Kyndaron Reinier, Elizabeth Thomas,
Douglas L. Andrusiek, Tom P. Aufderheide, Steven C. Brooks, Clifton W.
Callaway, Paul E. Pepe, Thomas D. Rea, Robert H. Schmicker, Christian
Vaillancourt, Sumeet S. Chugh and the Resuscitation Outcomes
Consortium Investigators. Published in the Canadian Medical Association Journal
(Volume 183, Issue 15). 2011.
Up to 45,000 cardiac
arrests, or 1 every 12 minutes, occur each year in Canada. (Heart and Stroke
Foundation, 2011). Factors that increase a persons risk of having a stroke
include tobacco use, alcohol use, high blood pressure and poor nutrition.
Chronic stress, social isolation, anxiety and depression can all increase someones
chances of developing heart disease. Research has shown that low-income individuals
are less able to purchase nutritious foods, cope with stress, and engage in
healthy activities than those individuals who have more money at their
disposal. As a result, individuals with a low socioeconomic status may
have an increased risk of experiencing sudden cardiac arrest. Researchers who
worked on this study collected data on out-of-hospital sudden cardiac arrests
that occurred in the individuals home or a residential institution in seven
North American cities (three of them being Canadian) from April 1st
, 2006 to March 31st, 2007.
Researchers found that in the Canadian sites, the incidence
of sudden cardiac arrest was three times greater in the lowest quartile in
median household income in comparison to those living in the highest quartile. At
all seven sites, the incidence of sudden cardiac arrest across socioeconomic
quartiles was greatest among people who were less than 65 years of age. The
studys findings may be related to the fact that low-income individuals have
more risk factors for cardiovascular disease as well as poorer control over
Also, despite universal health care in Canada, lower income
individuals living in the Canadian cities that were studied during this report were
less likely to have access to a cardiac catheterization following acute
myocardial infarction or to receive an implantable defibrillator after a
hospital admission for heart failure.
Strategies that are recommended in the study to help lower the
rate of sudden cardiac arrests among those with low-income include offering CPR
classes and installing automated external defibrillators (AED) in lower income
communities. The study also acknowledges that it is important to focus
resources towards providing education on the risk factors of cardiac disease
and launching prevention initiatives such as smoking cessation.
The study had several limitations by including only cardiac
arrests that occurred at residential settings. As a result, there could be an
even higher incidence of cardiac arrest in the low socioeconomic group if they
had included the homeless population.
The study also included US Cities in
their sample. This affects the results since uninsured people in the US may
have been less likely to access health care services that low-income
individuals in this country can access for free.
Overall, the study recognizes that individuals with a
low-income are at a greater risk of experiencing sudden cardiac arrests than
those with a higher socioeconomic status. As well, the authors of the report encourage
local health authorities to address the needs of this cross-section of the
population as well as the barriers they face.
This report will be valuable to health professionals who
work in low-income communities, as well as those who have a general interest in
the social determinants of health.