Abstract 5022: Socioeconomic Disparities in Sudden Cardiac Arrest: Analysis of US Metropolitan Areas Within the Resuscitation Outcomes Consortium
Introduction: To determine whether a previously-observed association between lower neighborhood socioeconomic status (SES) and higher incidence of sudden cardiac arrest (SCA) could be generalized to other regions in the US, we examined SCA incidence across quartiles of SES in four major regional centers (RCC) of the Resuscitation Outcomes Consortium (ROC) study: Dallas, TX; Pittsburgh, PA; Portland, OR; and Seattle-King County, WA.
Methods: Cases were non-traumatic cardiac arrests of any age reported between 4/1/2006 and 4/1/2007 to each ROC RCC. Census tract economic indicators (US Census 2000) were used to ascertain neighborhood SES:
median household income;
percent ≥ bachelor’s degree; and
median home value.
Census tracts were identified based on location of SCA and grouped into quartiles. Incidence rates were calculated for SCAs that occurred at home or in a residential institution.
Results: A total of 7,094 SCAs were reported (ranged from n=1,177 to n=2,330 per RCC) with a mean age of 61.2 to 65.9 years, and proportion of males ranging from 60 to 61%. Residential SCAs comprised 83 to 89% of total SCAs. Rate ratios (RRs) indicated a significantly elevated incidence of SCA in the lowest vs. highest quartile for all SES measures, with median income having the strongest gradients [Seattle RR 1.77 (95% CI 1.75 – 1.79); Dallas RR 2.46 (95% CI 2.43–2.49)]. Disparities were more pronounced for SCAs occurring in younger individuals (0 – 64 yrs), with incidence more than double in the lowest quartile.
Conclusions: SCA incidence was consistently higher in poorer neighborhoods among four US metropolitan areas with varied age and racial demographics, and with younger residents most vulnerable. These findings could guide future deployment of resuscitation measures in communities. Further evaluation of this disparity may lead to novel opportunities for prevention.