Scripted television programs in the United States frequently misrepresent who is most likely to need cardiopulmonary resuscitation and where out-of-hospital cardiac arrests occur, according to research published in the American Heart Association's journal Circulation: Population Health and Outcomes. An analysis of more than 160 TV episodes aired since 2008 suggests these inaccurate portrayals may contribute to real-world disparities in who receives bystander CPR.
Researchers found television programs tend to focus on white people or men receiving CPR, mirroring real-life disparities where women and Black and Latino adults are less likely than white people to receive CPR from a lay rescuer. "It could be that what is on TV is a reflection of real-life, or that what people are watching on TV reinforces implicit biases or stereotypes that contribute to lower rates of CPR receipt for women, Black adults and Latino adults," said Ore Fawole, first author on the research letter.
The study examined TV depictions of out-of-hospital CPR as a potential reason why there is a low prevalence of Hands-Only CPR performed outside of hospitals, particularly for Black adults, Latino adults and women. According to the American Heart Association, each year, more than 350,000 out-of-hospital cardiac arrests occur in the U.S., but only about 40% of people experiencing a cardiac arrest outside a hospital receive the immediate help they need.
"We know that TV depictions of health topics can influence viewers," said senior author Beth L. Hoffman, Ph.D., M.P.H. "Considering the sheer number of people who watch TV, it's important to think of how to leverage this to improve the likelihood that people will perform CPR and save lives." The research team reviewed 169 American scripted TV episodes depicting CPR that aired after 2008, the year the American Heart Association endorsed Hands-Only CPR.
The analysis revealed several significant discrepancies between television portrayals and reality. Less than 30% of the TV episodes accurately portrayed Hands-Only CPR, which involves calling 911 and beginning chest compressions. More than half of the people who received Hands-Only CPR on TV were younger than 40 years old, while real-life recipients needing CPR are typically older with an average age of 62 years.
Location disparities were also substantial. In reality, more than 80% of out-of-hospital cardiac arrests occur at home versus about 20% on screen. Out-of-hospital cardiac arrests portrayed on TV were more likely to happen in remote areas (37%) or in public spaces (26%). The Association's Nation of Lifesavers™ initiative is committed to turning a nation of lay rescuers into lifesavers with a goal of doubling cardiac arrest survival rates by 2030.
"Wouldn't it be great if seeing CPR being used to save a life on TV motivated more people to act quickly if they witness an out-of-hospital cardiac arrest?" said Stacey E. Rosen, M.D., FAHA, volunteer president of the American Heart Association. "Hands-Only CPR is a simple two-step process - call 911 if you see a teen or adult suddenly collapse and then push hard and fast in the center of the chest." The Association provides educational resources on how to perform Hands-Only CPR at https://cpr.heart.org/en/cpr-courses-and-kits/hands-only-cpr.
The researchers hope their findings will encourage more accurate TV depictions of CPR that can help close gaps in these disparities. "We hope that this research paves the way for accurate TV depictions of CPR that can help close the gaps on these disparities for all people to receive CPR and ultimately save more lives," Fawole said. The full manuscript detailing the study's methods and findings can be accessed at https://www.ahajournals.org/doi/abs/10.1161/CIRCOUTCOMES.126.009876 after the embargo lifts.
