Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #111198

Shannon Blaney, MPH¹, Monique Kusick¹, Robert Silverman, MD², Neal Richmond, MD³, David Vlahov, PhD⁴, and Sandro Galea, MD, MPH¹. (1) Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029, 212-4193541, sblaney@nyam.org, (2) Long Island Jewish Medical Center, 270-05 76th Avenue, New Hyde Park, NY 11040, (3) Louisville Metro EMS, 437 South Third Street, Louisville, KY 40202, (4) Center for Urban Epidemiologic Studies (CUES), New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029

There is little evidence about the relationship between neighborhood characteristics and administration of CPR to persons who have an out-of-hospital cardiac arrest (OOHCA). We conducted a prospective observational study of consecutive patients with in NYC from April 1, 2002-March 31, 2003. Data were collected from prehospital providers by trained paramedics. Information obtained included demographic characteristics of patients with OOHCA, Utstein core measures, and critical prehospital time intervals. All OOHCA were geocoded to their neighborhood of arrest incidence (n=59). Overall, data was collected on 4653 OOHCA. Citywide, CPR was carried out in 32.8% of cases of OOHCA. In wealthier neighborhoods, the likelihood of CPR was 16.7%, compared to 10.7% in less wealthy neighborhoods (p<0.001). The sample was restricted to the 2686 patients with complete data available on key variables. In a multivariable logistic model that accounted for demographics (patient age, gender, race/ethnicity, prior cardiac history and functional status), OOHCA event characteristics (witnessed status, arrest location type), and neighborhood racial/ethnic composition, living in a wealthier neighborhood was associated with a greater likelihood of receipt of CPR (p<0.001) than living in less wealthy neighborhoods. This study suggests differences in likelihood of CPR receipt in different urban neighborhoods, independent of characteristics of the individual or of the event characteristics themselves. Differential education about CPR or social norms about CPR administration may explain some of the observed association. CPR education, already low overall in NYC, may beneficially target specific neighborhoods in the City.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Describe the likelihood of CPR performance by lay bystanders on victims of out-of-hospital cardiac arrest in NYC.
• List the individual-level and neighborhood-level factors that significantly affect the likelihood of lay bystander CPR.
• Recognize the impact of neighborhood-level income on the likelihood of performance of bystander CPR on victims of out-of-hospital cardiac arrests within neighborhoods.

Keywords: Community Response, Health Disparities

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.