Racial and Ethnic Differences in Bystander CPR for Witnessed Cardiac Arrest

This registry-based analysis examined racial and ethnic disparities in the provision of bystander cardiopulmonary resuscitation (CPR) for 110,054 witnessed out-of-hospital cardiac arrests (OHCA) across the United States (2013–2019). Black and Hispanic individuals 32.2% of cases were significantly less likely than White individuals to receive bystander CPR both at home (38.5% vs. 47.4%; adjusted odds ratio [aOR]: 0.74; 95% CI: 0.72–0.76) and in public locations (45.6% vs. 60.0%; aOR: 0.63; 95% CI: 0.60–0.66). Disparities persisted across neighborhood racial and income strata: even in predominantly White or high-income areas, CPR rates remained lower for Black and Hispanic patients. The disparity also held across all categories of public locations including workplaces, streets, recreational facilities, and transport centers and was associated with lower survival and neurologic outcomes. The findings highlight the need for targeted public health interventions that address structural barriers, expand culturally tailored training, and mitigate implicit bias to improve equitable access to lifesaving CPR.

This registry-based analysis examined racial and ethnic disparities in the provision of bystander cardiopulmonary resuscitation (CPR) for 110,054 witnessed out-of-hospital cardiac arrests (OHCA) across the United States (2013–2019). Black and Hispanic individuals 32.2% of cases were significantly less likely than White individuals to receive bystander CPR both at home (38.5% vs. 47.4%; adjusted odds ratio [aOR]: 0.74; 95% CI: 0.72–0.76) and in public locations (45.6% vs. 60.0%; aOR: 0.63; 95% CI: 0.60–0.66). Disparities persisted across neighborhood racial and income strata: even in predominantly White or high-income areas, CPR rates remained lower for Black and Hispanic patients. The disparity also held across all categories of public locations including workplaces, streets, recreational facilities, and transport centers and was associated with lower survival and neurologic outcomes. The findings highlight the need for targeted public health interventions that address structural barriers, expand culturally tailored training, and mitigate implicit bias to improve equitable access to lifesaving CPR.