Bystander CPR More Likely in High-Income Neighborhoods

Chances that people with cardiac arrest will get help from a bystander providing cardiopulmonary resuscitation are greater if the victim is stricken in a high-income neighborhood, a study found.

A person suffering from cardiac arrest had a 55 percent chance of getting lifesaving CPR in upper-income, white neighborhoods and at a similar rate in high-income, racially-mixed areas, the research showed. That compares with a 35 percent chance of receiving CPR in a poor, black neighborhood, according to a study published yesterday in the New England Journal of Medicine.

The study is the first to look at the rates of bystander-initiated CPR in neighborhoods with different demographics, said Comilla Sasson, the lead author. The findings suggest that income levels as well as the racial makeup of an area where a person collapses affect survival. Public health officials should target certain areas to boost training and education, she said.

“It shouldn’t matter where you live to have someone stop and help you,” Sasson, an assistant professor in the Department of Emergency Medicine at the University of Colorado in Aurora, said in an Oct. 22 telephone interview. “My survival should not be dependent on my heart stopping in a grocery store on a nice side of the street versus the other side.”

383,000 Incidents

Nearly 383,000 cardiac arrests occur each year outside a hospital, according to the American Heart Association. Survival rates vary from 0.2 percent in Detroit to 16 percent in Seattle, the authors wrote. For every one minute that a person who is having cardiac arrest doesn’t receive CPR, the chance of survival drops 10 percent, Sasson said.

When giving CPR to adults, people no longer need to breathe in a victim’s mouth. They should just push hard and fast in the center of the victim’s chest to the tune of the Bee Gees’ song “Stayin’ Alive,” which helps keep the proper rhythm to perform CPR correctly, until help arrives, she said. The researchers analyzed data on 14,225 patients who suffered cardiac arrest from October 2005 to December 2009. CPR by a bystander was only initiated in 29 percent of those patients. Only 8 percent of patients in the study, or 1,144, survived to leave the hospital.

Researchers classified neighborhoods as high-income or low-income on the basis of a $40,000 per year household income. A neighborhood was white or black if more than 80 percent of the census count in the area was predominantly of one race.

The study also found that those in low-income white neighborhoods were 35 percent less likely than people in high-income white areas to get CPR, while those in high-income black neighborhoods were 23 percent less likely, the authors said.

Sasson said people in low-income areas may not have extra money to pay for CPR classes or they may be concerned if they help, the person might be pretending to be injured and hurt them. Local officials should target these areas to teach people CPR to help reduce cardiac arrest deaths, she said.

“There’s very simple things we can do that are very cost effective such as teaching people about hands-only CPR and when to call 911 and the signs and symptoms of when people’s hearts stop,” Sasson said.

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