Abstract P445: Associations of Homeownership and Overcrowding Conditions With Cardiovascular Health Among Diverse U.S. Children and Adults

Background: We hypothesized that children and adults living in rented and overcrowded houses have lower cardiovascular health (CVH), as measured by Life Essential 8 (LE8), a powerful predictor of CVD. We evaluated if this association varied by race/ethnicity. Methods: This cross-sectional study used pooled data from the National Health and Nutrition Examination Survey 2013-2018 (NHANES). LE8 scores (range 0-100) were estimated following age-specific criteria with all metrics available for each age group. Overcrowding was defined as two or more persons per room, per Census Bureau’s criteria. Multivariable linear regressions estimated the association of overcrowding and homeownership (v. rental status) with CVH, for children (aged 2-19) and adults separately. Racial/ethnic differences were examined using interaction terms. Weighted models adjusted for the complex survey design and the following covariates: age, sex, race/ethnicity, insurance status, country of birth, and self or parental education and marital status. Results: Homeownership was associated with a 1-point higher CVH among children ( p =0.02), except for Black children, who had higher CVH when they lived in rented homes (86.51 for renters vs. 85.46 for homeowners). Among adults, homeownership was associated with 2.4 points higher CVH (p=0.008). An interaction showed that for Black and Latinx adults, homeownership was associated with lower CVH than renters (MD=-3.30, p= 0.004 for Black and -2.91, p = 0.006 for Latinx). Overcrowding was not associated with child CVH ( p =0.57). Among adults, and interaction showed that living in overcrowded houses was associated with lower CVH for Black (MD= -2.47, p=0.006) and Latinx adults (MD= -3.53, p <0.001). Conclusions: Overcrowded housing and homeownership are associated with CVH in children and adults, but relationships vary by race/ethnicity. Findings underscore the need to better understand how housing conditions influence CVH disparities and advocate for affordable housing for all.