Bystander CPR less likely for people living in Hispanic neighborhoods

January 02, 2020

PHILADELPHIA--People living in predominately Hispanic neighborhoods are less likely to receive CPR from a bystander following an out-of-hospital cardiac arrest compared to people living in non-Hispanic neighborhoods, researchers from Penn Medicine and the Duke University of School of Medicine reported in the journal Circulation. This same group also had a lower likelihood of survival.

Most previous studies, including ones led by Penn, have concentrated on gender, age, and residents of predominantly black neighborhoods, who are also less likely to receive CPR from bystanders. However, few have been conducted around CPR delivery in the Hispanic population, despite it being the fastest growing community in the United States.

"This is an underrecognized disparity that deserves more attention and resources if we're going to better understand what's driving it," said senior author Benjamin S. Abella, MD, MPhil, a professor of Emergency Medicine in the Perelman School of Medicine at the University of Pennsylvania and director of the Penn Center for Resuscitation Science. "One of the first steps is to focus on ways to implement programs that help more people from the Hispanic community get CPR trained and ultimately save more lives."

Administering CPR following cardiac arrest can double or even triple a person's chance of survival, according to the American Heart Association.

"It is critical to consider how to address these disparities, including targeted CPR training for Hispanic populations," said lead author Audrey L. Blewer, PhD, MPH, an assistant professor in the department of Family Medicine and Community Health at Duke, who began the study as the assistant director for Educational Programs at the Center for Resuscitation Science at Penn Medicine.

The team conducted a retrospective cohort study using data from the Resuscitation Outcomes Consortium, a network of regional clinical centers in the United States and Canada that study out-of-hospital treatments of cardiac arrest and trauma. The study analyzed over 27,000 different cardiac arrest events between 2011 and 2015.

In neighborhoods with less than 25 percent Hispanic residents, CPR was administered in 39 percent of events, compared to only 27 percent of events in neighborhoods with more than 75 percent Hispanic residents.

Patients who suffered a cardiac arrest in neighborhoods with predominately Hispanic residents also had a 44 percent lower likelihood of survival, as compared to those who lived in neighborhoods with predominantly non-Hispanic residents. Most of the bystander CPR events occurred in the home.

"These findings should inform future messaging around bystander CPR and educational initiatives, including the provision of dispatch CPR targeting largely Hispanic neighborhoods," the authors wrote.
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Co-authors of the study include Robert Schmicker, Laurie J. Morrison, Tom P. Aufderheide, Mohamud Daya, Monique A. Starks, Susanne May, Ahamed H. Idris, Clifton W. Callaway, Peter J. Kudenchuk, and Gary M. Vilke.

The work was supported by a Mentored Clinical and Population Award from the American Heart Association (15MCPRP25090161).

Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $7.8 billion enterprise.

The Perelman School of Medicine has been ranked among the top medical schools in the United States for more than 20 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $425 million awarded in the 2018 fiscal year.

The University of Pennsylvania Health System's patient care facilities include: the Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center--which are recognized as one of the nation's top "Honor Roll" hospitals by U.S. News & World Report--Chester County Hospital; Lancaster General Health; Penn Medicine Princeton Health; and Pennsylvania Hospital, the nation's first hospital, founded in 1751. Additional facilities and enterprises include Good Shepherd Penn Partners, Penn Home Care and Hospice Services, Lancaster Behavioral Health Hospital, and Princeton House Behavioral Health, among others.

Penn Medicine is powered by a talented and dedicated workforce of more than 40,000 people. The organization also has alliances with top community health systems across both Southeastern Pennsylvania and Southern New Jersey, creating more options for patients no matter where they live.

Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2018, Penn Medicine provided more than $525 million to benefit our community.

University of Pennsylvania School of Medicine

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