Bystander CPR less common in Hispanic neighborhoods

By American Heart Association News

Science Photo Library, Getty Images
(Science Photo Library, Getty Images)

Receiving CPR from a bystander can double the chance of surviving a cardiac arrest. But you're less likely to get this help – and less likely to survive – if your heart stops in a Hispanic neighborhood, a new study shows.

The study, published Monday in the American Heart Association journal Circulation, found the greater the percentage of Hispanic residents in a neighborhood, the lower the chances of receiving bystander CPR and the lower the chances of survival.

Specifically, it showed people who had a cardiac arrest in neighborhoods where at least half of the residents were Hispanic were 39% less likely to receive bystander CPR than those living in neighborhoods that were less than a quarter Hispanic. In neighborhoods where more than three-fourths of the residents were Hispanic, people in cardiac arrest were 40% less likely to receive bystander CPR – and 44% less likely to survive.

The study analyzed data from out-of-hospital cardiac arrests in neighborhoods in Alabama; Dallas; Milwaukee; San Diego; Pittsburgh; Seattle; and Portland, Oregon, from 2011-2015.

"We know that bystander CPR improves your chances for survival," said Audrey Blewer, the study's lead author and an assistant professor at Duke University School of Medicine in Durham, North Carolina. "But in Hispanic neighborhoods, it's not happening."

More than 350,000 cardiac arrests occur outside hospitals each year, with 18.8% of those taking place in public settings. About 9 out of 10 people whose hearts stop outside a hospital die. But nearly 45% would survive if bystander CPR is administered, prior research shows.

Blewer said her study points to the need for greater CPR training in Hispanic communities, as well as a deeper look into why these disparities may exist.

The study didn't delve into those reasons, but Marina Del Rios has some ideas.

"That's the million-dollar question that a lot of us are trying to answer," said Del Rios, an associate professor in the department of emergency medicine and director of social emergency medicine and population health at the University of Illinois College of Medicine in Chicago. "I think a lot of it really has to do with fear."

Del Rios, who was not involved in the new study, pointed to a 2015 study of Hispanic neighborhoods in Denver that identified distrust of law enforcement, immigration status, language issues and other barriers to calling 911. The study also found in these communities a lack of knowledge about cardiac arrest and how to administer CPR. But Del Rios said that could be overcome with help from 911 dispatchers, if people were willing to call and dispatchers were able to communicate in Spanish.

Del Rios, who works with the 911 dispatch center in Chicago to encourage greater use of telephone-assisted CPR in minority and low-income neighborhoods, said she was concerned with recent trends.

"Anecdotally, I have noticed a hesitation from these (Hispanic) communities to contact 911," she said. As part of her own research, she has noticed a downward trend in bystander CPR in predominantly Hispanic neighborhoods compared to others.

"This study aligns with what I have observed in Chicago," Del Rios said. "We have seen a trend with bystander CPR where there is an increase in white and some minority neighborhoods, but in Hispanic neighborhoods, that has not been the same."

In fact, she said, there's been a dip.

"The last few years, politically there has been a real fear of deportation," she said. "It makes it more difficult for people to call and then stay on the phone long enough to follow directions. And then there's the language barrier as well. It's a confluence of negative characteristics that are more prevalent in Hispanic neighborhoods than in other communities."

Nationwide legislation that protects people who call 911 from deportation and technology that helps 911 dispatchers translate directions into Spanish could go a long way toward solving this problem, Del Rios said.

If you have questions or comments about this story, please email editor@heart.org.


American Heart Association News Stories

American Heart Association News covers heart disease, stroke and related health issues. Not all views expressed in American Heart Association News stories reflect the official position of the American Heart Association.

Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. Permission is granted, at no cost and without need for further request, for individuals, media outlets, and non-commercial education and awareness efforts to link to, quote, excerpt or reprint from these stories in any medium as long as no text is altered and proper attribution is made to American Heart Association News.

Other uses, including educational products or services sold for profit, must comply with the American Heart Association’s Copyright Permission Guidelines. See full terms of use. These stories may not be used to promote or endorse a commercial product or service.

HEALTH CARE DISCLAIMER: This site and its services do not constitute the practice of medical advice, diagnosis or treatment. Always talk to your health care provider for diagnosis and treatment, including your specific medical needs. If you have or suspect that you have a medical problem or condition, please contact a qualified health care professional immediately. If you are in the United States and experiencing a medical emergency, call 911 or call for emergency medical help immediately.