Sudden cardiac arrest
=====================

* Sumeet S. Chugh
* Kyndaron Reinier

We appreciate Danyaal Raza’s letter,1 which appeared in the Nov. 22 issue of *CMAJ*, regarding our paper “Socioeconomic status and incidence of sudden cardiac arrest.”2 We also appreciate her suggestion that addressing low socioeconomic status itself may be instrumental in reducing mortality from sudden cardiac arrest.

Our data showed that for seven combined US and Canadian sites, the incidence of sudden cardiac arrest in the lowest socioeconomic quartile was nearly double that in the highest quartile (as measured by census tract median household income). However, we were unable to determine from our data whether low socioeconomic status itself could cause these observed higher rates of sudden cardiac arrest, or if low socioeconomic status is a marker for other factors that increase this risk.

Because we were unable to explore how low neighbourhood socioeconomic status is associated with higher rates of sudden cardiac arrest, we focused our discussion on two interventions that can be implemented immediately and are proven to increase survival from out-of-hospital sudden cardiac arrest.

We agree that addressing low socioeconomic status should be a public policy goal. As scientists, we can work toward providing better data regarding opportunities to improve health outcomes via reduction of poverty and income inequality, improved access to education, targeted education regarding disease risk factors, and improvements in promoting health in impoverished neighbourhoods.

## References

1.  Raza D. Addressing the root cause [letter]. CMAJ 2011;183:2019.
    
    [FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czoxMzoiMTgzLzE3LzIwMTktYSI7czo0OiJhdG9tIjtzOjIyOiIvY21hai8xODQvMi8yMTQuMy5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=) 

2.  Reinier K, Thomas E, Andrusiek DL, et al.; the Resuscitation Outcomes Consortium Investigators. Socioeconomic status and incidence of sudden cardiac arrest. CMAJ 2011;183:1705–1712.
    
    [Abstract/FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czoxMToiMTgzLzE1LzE3MDUiO3M6NDoiYXRvbSI7czoyMjoiL2NtYWovMTg0LzIvMjE0LjMuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9)