Abstract TAC132: Racial/Ethnic Disparities in Life’s Essential 8 Outcomes Among Women of Reproductive Age in Baltimore and Washington D.C.

Introduction: Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality among women in the United States, with risks increasingly emerging in the reproductive years. Life’s Essential 8 (LE8) captures key health behaviors and factors influencing cardiovascular health. However, racial and ethnic disparities in LE8 components remain underexplored among women of reproductive age, particularly in community-based settings. Methods: We analyzed cross-sectional data from women aged 18–50 years enrolled in the SAFE HEART Study in Baltimore and Washington, D.C. Participants self-identified race and ethnicity and were categorized into four mutually exclusive groups: Non-Hispanic White, Non-Hispanic Black, Non-Hispanic Asian, and Hispanic (of any race). LE8 outcomes—including hypertension, hyperlipidemia, diabetes, BMI, diet, physical activity, sleep, and smoking—were based on self-report. Multivariable logistic regression models estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for each LE8 metric by racial/ethnic group, adjusting for age, education, income, insurance, and employment. Non-Hispanic White women served as the reference group. Results: The mean age of the sample was 30.86 ± 6.66 years. The sample was racially diverse: 47.8% identified as Non-Hispanic Black, 21.1% as Non-Hispanic White, 24.4% as Hispanic, and 3.1% as Asian. Most participants had some college education or higher (79.7%), were insured (79.4%), and employed (86.9%), though 68.1% reported financial strain. Significant disparities emerged across several LE8 metrics. Compared to Non-Hispanic White women, Non-Hispanic Black women had significantly higher odds of hypertension (OR=2.75, 95% CI: 1.45–5.23), hyperlipidemia (OR=2.41, 95% CI: 1.24–4.71), diabetes (OR=4.21, 95% CI: 2.04–8.72), and smoking (OR=4.70, 95% CI: 2.12–10.42). Hispanic women also had elevated odds of hypertension (OR=2.64, 95% CI: 1.27–5.46) and hyperlipidemia (OR=2.55, 95% CI: 1.19–5.49). No Asian participants reported hypertension or hyperlipidemia. Differences in sleep, diet, and physical activity were not statistically significant. Conclusion: Women of reproductive age in this urban sample face high burdens of cardiovascular risk, with pronounced disparities by race and ethnicity, particularly among Non-Hispanic Black and Hispanic women. Findings underscore the urgent need for culturally tailored prevention strategies that address both clinical and social drivers of cardiovascular health.