3
|
Garcia RA, Spertus JA, Girotra S, Nallamothu BK, Kennedy KF, McNally BF, Breathett K, Del Rios M, Sasson C, Chan PS. Racial and Ethnic Differences in Bystander CPR for Witnessed Cardiac Arrest. N Engl J Med 2022; 387:1569-1578. [PMID: 36300973 PMCID: PMC9760357 DOI: 10.1056/nejmoa2200798] [Citation(s) in RCA: 66] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Differences in the incidence of cardiopulmonary resuscitation (CPR) provided by bystanders contribute to survival disparities among persons with out-of-hospital cardiac arrest. It is critical to understand whether the incidence of bystander CPR in witnessed out-of-hospital cardiac arrests at home and in public settings differs according to the race or ethnic group of the person with cardiac arrest in order to inform interventions. METHODS Within a large U.S. registry, we identified 110,054 witnessed out-of-hospital cardiac arrests during the period from 2013 through 2019. We used a hierarchical logistic regression model to analyze the incidence of bystander CPR in Black or Hispanic persons as compared with White persons with witnessed cardiac arrests at home and in public locations. We analyzed the overall incidence as well as the incidence according to neighborhood racial or ethnic makeup and income strata. Neighborhoods were classified as predominantly White (>80% of residents), majority Black or Hispanic (>50% of residents), or integrated, and as high income (an annual median household income of >$80,000), middle income ($40,000-$80,000), or low income (<$40,000). RESULTS Overall, 35,469 of the witnessed out-of-hospital cardiac arrests (32.2%) occurred in Black or Hispanic persons. Black and Hispanic persons were less likely to receive bystander CPR at home (38.5%) than White persons (47.4%) (adjusted odds ratio, 0.74; 95% confidence interval [CI], 0.72 to 0.76) and less likely to receive bystander CPR in public locations than White persons (45.6% vs. 60.0%) (adjusted odds ratio, 0.63; 95% CI, 0.60 to 0.66). The incidence of bystander CPR among Black and Hispanic persons was less than that among White persons not only in predominantly White neighborhoods at home (adjusted odds ratio, 0.82; 95% CI, 0.74 to 0.90) and in public locations (adjusted odds ratio, 0.68; 95% CI, 0.60 to 0.75) but also in majority Black or Hispanic neighborhoods at home (adjusted odds ratio, 0.79; 95% CI, 0.75 to 0.83) and in public locations (adjusted odds ratio, 0.63; 95% CI, 0.59 to 0.68) and in integrated neighborhoods at home (adjusted odds ratio, 0.78; 95% CI, 0.74 to 0.81) and in public locations (adjusted odds ratio, 0.73; 95% CI, 0.68 to 0.77). Similarly, across all neighborhood income strata, the frequency of bystander CPR at home and in public locations was lower among Black and Hispanic persons with out-of-hospital cardiac arrest than among White persons. CONCLUSIONS In witnessed out-of-hospital cardiac arrest, Black and Hispanic persons were less likely than White persons to receive potentially lifesaving bystander CPR at home and in public locations, regardless of the racial or ethnic makeup or income level of the neighborhood where the cardiac arrest occurred. (Funded by the National Heart, Lung, and Blood Institute.).
Collapse
Affiliation(s)
- R Angel Garcia
- From Saint Luke's Mid America Heart Institute (R.A.G., J.A.S., K.F.K., P.S.C.) and University of Missouri-Kansas City (R.A.G., J.A.S., P.S.C.) - both in Kansas City, MO; University of Iowa Carver College of Medicine (S.G., M.D.R.) and the Center for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Medical Center (S.G.) - both in Iowa City; the Michigan Integrated Center for Health Analytics and Medical Prediction, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor (B.K.N.); Rollins School of Public Health, Emory University School of Medicine, Druid Hills, Georgia (B.F.M); the Division of Cardiology, Krannert Cardiovascular Research Center, Indiana University, Bloomington (K.B.); and the American Heart Association, Dallas (C.S.)
