Trends in Pediatric Obesity Prevalence Among Community Health Center Patients by Latino Ethnicity and Nativity, 2012-2020.

Abstract

Latino pediatric patients have a higher prevalence of obesity, but less is known about how factors related to nativity are associated with obesity in youth. We examined the prevalence of childhood and adolescent obesity in primary care over time by nativity status for Latino and non-Hispanic White children. In this serial cross-sectional analysis, we used electronic health records from a multi-state network of community health centers which included data from clinics in 21 US states for patients aged 9 to 17 years from 2012 through 2020 in at least 1 of 4 nonmutually exclusive cross sections. We estimated the adjusted odds and prevalence of having obesity (ie, body mass index [BMI] at the 95th percentile or greater for age and sex) at all encounters during each cross section by ethnicity and nativity status. The sample included a total of 147,376 patients. In the 2012-2013 cross section, 38,697 children and adolescents had at least 1 BMI measurement recorded compared with 72,747 in the 2018-2020 cross section. US-born Latino children had higher odds of having obesity than non-Hispanic White children. Foreign-born Latino and non-Hispanic White children had lower prevalence of obesity in each cross section compared with US-born Latino children (with a range from 20.4% [95% CI, 16.9%-23.8%] to 32.7% [95% CI, 31.6%-33.9%]). Differences in the prevalence of documented childhood and adolescent obesity by nativity status exist in this sample of community health center patients. This demonstrates opportunity for primary care practice to further consider patients' background and culture when providing obesity care and cardiovascular and metabolic disease prevention.