomayko EJ

PROVIDER: S-EPMC4492911 | biostudies-literature | 2015 Dec

REPOSITORIES: biostudies-literature

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Linking electronic health records with community-level data to understand childhood obesity risk.

Tomayko E J EJ Flood T L TL Tandias A A Hanrahan L P LP

Pediatric obesity 20150105 6

<h4>Background</h4>Environmental and socioeconomic factors should be considered along with individual characteristics when determining risk for childhood obesity.<h4>Objectives</h4>To assess relationships and interactions among the economic hardship index (EHI) and race/ethnicity, age and sex in regard to childhood obesity rates in Wisconsin children using an electronic health record dataset.<h4>Methods</h4>Data were collected using the University of Wisconsin (UW) Public Health Information Exch ...[more]

PMID: 25559099

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Project description:ContextEarly childhood caries (ECC) is a persistent public health challenge, affecting more than 56% of US toddlers and preschool-aged children. Despite this, ECC is largely preventable with routine oral hygiene practices, diet, and application of topical fluoride.ObjectiveThis study assessed the utilization of preventive oral health care in primary care practices and evaluated the variation in patient characteristic and geographic disparities.DesignWe conducted a retrospective study using electronic health records (EHRs) over a 2-year period. Patients' home addresses were geocoded and linked to census-based neighborhood statistics and fluoridated water accessibility. Multiple logistic regression modeling was used to assess the risk of ECC in patients with fluoride preventive care, controlled for demographics, comorbid conditions, and neighborhood risk factors.ParticipantsPatients aged 6 to 71 months who had primary care providers at family medicine and general pediatric clinics in a large academic medical center.Main outcome measureThe presence of dental caries based on diagnoses in EHRs.ResultsThe study consisted of 10 836 patients: 17% treated with topical fluoride varnish (TFV), 12% prescribed oral fluoride supplement, 6.1% with both TFV and supplement, and 64% without fluoride treatment. Patients with fluoride treatment were 24% to 53% less likely to have ECC. Children living in rural and nonfluoridated water communities had 1.7 to 1.8 times greater risk of developing ECC. Minority, under/uninsured, and low-income patients also were at an increased risk of ECC.ConclusionDespite continuing efforts to improve access to dental care for vulnerable populations, substantial disparities remain among socioeconomically disadvantaged children. To address dental care shortage, primary care clinicians should serve as the safety net to care for vulnerable and underserved children who have no or limited access to oral health services. Future research into the collaboration between primary care and dental providers at the level of both practice and professional education should be considered.

Dataset Information

Linking electronic health records with community-level data to understand childhood obesity risk.

Publications

Linking electronic health records with community-level data to understand childhood obesity risk.

Similar Datasets

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