Acute cardiac care & resuscitation

Health inequalities in out-of-hospital cardiac arrest incidence and bystander cardiopulmonary resuscitation rates in England 2018–23

ResuscitationPublished retrospective analysis of observational data

Authors' conclusion

This analysis highlights persistent geographic and socioeconomic disparities in OHCA incidence, BCPR rates and survival across England that remain unchanged since 2015. Identifying local patterns in BCPR and understanding community-specific characteristics can guide more effective, equitable CPR training. Targeted, community-based interventions-especially in high-risk areas-are needed to reduce mortality.

Study context

Population
Out-of-hospital cardiac arrest (OHCA) patients in England, 2018–2023OHCA patients mapped to 2102 postcode districts
Participants
165,701 patients
Exposure
High-risk vs low-risk areas
  • High-risk areasn = 499
Outcome
BCPR
Methodological detailsOHCA Outcomes registry, geocoded case locations linked to 2021 Census data
  • OHCA Outcomes registry
  • Geocoded case locations linked to 2021 Census data

Main finding

As reported in the abstract

Observational data: associations, not effects.

Further findings

Return of spontaneous circulation (ROSC) and survival

ROSC
27.4% vs 26.5%
Survival
8.2% vs 7.9%
ROSC and survival rates slightly higher

Characteristics of high-risk areas

More urban, deprived, and ethnically diverse, with lower shockable rhythm and public access defibrillation rates

Postcode districts remaining high-risk

Postcode districts remain high-risk
23.6%
Geographic patterns have slightly shifted since 2013-2015

Original publication

Health inequalities in out-of-hospital cardiac arrest incidence and bystander cardiopulmonary resuscitation rates in England 2018–23. Resuscitation. Published 8 June 2026. doi:10.1016/j.resuscitation.2026.111162

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