Abstract
Background:
Obesity, elevated blood pressure (BP), and diabetes mellitus are rising among the general U.S. adolescent population, but prevalence estimates are not available for uninsured or Medicaid populations.
Methods:
This retrospective epidemiological study extracted 155,139 electronic medical records collected between 1998 and 2012 on patients aged 10–19 years, from a clinical population predominantly uninsured or insured by Medicaid. Age, sex, race, height, weight, BP, and insurance type were captured at first clinic visit. Classifications included obesity (≥95th body mass index percentile), elevated BP (≥90th percentile), and diabetes mellitus (ICD-9-250.xx).
Results:
Among the 26,696 patients with complete data at first clinic visit, 24.4% were classified as obese and 39.5% had elevated BP. In logistic regression analyses, odds of obesity were significantly higher among uninsured versus commercially insured patients (odds ratio [OR]: 1.1 [95% confidence interval: 1.0–1.2]) and girls (OR: 1.3 [1.2–1.4]), but lower among older adolescents (for 15–17 years, OR: 0.7 [0.6–0.7]; for 18–19 years, OR: 0.7 [0.7–0.8]). Odds of elevated BP were significantly higher among Medicaid (OR: 1.1 [1.0–1.2]) and uninsured (OR: 1.2 [1.1–1.4]) versus commercially insured patients, but lower among African American versus White youth (OR: 0.9 [0.8–0.9]). Prevalence of type 1 diabetes was 1.46 per 1000 and prevalence of type 2 diabetes was 1.68 per 1000, with both occurring more often in girls versus boys and in Whites versus African Americans.
Conclusion:
In this low-income clinical population, prevalence of obesity and elevated BP were higher than national estimates. The provision of preventive healthcare to all Medicaid and uninsured youth should remain a priority.
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