P3.F115: Prevalence of Obesity in Children Receiving Care at Community Health Centers from 2019-2022

Background: The prevalence of children with obesity in the U.S. has increased significantly over decades. Community Health Centers (CHCs) are safety net clinics, and primarily serve patients living at or near poverty and those that identify as racial or ethnic minorities. Families receiving care at CHCs face systemic and structural inequities that introduce greater barriers to maintaining healthy weight. CHCs have a critical role in addressing obesity through education, prevention, and management. The understanding of how the COVID-19 pandemic impacted rates of obesity among youth is still evolving. Using Electronic Health Record (EHR) data, we sought to describe the prevalence of obesity from 2019 onward among youth receiving health care at 19 CHCs across the US.

Methods: In partnership with the CDC and the National Association of Community Health Centers (NACHC), we conducted a cross-sectional, retrospective analysis utilizing AllianceChicago’s EHR data from patients who received primary care visits between 2019 and 2022. AllianceChicago is a network of CHCs across over 18 states. The study population included patients aged 2 through 19 years old with at least one observation of body mass index (BMI) in a given year. Race and ethnicity information was derived from patient registration data in the EHR. The outcome of obese weight status (BMI>/=95th percentile) was examined. Prevalence was defined by calculating the percentage of this outcome among the total eligible population, with further breakdown by age, sex at birth, and race/ethnicity.

Results: The percentage of youth with obesity in 2019 in this population was 27.3%. The prevalence of obesity increased through 2021 to 33.2% and then decreased to 29.8% in 2022. This trend was seen in nearly every categorical breakdown. By ethnicity, in 2019, the prevalence of obesity was 25.1% of non-Hispanic white children, 24.3% of non-Hispanic Black children, 30.5% of Hispanic children, and 15.9% of Asian children seeking care at the CHCs. Prevalence of obesity increased through 2021 for all ethnicities except Native Hawaian or other Pacific-Islander and then decreased in 2022.

Conclusion: In thisl analysis describing the prevalence of obese-range BMI in pediatric patients aged 2-19 years receiving care at CHCs across the country, the prevalence of obesity increased significantly from 2019 through the first 2 years of the pandemic. A decrease in the prevalence of obesity was noted in 2022. This pattern was noted when data was broken down by age, race, and ethnicity as well.
The higher prevalence of obesity in this population underscores the need for comprehensive resources and programs that can be consistently accessed by resource-limited populations. The universal decrease in prevalence of obesity noted in 2022 demonstrates the potential protective effect of access to health services, healthier food, and safer spaces for physical activity that in-person education affords.