Socioeconomic disparities in layperson CPR training within a large U.S. city

Abstract

Aim of the study: We sought to understand how individual factors and neighborhood characteristics are associated with a layperson's likelihood of being trained in CPR. We hypothesized that higher socioeconomic status (educational attainment, and median household income (MHI)) would be associated with a higher likelihood of previous CPR training.

Methods: Through the Mobile CPR Project, a program providing hands-only CPR and AED education in Philadelphia, we surveyed participants regarding socioeconomic factors and prior CPR training. Survey questions pertained to race, gender, education, prior CPR training, automated external defibrillator (AED) awareness, and residential area. Community MHI was extrapolated via residential address and census tract data.

Results: From 7/2016 to 4/2018, 1703 subjects completed surveys, including location information, prior to participating in a Mobile CPR Project training event. Of these, 70% were female, 70% were non-white, mean age was 42 ± 20 years, and MHI was $39,318 [IQR $27,708-$60,795]. Subjects residing in census tracts with MHI below the cohort median were significantly less likely to have ever received CPR training (lowest quartile: OR 0.65, CI 0.49-0.85, p = 0.002). In multiple logistic regression controlling for age, race, gender, MHI, and education, higher educational attainment was associated with a higher likelihood of ever receiving CPR training (OR 7.96 Masters or Doctoral compared to less than high school, CI 5.24-12.11, p < 0.001).

Conclusions: There is a strong association between socioeconomic factors (MHI and educational attainment) and likelihood of prior layperson CPR training.

Keywords: AED training; CPR education; Cardiopulmonary resuscitation; Health disparities.