• Bridget Dicker, Nick Garrett, Samuel Wong, Helen McKenzie, John McCarthy, Gareth Jenkin, Tony Smith, Jonathan R Skinner, Tammy Pegg, Gerry Devlin, Andrew Swain, Tony Scott, and Verity Todd.
• Paramedicine Department, Auckland University of Technology, Auckland, New Zealand; Clinical Audit and Research, St John New Zealand, Auckland, New Zealand. Electronic address: bridget.dicker@stjohn.org.nz.
• Resuscitation. 2019 May 1; 138: 53-58.

BackgroundSurvival from out-of-hospital cardiac arrest (OHCA) is improved when public access defibrillators are used. Areas of socioeconomic deprivation may have higher rates of OHCA and thus a greater demand for public access defibrillators. We aimed to determine if there was a relationship between socioeconomic factors, the geographic distribution of public access defibrillators (PADs) and incidence of OHCA.MethodSocioeconomic deprivation data was obtained from the Census-based 2013 Index of Deprivation. Spatial information for PADs was obtained from a New Zealand PAD database (AED Locations) in 2016 and 2018. Location data for OHCA was obtained from the St John New Zealand OHCA registry for the period 1 October 2013 to 30 June 2016. Relationships between these variables were analysed using a Poisson regression analysis.ResultsCardiac arrest incidence increased with increasing deprivation. The incidence in the most deprived areas of 156.5 events per 100,000 person years (135.4-180.9, 95% CI) is double the incidence in the least deprived areas at 78.0 events per 100,000 person years (66.4-91.7, 95% CI). Significant increases in the rates of OHCA were observed with every 1% increase in proportions of Māori (1.0%, 0.61-1.4%, 95% CI, p = 0.001), Pacific Peoples (0.6%, 0.21-0.9%, p = 0.005), >65 year olds (3.7%, 3.0-4.3%, p < 0.001), and males (3.7%, 1.8-5.6%, p < 0.001). In 2018, the decile 10 areas had the lowest coverage of PADs (65% of these areas contained a PAD) compared with less deprived areas (68-84%, median 81%).ConclusionsThe most socioeconomically deprived communities had the highest incidence of OHCA and the least availability of PADs. This provides impetus for targeted PAD placement in areas of higher deprivation.Copyright © 2019 The Authors. Published by Elsevier B.V. All rights reserved.

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