| | - John A Spertus
- From Saint Luke's Mid America Heart Institute (R.A.G., J.A.S., K.F.K., P.S.C.) and University of Missouri-Kansas City (R.A.G., J.A.S., P.S.C.) - both in Kansas City, MO; University of Iowa Carver College of Medicine (S.G., M.D.R.) and the Center for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Medical Center (S.G.) - both in Iowa City; the Michigan Integrated Center for Health Analytics and Medical Prediction, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor (B.K.N.); Rollins School of Public Health, Emory University School of Medicine, Druid Hills, Georgia (B.F.M); the Division of Cardiology, Krannert Cardiovascular Research Center, Indiana University, Bloomington (K.B.); and the American Heart Association, Dallas (C.S.)
| | - Saket Girotra
- From Saint Luke's Mid America Heart Institute (R.A.G., J.A.S., K.F.K., P.S.C.) and University of Missouri-Kansas City (R.A.G., J.A.S., P.S.C.) - both in Kansas City, MO; University of Iowa Carver College of Medicine (S.G., M.D.R.) and the Center for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Medical Center (S.G.) - both in Iowa City; the Michigan Integrated Center for Health Analytics and Medical Prediction, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor (B.K.N.); Rollins School of Public Health, Emory University School of Medicine, Druid Hills, Georgia (B.F.M); the Division of Cardiology, Krannert Cardiovascular Research Center, Indiana University, Bloomington (K.B.); and the American Heart Association, Dallas (C.S.)
| | - Brahmajee K Nallamothu
- From Saint Luke's Mid America Heart Institute (R.A.G., J.A.S., K.F.K., P.S.C.) and University of Missouri-Kansas City (R.A.G., J.A.S., P.S.C.) - both in Kansas City, MO; University of Iowa Carver College of Medicine (S.G., M.D.R.) and the Center for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Medical Center (S.G.) - both in Iowa City; the Michigan Integrated Center for Health Analytics and Medical Prediction, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor (B.K.N.); Rollins School of Public Health, Emory University School of Medicine, Druid Hills, Georgia (B.F.M); the Division of Cardiology, Krannert Cardiovascular Research Center, Indiana University, Bloomington (K.B.); and the American Heart Association, Dallas (C.S.)
| | - Kevin F Kennedy
- From Saint Luke's Mid America Heart Institute (R.A.G., J.A.S., K.F.K., P.S.C.) and University of Missouri-Kansas City (R.A.G., J.A.S., P.S.C.) - both in Kansas City, MO; University of Iowa Carver College of Medicine (S.G., M.D.R.) and the Center for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Medical Center (S.G.) - both in Iowa City; the Michigan Integrated Center for Health Analytics and Medical Prediction, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor (B.K.N.); Rollins School of Public Health, Emory University School of Medicine, Druid Hills, Georgia (B.F.M); the Division of Cardiology, Krannert Cardiovascular Research Center, Indiana University, Bloomington (K.B.); and the American Heart Association, Dallas (C.S.)
| | - Bryan F McNally
- From Saint Luke's Mid America Heart Institute (R.A.G., J.A.S., K.F.K., P.S.C.) and University of Missouri-Kansas City (R.A.G., J.A.S., P.S.C.) - both in Kansas City, MO; University of Iowa Carver College of Medicine (S.G., M.D.R.) and the Center for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Medical Center (S.G.) - both in Iowa City; the Michigan Integrated Center for Health Analytics and Medical Prediction, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor (B.K.N.); Rollins School of Public Health, Emory University School of Medicine, Druid Hills, Georgia (B.F.M); the Division of Cardiology, Krannert Cardiovascular Research Center, Indiana University, Bloomington (K.B.); and the American Heart Association, Dallas (C.S.)
| | - Khadijah Breathett
- From Saint Luke's Mid America Heart Institute (R.A.G., J.A.S., K.F.K., P.S.C.) and University of Missouri-Kansas City (R.A.G., J.A.S., P.S.C.) - both in Kansas City, MO; University of Iowa Carver College of Medicine (S.G., M.D.R.) and the Center for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Medical Center (S.G.) - both in Iowa City; the Michigan Integrated Center for Health Analytics and Medical Prediction, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor (B.K.N.); Rollins School of Public Health, Emory University School of Medicine, Druid Hills, Georgia (B.F.M); the Division of Cardiology, Krannert Cardiovascular Research Center, Indiana University, Bloomington (K.B.); and the American Heart Association, Dallas (C.S.)
