Developing a Monitoring System of Overweight and Obesity in Finnish Children

Abstract Issue Childhood overweight and obesity are global public health challenges, requiring nationwide, measurement-based monitoring data. Data is needed to plan health policies, health promotion actions, and to evaluate outcome. Finland's register-based system for monitoring childhood overweight and obesity can serve as a model for other countries. Description of the problem Until the 2010s, Finland lacked national data on childhood overweight and obesity, despite regular, legally mandated health check-ups. Children undergo 15 check-ups in child health clinics and 9 in school health care, with height and weight measured at each visit. Since 2011, these measurements have been automatically transferred from electronic health records of primary health care to the national primary health care register, administered by the Finnish Institute for Health and Welfare. Results The use of primary health care register data for nationwide monitoring was tested in 2014-2015 and 2016-2017, proving its viability. Since 2018, the FinChildren register has reported the prevalence of overweight and obesity among children by sex in three age groups (2-6 years, 7-12 years, and 13-16 years) at national, area, and municipal levels. Coverage has grown from 31% in 2014 to 57% in 2023, including data on 496,058 children aged 2-16 years. Among boys aged 2-16 years, 26% were living with overweight (including obesity and severe obesity), 8% with obesity (including severe obesity), and 1.7% with severe obesity in 2023. The corresponding percentages for girls were 17 %, 3 %, and 0.6 %. Lessons Finland's primary health care system, regular monitoring of children's growth, and national registers enable consistent tracking of the prevalence of childhood overweight and obesity. Comprehensive and reliable registry data requires standardized height and weight measurements, careful recording of data, and technical capabilities for transferring data from electronic health records to the national registry. Key messages • National registers provide essential data on childhood overweight and obesity for health policies and promotion actions. • Reliable data requires standardized growth tracking and accurate recording in primary healthcare.