Abstract EP23: Age-related Disparities In Access To A Usual Source Of Healthcare Among Adults With Atherosclerotic Cardiovascular Disease: National Health And Nutrition Examination Survey 2013-2018

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Introduction: Among patients with atherosclerotic cardiovascular disease (ASCVD), regular follow-up is integral to secondary prevention. Lack of a usual source of healthcare may contribute to healthcare disparities, particularly among young adults with ASCVD. Methods: Using pooled data from National Health and Nutrition Examination Survey (NHANES; 2013-2018), the prevalence of a usual healthcare source among US adults with ASCVD was estimated overall and by age (20-39 years, 40-64 years, 65+ years). Covariates for demographic, socioeconomic, and health-related characteristics were obtained. Logistic regression was used to determine the association between age and having a usual source of healthcare among US adults with ASCVD with adjustment for socioeconomic, demographic variables, and health-related variables. Results: Among all adults with ASCVD (weighted N= 55,501,274.0), 95.2% had a usual source of healthcare. Adults with a usual source of healthcare were older adults, had history of high cholesterol, and more healthcare visits in the prior 12 months, compared to those without a usual source. Among adults aged 20-39 years 85.8% had usual source of healthcare, compared to 93.6% of adults 40-64 years and 96.5% of adults 65+. After full adjustment, adults 40-64 years and 65+ were more likely to have a usual source of healthcare (OR 5.1, 95% CI [1.3,19.7]; OR 6.5, 95% CI [1.6,26.5]), compared to adults 20-39 years. Additionally, among adults with ASCVD food insecurity was associated with a lower prevalence of a usual source of healthcare. Discussion: The majority of US adults with ASCVD had access to a usual source of healthcare. However, fewer young adults with ASCVD had access to a usual source of health care. Younger adults represent a vulnerable population, and face barriers to care that differ from older patients. Regular access to a usual source of healthcare represents a modifiable factor impeding the care of younger adults with ASCVD.