• Jake Toy, Nichole Bosson, Shira Schlesinger, and Marianne Gausche-Hill.
• University of California Los Angeles, Fielding School of Public Health, 650 Charles E Young Dr S, Los Angeles, CA 90095, USA; Harbor-UCLA Medical Center, Department of Emergency Medicine & The Lundquist Institute, 1000 W Carson Street, Torrance, CA 90502, USA; Los Angeles County EMS Agency, 10100 Pioneer Blvd, Santa Fe Springs, CA 90670, USA; David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095, USA. Electronic address: jtoy2@dhs.lacounty.gov.
• Resuscitation. 2023 Sep 1; 190: 109901109901.

ObjectiveTo evaluate the association between race/ethnicity and the odds of receiving bystander cardiopulmonary resuscitation (bCPR) after witnessed out-of-hospital cardiac arrest (OHCA).MethodsFor this cross-sectional retrospective study, data were obtained from the National Emergency Medical Services Information System database for adults (≥18 years) with a witnessed non-traumatic OHCA in the year 2021. Patients were separated into two groups including Black/Hispanic and White. The primary outcome was the odds of receiving bCPR. We excluded traumatic etiology, do-not-resuscitate orders, and arrest in a healthcare facility or wilderness location. Multiple logistic regression controlling for known covariates was utilized and analyses were stratified by public versus non-public location, median household income, and rural, suburban, or urban setting.ResultsA total of 64,007 witnessed OHCAs were included. When compared to White, the Black/Hispanic group were younger (62 vs 67 years) and more often female (40% vs 33%), in neighborhoods with the lowest median household income (31% vs 13%) and in an urban setting (92% vs 80%). Overall, bystander CPR rates were 60% and 67% for the Black/Hispanic and White groups, respectively. Multiple logistic regression stratified by OHCA location found that the Black/Hispanic group had a decreased odds of receiving bCPR compared to the White group both in the home (adjusted OR [aOR] 0.77; 95% CI 0.74-0.81) and in public (aOR 0.69; 95% CI 0.64-0.76). This difference persisted throughout neighborhoods of different socioeconomic status and across the rural-urban spectrum.ConclusionsRacial/ethnic disparities exist for Black and Hispanic persons in the odds of receiving bCPR after a witnessed non-traumatic OHCA regardless of public or private setting, neighborhood income level, or population density.Copyright © 2023 Elsevier B.V. All rights reserved.

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