Abstract 4371146: Risk Factors for Cardiovascular Disease patients at Health Care for the Homeless clinics versus Community Health Centers

Abstract

Background: Cardiovascular disease (CVD) is the number one cause of mortality in the United States and those experiencing homelessness are at a higher risk for developing CVD. The American Heart Association’s Life’s Essential 8 (LE8) risk factors for CVD (diet, physical activity, sleep, tobacco use, weight, cholesterol, blood sugar, and blood pressure) are effective predictors of CVD and related mortality in the general population but are under-studied in patients experiencing homelessness. Methods: We utilized the Health Center Patient Survey (HCPS 2022) to compare client's risk factors for cardiovascular disease for those accessing Health Care for the Homeless (HCH) clinics to those visiting a Community Health Center (CHC) clinic to identify potential opportunities for intervention or care recommendations. The data was analyzed using survey-weighted, bivariate, and multivariate logistic regressions. Results: HCH clinic patients were less likely to report sleeping between 7-9 hours (optimal), and more likely to report being overweight and engaging in moderate/vigorous physical activity 7 days per week compared with CHC patients. Those utilizing HCH clinics still had 2.07 (95% CI: 1.24, 3.46) greater odds of smoking at least 100 cigarettes in their lifetime and 2.29 (95% CI: 1.19, 4.40) greater odds of being diagnosed as pre-diabetic compared to CHC clinic patients, after adjusting for demographics and socioeconomic measures. There were no differences between clinic type in the frequency and management of diabetes, cholesterol, and hypertension. Conclusion: People experiencing homelessness experience a higher burden of CVD than the general population. Despite comparable chronic disease management, those using HCH clinics were at higher adjusted odds of smoking history and having pre-diabetes when compared to those who used CHC clinics. They also demonstrated greater unadjusted odds of being overweight, all of which can increase risk of CVD. Further research should identify and evaluate potential HCH clinic interventions for high-risk homeless populations to help reduce CVD mortality. Learning Objectives: 1) Compare Life’s Essential 8 cardiovascular risk factors between Health Care for Homeless clinic patients and Community Health Centers as the reference population. 2) Assess the odds of having life’s essential 8 factors between clinic types accounting for age, sex, and race, language preference, marital status, and employment status.