Black Children in Poorest Neighborhoods Less Likely to Receive CPR from Bystanders

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Maryam Naim, MD Maryam Naim, MD A new study led by Maryam Naim, MD, pediatric cardiac intensive care physician in the Division of Cardiac Critical Care Medicine at Children’s Hospital of Philadelphia (CHOP), found that African American children in the poorest neighborhoods are about half as likely to receive emergency bystander CPR following an out-of-hospital cardiac arrest than white children in disadvantaged or more prosperous neighborhoods. The research was published in the Journal of the American Heart Association on July 10, 2019.

In addition to her CHOP position, Naim is an assistant professor of Anesthesiology and Critical Care at the Perelman School of Medicine at the University of Pennsylvania.

Using the Cardiac Arrest Registry to Enhance Survival (CARES) database, the study team examined various factors influencing bystander CPR rates for pediatric non-traumatic out-of-hospital cardiac arrests between 2013 and 2017. Of the 3,399 children who received bystander CPR, bystander CPR was 41% less likely for black children, 22% less likely for Hispanics and 6% less likely for children from other ethnic groups, as compared to rates in white children.

While disparities in bystander CPR rates have been studied before in adults, this was the first time racial and socioeconomic factors have been analyzed exclusively in children in the United States. The striking disparity was found among black children living in primarily black neighborhoods with high unemployment, low education and low median income. An estimated 7,000 U.S. children suffer cardiac arrests outside the hospital every year.

“Targeted CPR training for family members in lower-income neighborhoods could potentially improve bystander CPR rates,” she said. “As most bystander CPR is provided by family members, lower response rates are likely due to a lack of CPR training and recognition of cardiac arrests.”

Naim and her colleagues suggest that teaching CPR to parents before a newborn is released from the hospital or during pediatrician visits would provide a good opportunity to improve training and potentially close the gap on this disparity.

Read the American Heart Association news release about this research.

Maryam Naim, al. "Race/Ethnicity and Neighborhood Characteristics Are Associated With Bystander Cardiopulmonary Resuscitation in Pediatric Out‐of‐Hospital Cardiac Arrest in the United States: A Study From CARES," Journal of the American Heart Association, July 10, 2019.

Contact: Natalie Solimeo, The Children’s Hospital of Philadelphia, 267-426-6246 or

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