Understanding the disproportionally high incidence of cardiac arrests in the Allegheny County population under the age of 65

Uray, Thomas (2013) Understanding the disproportionally high incidence of cardiac arrests in the Allegheny County population under the age of 65. Master Essay, University of Pittsburgh.

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Abstract

Introduction Every year approximately 300,000 out of hospital cardiac arrests (OHCA) occur in the US. Across seven large North American urban populations, the City of Pittsburgh had the highest crude rate in cardiac arrests. This discrepancy was most pronounced in young patients 18 to 64 years of age with the lowest quartile median household income. The aim of this thesis was to test the hypothesis that people in Pittsburgh who suffer a cardiac arrest live in poorer neighborhoods compared to the Pittsburgh/Allegheny/National average. In addition, I wanted to test the additional hypothesis that these cardiac arrest victims have more preexisting comorbid conditions and engage in poor health behaviors (e.g. illicit drug use). Methods A retrospective analysis of all treated in- and out-of hospital cardiac arrest patients at an inner-city hospital during a 16-month period was analyzed. Patients with all causes of cardiac arrest between the age of 18 and 64 years were included. Next to existing data about neurological outcome and basic demographic data, data about residence, insurance status, employment, marital status, history of drug abuse and urine toxicology screening was analyzed. Patient’s residences were geocoded and depicted in a map of Allegheny, which also contained census tracts color coded by poverty status. Results- Between March 2011 and July 2012, 95 patients between the ages of 18 and 64 (median age of 53) were included in this analysis. Among those, 69 were living in Allegheny County at time of arrest. 19 patients (20.2%) had a history of active drug abuse, and forty patients (42.1%) had no insurance or Medicaid or Medicare listed as support. 25 (36.2%) were living in a neighborhood with 20-30% poverty at the time of the arrest. Conclusion Cardiac arrest patients between the age of 18 and 64 treated at UPMC Mercy have a higher incidence of being unemployed, uninsured, living alone, being obese and using drugs than the rest of the population in Allegheny County. This major public health problem needs to be addressed by local authorities by designing special prevention programs targeted to this subpopulation.

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Details

Item Type:	Other Thesis, Dissertation, or Long Paper (Master Essay)
Status:	Unpublished
Creators/Authors:	Creators Email Pitt Username ORCID Uray, Thomas
Contributors:	Contribution Contributors Name Email Pitt Username ORCID Committee Chair Finegold, David dnf@pitt.edu DNF UNSPECIFIED Committee Member Dezfulian, Cameron dezfulianc@upmc.edu CAD117 UNSPECIFIED
Date:	August 2013
Date Type:	Publication
Defense Date:	August 2013
Submission Date:	22 July 2013
Access Restriction:	No restriction; Release the ETD for access worldwide immediately.
Publisher:	University of Pittsburgh
Institution:	University of Pittsburgh
Schools and Programs:	School of Public Health > Multidisciplinary MPH
Degree:	MPH - Master of Public Health
Thesis Type:	Master Essay
Refereed:	Yes
Uncontrolled Keywords:	cardiac, arrest, insurance, unemployment, obesity
Date Deposited:	12 May 2015 14:55
Last Modified:	04 Jul 2023 11:56
URI:	http://d-scholarship.pitt.edu/id/eprint/19564

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