The Relationship Between Cardiovascular Risk Factors and Use of Healthcare Services in Low-Income Preschool Children

Background: Cardiovascular disease (CVD) is the major cause of morbidity and mortality in the United States. Although the development of CVD does not occur until adulthood, the etiology of CVD begins in childhood. Two well-recognized risk factors for CVD include overweight/obesity and high blood pressure. Childhood obesity continues to be a significant public health concern in children. The prevalence of obesity among children 2 to 5 years old was most recently estimated at 8.4%. However, rates are higher for minority and low- income children with Black preschool children having double the rate of obesity of White preschool children. Many studies have shown that high levels of body mass index (BMI) among children are associated with adverse systolic blood pressure (SBP) levels, and just as overweight or obese children are more likely to become overweight or obese adults, children in the top quintile of SBP are three to four times more likely than their peers to develop clinical hypertension by age 30, and 50% of adults with hypertension had an elevated SBP in childhood. Although several studies have examined the impact of obesity on health care utilization in various populations, the association between weight, blood pressure, and use of health care services is not well understood in low- income, preschool children. Methods: This study was a secondary data analysis of previously collected data. Body mass index (BMI) and blood pressure were collected during health screenings, and information regarding use of health care services was collected by parent report. Results: Of the 660 children screened, 22.1% of the sample was classifi ed as obese and 15.2% were considered overweight. Obese children had significantly more doctor’s visits than both overweight and normal weight children. Systolic blood pressure (SBP) also emerged a significant predictor of number of doctor’s visits within the last year. Neither were signifi cantly associated with emergency department visits or hospitalizations. Conclusion: This study provides evidence that low-income, preschool children have high rates of obesity. It also provides new information regarding the association between obesity, SBP, and physician visits in this population.