b"CARES 2023 Annual ReportReduction of Health DisparitiesThe fourth and final pillar of the CDC CARES Expansion and Modernization Grant aims to tackle health disparities in OHCA outcomes, which disproportionately impact specific communities based on factors such as race, income, gender, and urbanicity. Recent research using CARES data have shed light on these disparities. For example, Uzendu et al. found that EMS agencies serving predominately Black and Hispanic communities had lower OHCA survival rates, even after adjusting for factors such as EMS response times and AED application before EMS arrival. 1Similarly, Garcia et al. found that Black and Hispanic individuals were less likely to receive bystander CPR compared to White individuals, irrespective of neighborhood racial/ethnic composition or income level. 2Studies examining income disparities using CARES data also unveil significant gaps, such as Sasson et al.'s discovery that cardiac arrest patients in the highest income quintile in Fulton County, Georgia, were five times more likely to receive bystander CPR than those in the lowest quintile. 3Chan et al. further demonstrated that survival rates were lower in low- and middle-income neighborhoods compared to high-income counterparts. 4In regards to gender, Kotini-Shah et al. observed lower rates of survival to hospital discharge and less favorable neurological outcomes in men across all age groups, even after adjusting for covariates, driven predominantly by lower rates of survival to hospital admission. 5 Grubic et al.s research illustrated significant disparities in the management and outcomes of OHCA cases between urban and rural settings, with rural areas generally exhibiting lower rates of successful resuscitation and survival to hospital discharge compared to urban areas. 6These diverse studies underscore the urgent need to address disparities in OHCA outcomes across various demographic, socioeconomic, and geographic groups, highlighting persistent challenges in access to timely care and effective resuscitation efforts.Seeking to aid in both the identification and reduction of OHCA disparities CARES has developed three targeted strategies encompassed within the three previous grant aims: CARES National Expansion: Reaching and Training All Fifty States By expanding its reach to all fifty states, CARES aims to gather comprehensive data on cardiac arrest incidents, interventions, and outcomes across diverse populations. This expansion will enable a deeper understanding of disparities that exist in various communities and facilitate tailored interventions at the local level.Quality Improvement Engagement: NHSTAs CPR LifeLinks and the Resuscitation AcademyCARES will collaborate with quality improvement partners and strategically disseminate CPRLLs toolkit and the RA training program to directly target at-risk communities. These initiatives focus on improving CPR quality and resuscitation efforts, with interventions tailored to the specific needs of disadvantaged communities. This integration ensures that CPR and resuscitation protocols are fine-tuned to tackle specific challenges and cultural nuances, thereby enabling the creation of training initiatives that are attuned to health disparities, resulting in improved responses in underserved areas.Deploying a Modernized Software Platform:Enhancing Accessibility and UsabilityCARES modernized software platform will prioritize user-friendliness and accessibility, empowering healthcare providers in diverse settings to input and access data. The platform will utilize advanced analytics to identify and visualize real-time disparities, enabling CARES to target communities with higher risk and lower access to care for timely intervention and resource allocation. Additionally, CARES has collaborated with the National EMS Information System (NEMSIS) to integrate CARES required fields into their standard version 3.5.0, allowing states to collect CARES elements more seamlessly and upload state-level data to the registry. This will expand case capture from rural and at-risk communities previously hindered by limited resources or software upload constraints. Lastly, GIS mapping functionality embedded in the software, along with more granular benchmarking reports, will provide more accurate comparisons, further increasing our understanding of improvement opportunities. 24 25"