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Bystander CPR Less Likely in Black Neighborhoods

People living in these areas may have less education about cardiac arrest and CPR, researchers say
(*this news item will not be available after 11/28/2017)
By Mary Elizabeth Dallas
Wednesday, August 30, 2017

WEDNESDAY, Aug. 30, 2017 (HealthDay News) -- If your heart suddenly stops beating, the racial makeup of the neighborhood may determine the likelihood of receiving CPR from a passer-by or having access to a public defibrillator, researchers say.

These lifesaving treatments for cardiac arrest occur less often in black neighborhoods in the United States, researchers discovered.

Delaying CPR (cardiopulmonary resuscitation) can dramatically reduce the odds of surviving cardiac arrest.

"We have known that there are differences in the rates of survival from cardiac arrest between blacks and whites, but it was surprising to see how the demographics of a neighborhood affected outcomes of residents who experience cardiac arrest," said Dr. Monique Starks, the study's lead author. She's a cardiologist at the Duke Clinical Research Institute in Durham, N.C.

"This is absolutely a call to action to improve and expand CPR training and defibrillator access," Starks said in a Duke news release.

Public defibrillators are less available in black neighborhoods, and people living in these areas may have less education in general about cardiac arrest and CPR than those living in white neighborhoods, the researchers said.

"This is something that can be addressed," Starks said. "This is a relatively low-cost solution that could save lives."

For the study, the researchers analyzed cardiac arrest data from seven U.S. cities: Birmingham, Ala.; Dallas-Fort Worth; Pittsburgh; Portland, Ore.; Seattle and Milwaukee. Using U.S. Census data, the study authors also examined the demographic information of neighborhoods within these cities.

The researchers identified more than 22,000 cases in which cardiac arrest occurred outside of a hospital during a four-year period, starting in 2008.

Overall, nearly 40 percent of those who suffered cardiac arrest outside of the hospital received bystander CPR. The researchers noted, however, rates of bystander CPR were nearly 47 percent in white neighborhoods, compared to only 18 percent in black neighborhoods.

Similarly, use of an automated external defibrillator occurred more often in white areas. In these neighborhoods, 4.5 percent of cardiac arrest victims received bystander defibrillation versus less than 1 percent of the victims in black neighborhoods, the study revealed. These racial disparities dramatically reduced rates of survival in mostly black neighborhoods, the researchers noted.

"We clearly see that treatments and outcomes for patients with cardiac arrest in black neighborhoods are worse than those in white neighborhoods," said senior author Dr. Graham Nichol.

"We then asked, does it matter if you were black or white within those neighborhoods?" said Nichol, director of the University of Washington-Harborview Center for Prehospital Emergency Care.

"Our observations were reassuring. It actually does not matter if you are black or white within the neighborhood, but the neighborhood matters," he said.

The study was published online Aug. 30 in JAMA Cardiology.

SOURCE: Duke Clinical Research Institute, news release, Aug. 30, 2017

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