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1496 Body mass index and use and costs of primary care services among white British and Pakistani children: findings from the born in Bradford cohort study
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  1. Taimoor Hasan1,
  2. Jane West2,
  3. Lorna Fraser1
  1. 1University of York
  2. 2Bradford Institute for Health Research

Abstract

Background Obesity is associated with increased morbidity and people of South Asian ethnicity have been reported to be at a higher risk of developing cardio-metabolic conditions at a lower BMI threshold compared to White European populations. In recent decades, childhood obesity has become a global health emergency with higher prevalence leading to obesity associated metabolic conditions that were previously unusual in childhood. The prevalence of childhood obesity in the United Kingdom is among the highest in Europe with recent estimates indicating that South Asian children have higher rates compared to White British children. We examined the direct impact of obesity on the health of children from different ethnic backgrounds through assessment of their utilisation of primary healthcare services.

Objectives To determine the association of body mass index with primary healthcare use and costs during childhood and assess the impact of ethnicity on this association.

Methods Prospective longitudinal analysis of the UK White British and Pakistani children in the Born in Bradford cohort study with linked primary care records and height and weight measurements recorded at age 4–5. Incidence rates of outcomes of primary care consultations and prescriptions up to the age of 8 years were modelled using negative binomial regression. Associated direct healthcare costs were modelled using a generalized linear model with log-link function and gamma distribution. All models were adjusted for child sex, birthweight, gestational age, Mother’s BMI, mother’s age and deprivation and accounting for time at risk for each child.

Results There were a total of 3,469 White British and 4,346 Pakistani children. The proportion of obese children was 9.97% in White British and 10.17% in Pakistani children. Overall, the adjusted incidence rates of consultations and prescriptions were significantly higher in obese children when compared with normal weight children (consultations: incidence rate ratio (IRR) 1.19, 95% CI 1.11–1.27; prescriptions IRR 1.20, 95% CI 1.10–1.30). The adjusted direct healthcare costs were also significantly higher in obese children when compared with normal weight children (absolute difference: £19.9, 95% CI 8.2–31.7).

The adjusted incidence rates (IRs) of consultations and prescriptions were significantly higher in Pakistani children in all BMI categories compared to White British children (e.g., consultations: Pakistani obese had 2,323 consultations per 1000 person-years, White British obese had 1,555 consultations per 1000 person-years; prescriptions: Pakistani obese had 4,421 prescriptions per 1000 person-years, White British obese had 2,056 prescriptions per 1000 person-years).

Conclusions Obese children in both groups had on average more primary care consultations and a greater number of prescriptions. This association was moderated by ethnicity with Pakistani children having significantly higher rates. These findings underline the importance of reducing childhood obesity and highlight the need for further research to understand the differences in use of primary care services between different ethnic communities.

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