High Cardiovascular Disease Risk Among Men and Women Experiencing Poverty and Homelessness in Medically Underserved Areas of West Texas.

BACKGROUND

While women are among the fastest-growing subgroups of the homeless population and have a higher prevalence of poverty than men, most studies of cardiovascular disease (CVD) risk in this vulnerable population are conducted primarily among men. We evaluated differences in CVD risk between men and women experiencing poverty and homelessness in West Texas, a medically underserved region.

METHODS

Data were collected from 152 adults (50% women) aged 30-74 years, who were seen at free health clinics. Prevalence ratios (PR) and 95% confidence intervals (CI) were calculated. The Framingham risk algorithm was used to estimate the risk for incident CVD in the next 10 years.

RESULTS

The mean age of participants was 55.3 years. The prevalence of CVD risk factors was high among participants and tended to be similar between men and women: diabetes (34%), current smokers (47%), obesity (50%), and hypertension (83%). After controlling for demographic factors, behavior/lifestyle factors, and health conditions, the high (>20%) 10-year risk of CVD was two-fold higher among men (PR: 2.41, 95%CI: 1.75-3.32). While the association was consistent among men regardless of the number of comorbid conditions, among women, those with three or more comorbid conditions had an elevated 10-year risk for CVD compared to those with no comorbid conditions (PR: 11.68, 95%CI: 1.88-72.60, p interaction = 0.001).

CONCLUSIONS

This study found that CVD risk was elevated among poor and homeless adults, with men having a higher risk than women. Comorbid conditions had a greater impact on women than men who were at high risk for CVD.