Cholesterol screening by nativity status in pediatric patients receiving care in United States community-based clinics

Objective: Accumulation of cardiovascular risks begins early in life. Some experts recommend cholesterol screening for children aged nine to 11. Latinos living in the U.S. have a high burden of cardiovascular disease and risk factors, and this is further influenced by birthplace, yet information on early screening for cardiovascular disease in this group is sparse. Methods: We used electronic health records from a national network including 771 community-based clinics across 21 states from 2012 to 2020, from 310,297 foreign-born Latino, US-born Latino, Latino with unknown birthplace, and non-Hispanic white patients aged nine to 17 years. Logistic regression including demographic and clinical covariates was conducted to estimate prevalence of cholesterol testing, stratified by obesity. Results: Latino children, regardless of nativity status, had higher adjusted prevalence of cholesterol screening compared to non-Hispanic white children for those with and without obesity. The highest prevalence of screening among those with obesity was in foreign-born Latinos (34.8 %), and among those who were not obese, US-born Latinos had the highest screening prevalence (16.8 %). Conclusions: Cholesterol screening was low overall in these community-based clinic patients but differed by ethnicity and nativity status. There is opportunity for further research on outcomes in Latino children to inform guidelines for early screening for cardiovascular health.