The 627 census tracts in San Diego County, 2014. Map A shows the percentage of children included in San Diego County’s electronic health record–based healthy weight surveillance system, in 2014, by census tract. Census tracts are separated into 5 categories to indicate the rates of children included in the county’s healthy weight surveillance system: 0% (9 census tracts), 1% to 15% (363 census tracts), 16% to 30% (155 census tracts), 31% to 45% (53 census tracts), and more than 45% (47 census tracts). Nearly all census tracts in the eastern portion of San Diego County have 1% to 15% of children included in the county’s healthy weight surveillance system. Map B shows the percentage of overweight or obese children in the 627 census tracts and presents data for 14.5% of San Diego County’s children. Census tracts are separated into 5 categories to indicate the rates of child overweight and obesity: 0% to 15% (49 census tracts), 16% to 30% (279 census tracts), 31% to 45% (265 census tracts), and more than 45% (23 census tracts). Where the census tract included fewer than 10 children, no information about overweight and obesity is illustrated (11 census tracts). High rates of child overweight and obesity were observed in southwest San Diego County; however, no conclusions about regional variation in rates of overweight and obesity were drawn, because these data were preliminary and nonrepresentative.

Figure. The San Diego EHR-Based Healthy Weight Surveillance System includes, on average, 18.5% (standard deviation, 19.4%) of children per census tract. These preliminary, nonrepresentative data illustrate geographic variation in the prevalence of overweight and obese children. The maps demonstrate both the strengths and the challenges of using EHR-based data for surveillance. Abbreviation: EHR, electronic health record.

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