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New study finds racial and ethnic disparities in bystander CPR during cardiac arrest
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Alexis Hauk
Communications Director, Emory Heart & Vascular Center
man receiving cpr

Following a review of six years’ worth of national data collected by Emory University School of Medicine’s Cardiac Arrest Registry for Enhanced Survival (CARES), a diverse team of researchers found that Black and Hispanic people were significantly less likely than white people to receive potentially lifesaving bystander cardiopulmonary resuscitation (CPR) during cardiac arrest. The new study published Nov.2 in the New England Journal of Medicine (NEJM).

The comprehensive analysis showed that Black and Hispanic individuals had 26% lower odds of receiving bystander CPR at home when compared with white individuals. Those odds dropped significantly in instances of public cardiac arrest, where Black and Hispanic individuals had 37% lower odds of bystander CPR than white individuals going through the exact same emergency event.

The new paper, which examined CARES data gathered from 2013 to 2019, builds upon previous scholarship into health equity and cardiac arrest in several key ways, including the additional examination of neighborhood income level and racial and ethnic make-up where individuals originally collapsed.

What researchers discovered is that the disparity between response for Black and Hispanic individuals versus white individuals remained consistent regardless of neighborhood income level or racial and ethnic makeup and regardless of the type of public setting. The inequity was consistent even in public areas that might have had a larger pool of layperson responders with CPR training available, such as recreational facilities and public transportation hubs. 

Bystander CPR can double or triple survival rates for those experiencing cardiac arrest. The earlier CPR is administered (ideally in the first two minutes after a patient collapses), the better the outcome will be. And bystander CPR doesn’t only impact whether someone lives or dies but can also significantly improve someone’s quality of life moving forward once they get treatment and recover.

“As an emergency medicine physician, I know how incredibly important bystander CPR is for cardiac arrest patients,” says Emory’s Bryan McNally, MD, a professor in the Department of Emergency Medicine and executive director of CARES. “Our research team hopes this publication may be a catalyst for change to help reduce racial and ethnic differences in cardiac resuscitation and improve outcomes for all communities.” McNally is co-author on the NEJM publication.

Looking ahead, McNally says that there are additional studies underway that will use CARES data to investigate racial and ethnic disparities in CPR rates between Asian and white individuals as well as Native American and Alaska Native populations compared to white populations. 

Founded by Emory and the Centers for Disease Control and Prevention (CDC) in 2004, CARES serves as a multicenter registry of people who have had nontraumatic, out-of-hospital cardiac arrest in the United States. Distinguished nationally, the registry covers an area of more than 175 million people or approximately 53% of the U.S. population, representing 32 participating states and the District of Columbia. To date, the registry has captured more than 850,000 cardiac arrest event records, with more than 2,400 EMS agencies and over 2,600 hospitals participating nationwide.

CARES is housed in Emory’s Woodruff Health Sciences Center and is managed by McNally and a team of 10 Emory staff. The registry is funded by the American Red Cross, the American Heart Association and through state-based subscription fees.

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