Jie Gao1, Tosi Monifa Gilford2, Hon K Yuen3, Myung Hwan Jeon4, Courtney Carraway4, Gyusik Park4, Stephanie Diel4, Alex Patel4, Ge Wang5, Brianna Miller6, Wei Li7. 1. Clinical Laboratory Sciences, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA. 2. Physician Assistant Studies, School of Health Professions, University of Alabama at Birmingham, 1720 2nd AVE S, Birmingham, AL, 35294, USA. 3. Occupational Therapy, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA. 4. Biomedical Sciences, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA. 5. Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. 6. Nutrition Sciences, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA. 7. Physician Assistant Studies, School of Health Professions, University of Alabama at Birmingham, 1720 2nd AVE S, Birmingham, AL, 35294, USA. wli@uab.edu.
Abstract
INTRODUCTION: Homelessness is associated with an increased risk of cardiometabolic morbidities. However, few studies have been performed to evaluate the racial differences on these morbidities commonly seen in the homeless. METHODS: A retrospective chart review was conducted to examine the racial differences in the prevalence of cardiometabolic morbidities among the homeless men served at a local health care screening clinic. Medical information was extracted and collated into a single Excel spreadsheet. Racial differences in cardiometabolic morbidities were evaluated using multivariable binary or ordinal logistic regression analyses, adjusting for age, body mass index, and smoking status. RESULTS: Of the 551 homeless men, 377 (68.4%) were Black, and 174 (31.6%) were White. The mean age (47.8±11.9 years) of Black homeless men was significantly older than that (45.4±13.0 years) of White homeless men (p=0.03). Blacks were 2.7 (95% CI = 1.75, 4.16) times more likely to be in the less desirable HbA1c categories than Whites. By contrast, Blacks were less likely to have non-desirable lipid profile than Whites. Blacks were 0.42 (95% CI = 0.29, 0.62) times and 0.51 (95% CI = 0.28, 0.94) times likely to be in the non-desirable high-density lipoprotein (HDL) and low-density lipoprotein (LDL) categories than Whites, respectively. CONCLUSION: Black homeless men are more likely to have pre-diabetes or diabetes than White counterparts. On the other hand, Black homeless men have better lipid profiles of HDL or LDL than their White counterparts. Our findings reveal the health challenges of the homeless men and can provide guidance on policy changes related to diet and nutrition of meal programs provided by homeless shelters and congregate meal program to address the health disparities by race in this population.
INTRODUCTION: Homelessness is associated with an increased risk of cardiometabolic morbidities. However, few studies have been performed to evaluate the racial differences on these morbidities commonly seen in the homeless. METHODS: A retrospective chart review was conducted to examine the racial differences in the prevalence of cardiometabolic morbidities among the homeless men served at a local health care screening clinic. Medical information was extracted and collated into a single Excel spreadsheet. Racial differences in cardiometabolic morbidities were evaluated using multivariable binary or ordinal logistic regression analyses, adjusting for age, body mass index, and smoking status. RESULTS: Of the 551 homeless men, 377 (68.4%) were Black, and 174 (31.6%) were White. The mean age (47.8±11.9 years) of Black homeless men was significantly older than that (45.4±13.0 years) of White homeless men (p=0.03). Blacks were 2.7 (95% CI = 1.75, 4.16) times more likely to be in the less desirable HbA1c categories than Whites. By contrast, Blacks were less likely to have non-desirable lipid profile than Whites. Blacks were 0.42 (95% CI = 0.29, 0.62) times and 0.51 (95% CI = 0.28, 0.94) times likely to be in the non-desirable high-density lipoprotein (HDL) and low-density lipoprotein (LDL) categories than Whites, respectively. CONCLUSION: Black homeless men are more likely to have pre-diabetes or diabetes than White counterparts. On the other hand, Black homeless men have better lipid profiles of HDL or LDL than their White counterparts. Our findings reveal the health challenges of the homeless men and can provide guidance on policy changes related to diet and nutrition of meal programs provided by homeless shelters and congregate meal program to address the health disparities by race in this population.