Social determinants of health and their associations with outcomes in pediatric out-of-hospital cardiac arrest: A national study of the NEMSIS database

•Social determinants of health are related to pediatric cardiac arrest outcomes.•Increased minority and poverty levels are associated with poorer outcomes.•Higher community education levels are associated with better outcomes.•Addressing health disparities requires understanding social determinants. Social determinants of health (SDOH) impact health disparities, though little is known about the effects of SDOH on pediatric out-of-hospital cardiac arrest (POHCA). This cross-sectional study utilized the NEMSIS Database to obtain nationwide POHCA data from 2021 to 2023. Outcomes included performance of bystander cardiopulmonary resuscitation (CPR), automated external defibrillator (AED) usage, and obtainment of return of spontaneous circulation (ROSC). SDOH data was obtained from the US Census Bureau and included minority race/ethnicities status, poverty levels, and educational attainment of the community where POCHAs occurred. Multivariable logistic regression and Cochran-Armitage trend tests were used to assess associations between SDOH and POHCA outcomes. Query of the NEMSIS Database yielded 27,137 POHCAs. The odds of CPR performance and obtainment of ROSC were significantly higher (p