Survival After Out-of-Hospital Cardiac Arrest: The Role of Racial Residential Segregation.
Health disparities
Out-of-hospital cardiac arrest
Racial residential segregation
Journal
Journal of urban health : bulletin of the New York Academy of Medicine
ISSN: 1468-2869
Titre abrégé: J Urban Health
Pays: United States
ID NLM: 9809909
Informations de publication
Date de publication:
12 2022
12 2022
Historique:
accepted:
15
09
2022
pubmed:
11
10
2022
medline:
15
12
2022
entrez:
10
10
2022
Statut:
ppublish
Résumé
Racial and racialized economic residential segregation has been empirically associated with outcomes across multiple health conditions but not yet explored in relation to out-of-hospital cardiac arrest (OHCA). We sought to examine if measures of racial and economic residential segregation are associated with differences in survival to discharge after OHCA for Black and White Medicare beneficiaries. Utilizing age-eligible Medicare fee-for-service claims data from 2013 to 2015, we identified OHCA claims and determined survival to discharge. The primary predictor, residential segregation, was calculated using the index of concentration at the extremes (ICE) for the beneficiary residential ZIP code. Multilevel modified Poisson regression models were used to determine the association of OHCA outcomes and ZIP code level ICE measures. In total, 194,263 OHCA cases were identified among beneficiaries residing in 75% of US ZIP codes. Black beneficiaries exhibited 12.1% survival to discharge, compared with 12.5% of White beneficiaries. In fully adjusted models of the three ICE measures accounting for differences in treating hospital characteristics, there was as high as a 28% (RR 1.28, CI 1.23-1.26) higher relative likelihood of survival to discharge in the most segregated White ZIP codes (Q5) as compared to the most segregated Black ZIP codes (Q1). Racial residential segregation is independently associated with disparities in OHCA outcomes; among Medicare beneficiaries who generated a claim after suffering an OHCA, ICE measures of racial segregation are associated with a lower likelihood of survival to discharge for those living in the most segregated Black and lower income quintiles compared to higher quintiles.
Identifiants
pubmed: 36216971
doi: 10.1007/s11524-022-00691-x
pii: 10.1007/s11524-022-00691-x
pmc: PMC9727016
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
998-1011Subventions
Organisme : NHLBI NIH HHS
ID : R01 HL141841
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR004419
Pays : United States
Organisme : NHLBI NIH HHS
ID : 5T32HL129974-04
Pays : United States
Organisme : NHLBI NIH HHS
ID : T32 HL129974
Pays : United States
Organisme : NHLBI NIH HHS
ID : 7R01HL141841-03
Pays : United States
Informations de copyright
© 2022. The New York Academy of Medicine.
Références
Resuscitation. 2019 Aug;141:44-62
pubmed: 31199944
Demography. 1996 Nov;33(4):395-412; discussion 413-6
pubmed: 8939412
Curr Cardiovasc Risk Rep. 2015 Mar;9(3):
pubmed: 25893031
Heart. 2016 Sep 1;102(17):1363-70
pubmed: 27117723
PLoS One. 2015 Dec 14;10(12):e0144882
pubmed: 26659851
J Urban Health. 2017 Apr;94(2):244-258
pubmed: 28130678
Resuscitation. 2020 Dec;157:49-59
pubmed: 33010372
JAMA Cardiol. 2017 Oct 1;2(10):1110-1118
pubmed: 28854308
Health Place. 2015 Jul;34:215-28
pubmed: 26093080
Am J Cardiol. 2017 Aug 1;120(3):421-427
pubmed: 28583683
N Engl J Med. 1993 Aug 26;329(9):600-6
pubmed: 8341333
Am J Epidemiol. 2007 Sep 1;166(5):534-43
pubmed: 17584756
J Clin Epidemiol. 2005 Dec;58(12):1325-9
pubmed: 16291479
Lancet. 2017 Apr 8;389(10077):1453-1463
pubmed: 28402827
J Epidemiol Community Health. 2015 Dec;69(12):1199-207
pubmed: 26136082
Circulation. 2019 Mar 5;139(10):e56-e528
pubmed: 30700139
Acute Med Surg. 2016 Apr 28;3(2):61-64
pubmed: 29123754
J Am Soc Nephrol. 2013 Feb;24(2):293-301
pubmed: 23334394
Circulation. 2015 Aug 4;132(5):380-7
pubmed: 26240262
J Clin Epidemiol. 2008 Apr;61(4):344-9
pubmed: 18313558
Am J Public Health. 2002 Jul;92(7):1100-2
pubmed: 12084688
Public Health Rep. 2001 Sep-Oct;116(5):404-16
pubmed: 12042604
JAMA Netw Open. 2019 Aug 2;2(8):e198642
pubmed: 31390036
Pharmacoepidemiol Drug Saf. 2010 Jun;19(6):555-62
pubmed: 19844945
Eur J Prev Cardiol. 2014 May;21(5):619-38
pubmed: 22692471
Am J Public Health. 1993 Jul;83(7):955-9
pubmed: 8328616
Cancer. 2020 Aug 15;126(16):3698-3707
pubmed: 32484923
J Urban Health. 2019 Apr;96(2):159-170
pubmed: 29869317
Am J Public Health. 2016 Feb;106(2):256-63
pubmed: 26691119
J Am Heart Assoc. 2020 Feb 18;9(4):e014178
pubmed: 32067590
Circulation. 2016 May 31;133(22):2159-68
pubmed: 27081119
Am J Hypertens. 2011 Aug;24(8):904-10
pubmed: 21509051
Circulation. 2020 Jan 7;141(1):34-41
pubmed: 31887076
J Am Coll Cardiol. 2019 Apr 2;73(12):1598-1600
pubmed: 30922482
Med Care. 2017 Jul;55(7):698-705
pubmed: 28498196
Resuscitation. 2018 Apr;125:8-11
pubmed: 29341874