Abstract Body: 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.