Trends in sex, racial, and ethnic disparities in cardiac arrest mortality in the United States: Insights from the CDC WONDER database 1999-2020

Author Department

Medicine; Cardiology

Document Type

Article, Peer-reviewed

Publication Date

12-2025

Abstract

Background: Sex, racial, and ethnic disparities have been documented in survival after cardiac arrest. Whether knowledge of these disparities has led to their mitigation remains unclear. We evaluated trends in sex and racial disparities in cardiac arrest mortality over a 22-year period.

Methods: Crude death rates (CDRs) for cardiac arrest per 100,000 individuals aged ≥15 years were obtained from the CDC WONDER database from 1999 through 2020. Inferential statistics and linear regression were performed to assess average annual percentage change (AAPC).

Results: Among 364,531 cardiac arrest deaths (CDR of 6.7 per 100,000; 95 % confidence interval [CI] 6.7-6.8), mortality declined significantly from 1999 through 2020 (slope -0.1, 95 % CI -0.14 to -0.05; p < 0.001). No difference was noted in CDR between Women and Men (6.59 vs 6.97; p = 0.117). By race, African Americans had the highest CDR (8.68), and Native Americans had the lowest (2.32), with significant differences across races (p < 0.001). Hispanics had a significantly lower CDR (1.38) than non-Hispanics (7.64; p < 0.001). Trend analysis showed a significant decline in CDR (AAPC -1.4, 95 % CI -1.4 to -1.7), with women experiencing a greater reduction (-2.1) than men (-0.88). Whites had the largest AAPC decline (-1.6; p < 0.001), while African Americans had the smallest (-0.6; p = 0.04). Hispanics showed a non-significant AAPC increase (0.77; p = 0.28).

Conclusions: Cardiac arrest mortality declined over two decades, but the decline was not equal across sexes, races, and ethnicities. Further work is required to develop interventions to address these disparities.

Keywords: Cardiac arrest; Disparities; Mortality; Race; Sex.

PMID

41412285

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