Journal of Community Health

, Volume 42, Issue 3, pp 558–564 | Cite as

Community BMI Surveillance Using an Existing Immunization Registry in San Diego, California

  • Amanda R. Ratigan
  • Suzanne Lindsay
  • Hector Lemus
  • Christina D. Chambers
  • Cheryl A. M. Anderson
  • Terry A. Cronan
  • Deirdre K. Browner
  • Wilma J. Wooten
Original Paper


This study examines the demographic representativeness of the County of San Diego Body Mass Index (BMI) Surveillance System to determine if the BMI estimates being obtained from this convenience sample of individuals who visited their healthcare provider for outpatient services can be generalized to the general population of San Diego. Height and weight were transmitted from electronic health records systems to the San Diego Immunization Registry (SDIR). Age, gender, and race/ethnicity of this sample are compared to general population estimates by sub-regional area (SRA) (n = 41) to account for regional demographic differences. A < 10% difference (calculated as the ratio of the differences between the frequencies of a sub-group in this sample and general population estimates obtained from the U.S. Census Bureau) was used to determine representativeness. In 2011, the sample consisted of 352,924 residents aged 2-100 years. The younger age groups (2–11, 12–17 years) and the oldest age group (≥65 years) were representative in 90, 75, and 85% of SRAs, respectively. Furthermore, at least one of the five racial/ethnic groups was represented in 71% of SRAs. This BMI Surveillance System was found to demographically represent some SRAs well, suggesting that this registry-based surveillance system may be useful in estimating and monitoring neighborhood-level BMI data.


Body mass index Electronic health records Surveillance 



The authors greatly appreciate the activities performed by Robert Wester, Manager of the San Diego Immunization Registry, and Richard F.W. Barnes, Epidemiologist. The project was supported in part by a cooperative agreement with the Centers for Disease Control (CDC) no. 1U58DP002496-01. Portions of this project’s work involve the CPPW Initiative supported by CDC funding. The CDC had no role in the design, analysis, or writing of this article. The authors do not have any conflicts of interest to disclose.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This research was approved by the University of California San Diego Human Research Protection Program.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Amanda R. Ratigan
    • 1
    • 2
    • 3
  • Suzanne Lindsay
    • 1
    • 3
  • Hector Lemus
    • 1
  • Christina D. Chambers
    • 2
  • Cheryl A. M. Anderson
    • 2
  • Terry A. Cronan
    • 4
  • Deirdre K. Browner
    • 5
  • Wilma J. Wooten
    • 5
  1. 1.Graduate School of Public HealthSan Diego State UniversitySan DiegoUSA
  2. 2.Department of Family Medicine and Public HealthUniversity of California San Diego, School of MedicineSan DiegoUSA
  3. 3.Institute of Public HealthSan Diego State UniversitySan DiegoUSA
  4. 4.Department of PsychologySan Diego State UniversitySan DiegoUSA
  5. 5.County of San Diego Health and Human Services AgencySan DiegoUSA

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