TY - JOUR
T1 - Community disparities in out of hospital cardiac arrest care and outcomes in Texas
AU - Huebinger, Ryan
AU - Vithalani, Veer
AU - Osborn, Lesley
AU - Decker, Cameron
AU - Jarvis, Jeff
AU - Dickson, Robert
AU - Escott, Mark
AU - White, Lynn
AU - Al-Araji, Rabab
AU - Nikonowicz, Peter
AU - Villa, Normandy
AU - Panczyk, Micah
AU - Wang, Henry
AU - Bobrow, Bentley
N1 - Publisher Copyright:
© 2021 Elsevier B.V.
PY - 2021/6
Y1 - 2021/6
N2 - Background: Large racial and socioeconomic inequalities exist for out-of-hospital cardiac arrest (OHCA) care and outcomes. We sought to characterize racial, ethnic, and socioeconomic disparities in OHCA care and outcomes in Texas. Methods: We analyzed 2014–2018 Texas-Cardiac Arrest Registry to Enhance Survival (CARES) data. Using census tracts, we defined race/ethnicity neighborhoods based on majority race/ethnicity composition: non-Hispanic/Latino white, non-Hispanic/Latino black, and Hispanic/Latino. We also stratified neighborhoods into socioeconomic categories: above and below the median for household income, employment rate, and high school graduation. We defined outcomes as bystander CPR rates, public bystander AED use, and survival to hospital discharge. Using mixed models, we analyzed the associations between outcomes and neighborhood (1) racial/ethnic categories and (2) socioeconomic categories. Results: We included data on 18,488 OHCAs. Relative to white neighborhoods, black neighborhoods had lower rates of AED use (OR 0.3, CI 0.2–0.4), and Hispanic/Latino neighborhoods had lower rates of bystander CPR (OR 0.7, CI 0.6–0.8), AED use (OR 0.4, CI 0.3–0.6), and survival (OR 0.8, CI 0.7–0.8). Lower income was associated with a lower rates of bystander CPR (OR 0.8, CI 0.7–0.8), AED use (OR 0.5, CI 0.4–0.8), and survival (OR 0.9, CI 0.9–0.98). Lower high school graduation was associated with a lower rate of bystander CPR (OR 0.8, CI 0.7–0.9) and AED use (OR 0.6, CI 0.4–0.9). Higher unemployment was associated with lower rates of bystander CPR (OR 0.9, CI 0.8–0.94) and AED use (OR 0.7, CI 0.5–0.99). Conclusion: Minority and poor neighborhoods in Texas experience large and unacceptable disparities in OHCA bystander response and outcomes.
AB - Background: Large racial and socioeconomic inequalities exist for out-of-hospital cardiac arrest (OHCA) care and outcomes. We sought to characterize racial, ethnic, and socioeconomic disparities in OHCA care and outcomes in Texas. Methods: We analyzed 2014–2018 Texas-Cardiac Arrest Registry to Enhance Survival (CARES) data. Using census tracts, we defined race/ethnicity neighborhoods based on majority race/ethnicity composition: non-Hispanic/Latino white, non-Hispanic/Latino black, and Hispanic/Latino. We also stratified neighborhoods into socioeconomic categories: above and below the median for household income, employment rate, and high school graduation. We defined outcomes as bystander CPR rates, public bystander AED use, and survival to hospital discharge. Using mixed models, we analyzed the associations between outcomes and neighborhood (1) racial/ethnic categories and (2) socioeconomic categories. Results: We included data on 18,488 OHCAs. Relative to white neighborhoods, black neighborhoods had lower rates of AED use (OR 0.3, CI 0.2–0.4), and Hispanic/Latino neighborhoods had lower rates of bystander CPR (OR 0.7, CI 0.6–0.8), AED use (OR 0.4, CI 0.3–0.6), and survival (OR 0.8, CI 0.7–0.8). Lower income was associated with a lower rates of bystander CPR (OR 0.8, CI 0.7–0.8), AED use (OR 0.5, CI 0.4–0.8), and survival (OR 0.9, CI 0.9–0.98). Lower high school graduation was associated with a lower rate of bystander CPR (OR 0.8, CI 0.7–0.9) and AED use (OR 0.6, CI 0.4–0.9). Higher unemployment was associated with lower rates of bystander CPR (OR 0.9, CI 0.8–0.94) and AED use (OR 0.7, CI 0.5–0.99). Conclusion: Minority and poor neighborhoods in Texas experience large and unacceptable disparities in OHCA bystander response and outcomes.
KW - Cardiac arrest
KW - Out-of-hospital cardiac arrest
UR - http://www.scopus.com/inward/record.url?scp=85107650206&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85107650206&partnerID=8YFLogxK
U2 - 10.1016/j.resuscitation.2021.03.021
DO - 10.1016/j.resuscitation.2021.03.021
M3 - Article
C2 - 33798624
AN - SCOPUS:85107650206
SN - 0300-9572
VL - 163
SP - 101
EP - 107
JO - Resuscitation
JF - Resuscitation
ER -