Original Research
The association between body mass index,
primary healthcare use and morbidity in early
childhood: findings from the Born In Bradford
cohort study
B. Kelly
a,*
, J. West
a
, T.C. Yang
a
, D. Mason
a
, T. Hasan
a,b
, J. Wright
a
a
Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
b
Department of Health Sciences, University of York, York, UK
article info
Article history:
Received 8 August 2018
Received in revised form
1 October 2018
Accepted 25 October 2018
Keywords:
Childhood BMI
Primary care use
Childhood morbidity
Routine data
abstract
Objectives: The objective of the article was to examine the association between body mass
index (BMI), health and general practice (GP) healthcare use in early childhood.
Study design: This study is a prospective cohort study.
Methods: Multivariate Poisson and logistic regression models were used to explore the as-
sociation between BMI and health outcomes using data from the Born In Bradford cohort
study, linked to routine data capturing objective measures of BMI at age 5 years, alongside
GP appointment rates, GP prescriptions and specific morbidities in the subsequent 3-year
period.
Results: Compared with healthy weight, children who were obese at the age of 5 years had
significantly higher rates of GP appointments (incident rate ratio 1.14, 95% confidence in-
terval [CI]: 1.06e1.23), GP prescriptions (incident rate ratio 1.15, 95% CI: 1.04e1.27), asthma
(odds ratio 1.46, 95% CI: 1.21e1.77), sleep apnoea (odds ratio 2.50, 95% CI: 1.36e4.58), in-
fections (incident rate ratio 1.19, 95% CI: 1.08e1.30), antibiotic prescriptions (incident rate
ratio 1.25, 95% CI: 1.10e1.42) and accidents (incident rate ratio 1.20, 95% CI: 1.01e1.42) in the
subsequent 3 years. Underweight children were found to have higher rates of GP ap-
pointments (incident rate ratio 1.25, 95% CI: 1.04e1.52), but there were no differences be-
tween overweight and healthy weight children.
Conclusions: Childhood obesity was found to be associated with increased primary
healthcare use and a range of poorer health outcomes at the age of 8 years, underlining the
importance of reducing childhood obesity in early childhood.
© 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
* Corresponding author. Bradford Institute for Health Research, Bradford Royal Infirmary, Duckworth Lane, Bradford BD9 6RJ, UK. Tel.:
þ44 01274 364474.
E-mail address: brian.kelly@bthft.nhs.uk (B. Kelly).
Available online at www.sciencedirect.com
Public Health
journal homepage: www.elsevier.com/puhe
public health 167 (2019) 21 e27
https://doi.org/10.1016/j.puhe.2018.10.019
0033-3506/© 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.