Estimating diabetes prevalence among NYC youth: Evidence from the Automated Student Health Record

We provide the first estimates of childhood type 1 and type 2 diabetes prevalence following the onset of the COVID-19 pandemic. Our analysis documents change in prevalence from 2010−11–2021−22, with a particular focus on trends from 2016−17 onward, using Automated Student Health Record (ASHR) data maintained by New York City Department of Health and Mental Hygiene (NYC DOHMH). We study non-homeschooled students aged 5−17 in grades pre-K to 12 enrolled in New York City Public Schools (NYCPS), resulting in an analytic sample of 2,167,033 unique students. Our main outcome measure is type 1 or 2 diabetes prevalence per 1,000 students each school year. In 2021−22, type 1 diabetes prevalence was highest among White students (2.73 per 1,000; 95% CI: 2.44, 2.97) and those aged 15−17 (2.24 per 1,000; 95% CI: 2.03, 2.45), with no significant increase since 2016−17 ( p > 0.050). Meanwhile, we find type 2 diabetes increased nearly 40% from 2016−17–2021−22 ( p < 0.050), with the highest prevalence among students with obesity (2.35 per 1,000; 95% CI: 1.96, 2.74). While type 2 diabetes has been rising for most demographic groups since 2016−17, we estimate that increases in type 2 diabetes prevalence are largest for older students, students of color, those with obesity, or those living in high-poverty areas, although most increases are not significantly different from other groups. Finally, we demonstrate that systems like ASHR can be a valuable resource for tracking chronic conditions in youth nationwide, underscoring its potential for broader public health monitoring.