Are there socioeconomic disparities in geographic accessibility to community first responders to out-of-hospital cardiac arrest in Ireland?. (September 2022)

• Record Type: Journal Article
• Authors: Masterson, Siobhán; Teljeur, Conor; Cullinan, John
• Is Part Of: SSM - population health. Volume 19(2022)
• Publication Date: 2022-09
• Subjects: Out-of-hospital cardiac arrest -- Resuscitation -- First responders -- Volunteerism -- Community -- Socioeconomic status; Social medicine -- Periodicals; Medical anthropology -- Periodicals; Public health -- Periodicals; Psychology -- Periodicals; Medicine -- Periodicals; 362.105
• DOI: 10.1016/j.ssmph.2022.101151
• Languages: English
• ISSNs: 2352-8273

Abstract

Abstract: Out-of-hospital cardiac arrest (OHCA) is a leading cause of death worldwide. Without appropriate early resuscitation interventions, the prospect of survival is limited. This means that an effective community response is a critical enabler of increasing the number of people who survive. However, while OHCA incidence is higher in more deprived areas, propensity to volunteer is, in general, associated with higher socioeconomic status. In this context, we consider whether there are socioeconomic disparities in geographic accessibility to volunteer community first responders (CFRs) in Ireland, where CFR groups have developed organically and communities self-select to participate. We use geographic information systems and propensity score matching to generate a set of control areas with which to compare established CFR catchment areas. Differences between CFRs and controls in terms of the distribution of catchment deprivation and social fragmentation scores are assessed using two-sided Kolmogorov-Smirnov tests. Overall we find that while CFR schemes are centred in more deprived and socially fragmented areas, beyond a catchment of 4 min there is no evidence of differences in area-level deprivation or social fragmentation. Our findings show that self-selection as a model of CFR recruitment does not lead to more deprived areas being disadvantaged in terms of access to CFR schemes. This means that community-led health interventions can develop to the benefit of community members across the socioeconomic spectrum and may be relevant for other countries and jurisdictions looking to support similar models within communities. Highlights: Out-of-hospital cardiac arrest (OHCA) is a major cause of unexpected death. OHCA is more prevalent in deprived areas and community response is key for survival. Irish community first responders (CFRs) self-select to participate in CFR schemes. We consider if there are socioeconomic disparities in geographic access to CFRs. Self-selection does not result in deprived areas having worse access to CFR schemes.