| | - Marina Del Rios
- From Saint Luke's Mid America Heart Institute (R.A.G., J.A.S., K.F.K., P.S.C.) and University of Missouri-Kansas City (R.A.G., J.A.S., P.S.C.) - both in Kansas City, MO; University of Iowa Carver College of Medicine (S.G., M.D.R.) and the Center for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Medical Center (S.G.) - both in Iowa City; the Michigan Integrated Center for Health Analytics and Medical Prediction, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor (B.K.N.); Rollins School of Public Health, Emory University School of Medicine, Druid Hills, Georgia (B.F.M); the Division of Cardiology, Krannert Cardiovascular Research Center, Indiana University, Bloomington (K.B.); and the American Heart Association, Dallas (C.S.)
| | - Comilla Sasson
- From Saint Luke's Mid America Heart Institute (R.A.G., J.A.S., K.F.K., P.S.C.) and University of Missouri-Kansas City (R.A.G., J.A.S., P.S.C.) - both in Kansas City, MO; University of Iowa Carver College of Medicine (S.G., M.D.R.) and the Center for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Medical Center (S.G.) - both in Iowa City; the Michigan Integrated Center for Health Analytics and Medical Prediction, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor (B.K.N.); Rollins School of Public Health, Emory University School of Medicine, Druid Hills, Georgia (B.F.M); the Division of Cardiology, Krannert Cardiovascular Research Center, Indiana University, Bloomington (K.B.); and the American Heart Association, Dallas (C.S.)
| | - Paul S Chan
- From Saint Luke's Mid America Heart Institute (R.A.G., J.A.S., K.F.K., P.S.C.) and University of Missouri-Kansas City (R.A.G., J.A.S., P.S.C.) - both in Kansas City, MO; University of Iowa Carver College of Medicine (S.G., M.D.R.) and the Center for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Medical Center (S.G.) - both in Iowa City; the Michigan Integrated Center for Health Analytics and Medical Prediction, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor (B.K.N.); Rollins School of Public Health, Emory University School of Medicine, Druid Hills, Georgia (B.F.M); the Division of Cardiology, Krannert Cardiovascular Research Center, Indiana University, Bloomington (K.B.); and the American Heart Association, Dallas (C.S.)
| |
Collapse
|
4
|
Civile C, McLaren IPL. Transcranial direct current stimulation (tDCS) eliminates the other-race effect (ORE) indexed by the face inversion effect for own versus other-race faces. Sci Rep 2022; 12:12958. [PMID: 35902662 PMCID: PMC9333056 DOI: 10.1038/s41598-022-17294-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/22/2022] [Indexed: 11/17/2022] Open
Abstract
We investigate here individuals’ reduced ability to recognise faces from other racial backgrounds, a robust phenomenon named the other-race effect (ORE). In this literature the term “race” is used to refer to visually distinct ethnic groups. In our study, we will refer to two of such groups: Western Caucasian (also known as White European) and East Asian e.g., Chinese, Japanese, Korean. This study applied the tDCS procedure (double-blind, 10 min duration, 1.5 mA intensity, targeting Fp3 location), developed in the perceptual learning literature, specifically used to remove the expertise component of the face inversion effect (FIE), which consists of higher recognition performance for upright than inverted faces. In the tDCS-sham condition (N = 48) we find a robust ORE i.e., significantly larger FIE for own versus other-race faces due to higher performance for upright own-race faces. Critically, in the anodal-tDCS condition (N = 48) the FIE for own-race faces was significantly reduced compared to sham due to impaired performance for upright faces thus eliminating the cross-race interaction index of the ORE. Our results support the major role that perceptual expertise, manifesting through perceptual learning, has in determining the ORE indexed by the FIE.
Collapse
Affiliation(s)
- Ciro Civile
- School of Psychology, College of Life and Environmental Sciences, University of Exeter, Exeter, UK.
| | - I P L McLaren
- School of Psychology, College of Life and Environmental Sciences, University of Exeter, Exeter, UK.
| |
Collapse
|