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CMAJ. 2011 Oct 18;183(15):1705-12. doi: 10.1503/cmaj.101512. Epub 2011 Sep 12.

Socioeconomic status and incidence of sudden cardiac arrest.

Collaborators (330)

Kerby JD, Brown TB, Terndrup T, Stephens SW, Williams CR, Acker JE, Minor ML, MacLennan PA, Pritchard PR, Caldwell S, Lai KR, Idris AH, Benitez F, Fowler R, Lemecha D, Minei J, Pepe P, Ramsay M, Simonson R, Wigginton J, Climer D, Moffat M, Newman K, Owens P, Bennett A, Black R, Cason D, Craft B, Detamble L, Dykes R, Harvey T, Hewitt S, Isaacs M, Kay J, Kayea T, LaChance R, Lehman T, Mayer P, Metzger J, Miller D, Navarro K, Parker S, Pickard K, Porter W, Starling TJ, Tine T, Vinson C, Abebefe D, Arze S, Black S, Bush M, Forman M, Goodloe J, Kelly R, Lachar G, Mangram A, Morales M, Thornton E, Wiebe R, Kerber R, Hata S, Atkins D, Kenney M, Rost C, Drum A, Hartley M, Aufderheide TP, Pirrallo RG, Brasel KJ, Winthrop AL, Klein JP, Kitscha DJ, Burja BJ, von Briesen C, Sparks CW, Kaebisch S, Chianelli J, Forster R, Milbrath M, Pukansky L, Sternig K, Chin E, Frieberg N, Krueger K, Szewczuga D, Duerr T, Funk R, Jacobsen G, Spitzer J, Demien R, Martins J, Cohn J, Spahn RR, Jankowski M, James T, Wentlandt WE Jr, Berousek D, Satula BM, Behling JB, Redman DK, Hook S, Neargarder A, Singer J, Reminga T, Shepherd D, Holzhauer P, Rubin J, Skold C, Alvarez O, Harkins H, Barthell E, Haselow W, Yee A, Whitcomb J, Castro EE, Motarjeme S, Stiell I, Christenson J, Hameed M, Yelle JD, Osmond M, Vaillancourt C, Evans D, Abu-Laban R, Clement C, Beaudoin T, Boychuk B, Pennington S, Connolly H, Lefaivre P, Banek J, Marcantonio A, Marcantonio R, Leclair C, Cummins J, Stempien M, Dreyer J, Munkley D, Maloney J, Colella P, Affleck A, Waldbillig D, Bradford P, Lees M, Arcieri V, Wilson A, Boyle K, Luinstra-Toohey L, Trickett J, Sykes N, Graham E, Ballah K, Hedges C, Mathers P, Andrusiek D, Bishop D, Straight R, Twaites B, Donn S, Callaway C, Tisherman S, Rittenberger J, Hostler D, Condle J, Kampmeyer M, Markham T, Morgan M, Sabol P, Sicchitano G, Sherry S, Shrader A, Stull G, Torres M, Groft W, McCaughan R, Rohrer R, Cole J, Fuchs D, Guyette F, Jenkins W, Roth R, Walker H, Corcos A, Doshi A, Ong A, Peitzman A, Hedges JR, Newgard CD, Daya MR, Lowe RA, Griffiths D, Brett J, Zive D, Yekrang A, Nakamura Y, Frakes B, Monnig A, Jui J, Schmidt TA, Sahni R, Warden CR, Muhr MD, Stouffer JA, Gorman K, Rosteck P, Koenig K, Lee J, Barnes R, Tucker H, Allen B, Bishop TJ, Glaser A, Schreiber MA, Anderson J, Ramzy AI, Gubler KD, Wittwer LK, Underwood S, Barone B, Haun-Taylor D, Bryant E, Miller J, Davis D, Hoyt D, Coimbra R, Vilke G, Kelly D, McCallum-Brown L, Haynes B, Schwartz B, Sise M, Kennedy F, Simon F, Tominaga G, Steele J, Kudenchuk PJ, Rea TD, Bulger E, Eisenberg MS, Copass M, Olsufka M, Ragsdale S, Solberg D, Damon S, Phelps R, O'Brien J, Sodeman E, LaFave M, Boehl J, Jones D, Somers G, Ayrs D, Whorton A, Warren S, Fogarty J, Larsen J, Helbock M, Slutsky A, Morrison L, Dorian P, Beers C, Bigham B, Braga D, Burgess G, Cameron B, Chung S, De Maio P, Driscoll S, Fell L, Frank J, McLennan M, Molyneaux LA, Ryan W, Schotsman A, Simonini J, Turcotte L, Veel F, Wassenaar A, Zahn C, Bradshaw D, Burgess R, Cameron B, Chad S, Cheskes S, Craig A, Dewar S, Dodd T, Duquette R, Epp M, Feldman M, Jones V, MacDonald R, MacKay L, McNenley S, Moore J, Moran P, Murray M, Nemeth M, Olnyk R, Perreira T, Renaud R, Roche K, Shield J, Silver D, Stevens J, Verbeek R, Waite T, Webb K, Welsford M, Weisfeldt M, Ornato JP, Hoyt DB, Holcomb JB, Hoke T, Sopko G, Lathrop D, Mascette A, Nickens PD, Hallstrom A, Nichol G, Emerson S, Powell J, Sears G, Bardarson B, Van Ottingham L, Leonen A, Ledingham RB, Finley C, Moore R, Bergsten-Buret B.

Author information

1
The Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Abstract

BACKGROUND:

Low socioeconomic status is associated with poor cardiovascular health. We evaluated the association between socioeconomic status and the incidence of sudden cardiac arrest, a condition that accounts for a substantial proportion of cardiovascular-related deaths, in seven large North American urban populations.

METHODS:

Using a population-based registry, we collected data on out-of-hospital sudden cardiac arrests occurring at home or at a residential institution from Apr. 1, 2006, to Mar. 31, 2007. We limited the analysis to cardiac arrests in seven metropolitan areas in the United States (Dallas, Texas; Pittsburgh, Pennsylvania; Portland, Oregon; and Seattle-King County, Washington) and Canada (Ottawa and Toronto, Ontario; and Vancouver, British Columbia). Each incident was linked to a census tract; tracts were classified into quartiles of median household income.

RESULTS:

A total of 9235 sudden cardiac arrests were included in the analysis. For all sites combined, the incidence of sudden cardiac arrestin the lowest socioeconomic quartile was nearly double that in the highest quartile (incidence rate ratio [IRR] 1.9, 95% confidence interval [CI] 1.8-2.0). This disparity was greater among people less than 65 years old (IRR 2.7, 95% CI 2.5-3.0) than among those 65 or older (IRR 1.3, 95% CI 1.2-1.4). After adjustment for study site and for population age structure of each census tract, the disparity across socioeconomic quartiles for all ages combined was greater in the United States (IRR 2.0, 95% CI 1.9-2.2) than in Canada (IRR 1.8, 95% CI 1.6-2.0) (p<0.001 for interaction).

INTERPRETATION:

The incidence of sudden cardiac arrest at home or at a residential institution was higher in poorer neighbourhoods of the US and Canadian sites studied, although the association was attenuated in Canada. The disparity across socioeconomic quartiles was greatest among people younger than 65. The association between socioeconomic status and incidence of sudden cardiac arrest merits consideration in the development of strategies to improve survival from sudden cardiac arrest, and possibly to identify opportunities for prevention.

PMID:
21911550
PMCID:
PMC3193117
DOI:
10.1503/cmaj.101512
[Indexed for MEDLINE]
Free PMC Article

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