Black and Hispanic people in the US are a lot less likely to receive cardiopulmonary resuscitation (CPR) compared to white people, both at home and in public. Given that almost 1,000 Americans suffer from cardiac arrest outside of health care facilities each day, this disparity puts members of already institutionally marginalized communities at further risk.
The team of researchers looked at 110,000 cardiac arrests between 2013 and 2019 that took place outside of hospitals but were witnessed by at least one bystander. In public, 46 percent of Black and Hispanic people received CPR compared to 60 percent of white people. At home, 39 percent of Black and Hispanic people received CPR, compared to 47 percent of white people.
This disparity is present in all neighborhoods, regardless of racial makeup and income level. The research put forward the example that a white person going into cardiac arrest in a neighborhood that was more than 50 percent Black and Hispanic were still more likely to get CPR than a Black or Hispanic person in that community. The shocking findings are reported in a study being presented at the American College of Cardiology’s 71st Annual Scientific Session.
“It’s critically important to understand who gets bystander CPR for a cardiac arrest and how we can improve those rates,” senior author Paul S. Chan, MD, professor of medicine at the University of Missouri–Kansas City School of Medicine and the Saint Luke’s Mid America Heart Institute, said in a statement. “We found that bystander CPR rates are much higher in white communities compared with Black communities. In addition, there were patient-level disparities in getting bystander CPR regardless of the type of community the person was in, even though there were, in all of these cases, bystanders who could have provided aid and assistance.”
The team has not yet investigated the specific factors behind these different CPR rates. There could be implicit and explicit racism playing a role in people's willingness to assist a person of color. There might be variability in 911 dispatchers instructing the bystanders on giving CPR and there could be language barriers in such instructions. Access to CPR training is also expected to play an important role in this.
“We need to think creatively about how to offer CPR instruction to vulnerable populations that have historically not received training and focus on conducting more trainings in the communities where the disparities are greatest,” Chan added. “For example, we could make CPR training available at little to no cost and do it at times and locations that are more convenient, such as Black churches or Hispanic community centers, or allow many people to be trained at once, for example as part of a Juneteenth or Martin Luther King Jr. Day event.”
Over the last decade, recommendations on CPR have changed. Bystanders are now asked to administer 100 to 120 chest compressions per minute, without pausing to give mouth-to-mouth or check the pulse, while waiting for paramedics to arrive.