acase@tulane.edu / Out of hospital cardiac arrest remains one of the most common causes of death in the United States. Researchers continue to study a wide variety of modifiable risk factors at the individual level and research survival with the goal of creating interventions at multiple levels to reduce mortality and morbidity. These traditional variables, however, account for only a portion of the survival, and research on neighborhood level factors has recently shown promise for explaining differences in outcomes, including short term survival. In this dissertation we seek to evaluate out of hospital cardiac arrest (OHCA) data from New Orleans, Louisiana, over the five-year period from 2012 to 2017 (n=1,602 cases) and to examine selected literature and neighborhood level variables to determine the associations with OHCA. Traditionally studied predictors of cardiac arrest, such as age, sex, race, and health status, account for less than 75 percent of the variability in survival and substantial differences in survival among communities remains unexplained. Seeking to better explain the factors influencing survival, the central hypothesis is that certain neighborhoods, delineated by census tracts in New Orleans (n=172), have previously unidentified characteristics, namely violent crime, which contribute to increased incidence of cardiac arrest. First, we examine the level of association between violence in neighborhoods and incidence of cardiac arrest. Then, we examine the role of bystander CPR and what correlations with neighborhood violent crime rates may exist. Finally, we examine ambulance response times in neighborhoods with high rates of violent crime.
We find that those neighborhoods with higher rates of violent crime are more likely to have higher rates of cardiac arrest, to a statistically significant level. We also identify opportunities for public health interventions based upon analysis of rates of both witnessed cardiac arrests and bystander CPR provision, as well as ambulance response times to cardiac arrests in neighborhoods with high rates of violent crime. / 1 / Aaron Miller
| Identifer | oai:union.ndltd.org:TULANE/oai:http://digitallibrary.tulane.edu/:tulane_80886 |
| Date | January 2018 |
| Contributors | Miller, Aaron (author), Kendall, Carl (Thesis advisor), School of Public Health & Tropical Medicine School of Public Health and Tropical Medicine (Degree granting institution) |
| Publisher | Tulane University |
| Source Sets | Tulane University |
| Language | English |
| Detected Language | English |
| Type | Text |
| Format | electronic |
| Rights | 6 months, Copyright is in accordance with U.S. Copyright law. |
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