Digital illustration depicting the disparity in public defibrillator access across different socioeconomic areas of a city.

Unequal Access: Are Public Defibrillators Located Where They're Needed Most?

Jordan Keane in Health & Wellness July 2025 • 4 min read.

"New research reveals how community wealth influences the placement of life-saving public defibrillators, potentially widening health disparities."

Sudden cardiac arrest is a major public health concern, and timely defibrillation is crucial for survival. Public access defibrillator (PAD) programs aim to improve outcomes by making these life-saving devices readily available. Guidelines recommend placing PADs based on the historical risk of cardiac arrest in a given area.

However, a new study from Seoul, Korea, reveals a troubling disparity: community socioeconomic status (SES) may be a greater determining factor in PAD placement than actual risk. This means that wealthier neighborhoods may have disproportionately more PADs, regardless of whether they have a higher incidence of cardiac arrest.

This article explores the findings of this research, examining the link between community SES and PAD distribution. We'll delve into why this inequality exists, the potential consequences for public health, and what steps cities can take to ensure equitable access to these life-saving devices.

The Wealth Disparity in Defibrillator Access: What the Seoul Study Reveals

Digital illustration depicting the disparity in public defibrillator access across different socioeconomic areas of a city.

The study, which analyzed data from Seoul's PAD program, found that more affluent neighborhoods had a significantly higher per capita number of PADs compared to less affluent areas. This disparity persisted even after accounting for the historical risk of out-of-hospital cardiac arrest (OHCA). In other words, wealthier areas had more defibrillators, even if they didn't necessarily have a higher incidence of cardiac arrest.

Specifically, the research team examined the number of PADs in relation to neighborhood per capita tax, a proxy for SES. They discovered a clear gradient: neighborhoods in the highest tax quartile had almost three times as many PADs per capita as those in the lowest quartile. While guidelines suggest focusing on high-risk areas, the study found that risk-grid coverage (the percentage of high-risk areas covered by at least one PAD) was generally low across all neighborhoods, regardless of SES.

Unequal Distribution: Wealthier neighborhoods have more PADs, regardless of cardiac arrest risk.
Low Risk-Grid Coverage: Many high-risk areas remain without adequate defibrillator access across all socioeconomic levels.
Public vs. Residential: The disparity is driven mainly by PADs in public locations, with less variation in residential areas.

These findings highlight a potential inequity in the distribution of PADs, suggesting that factors beyond historical risk, such as community wealth, may be influencing placement decisions. This could have significant implications for public health, as it means that individuals in less affluent areas may have reduced access to life-saving defibrillation.

Closing the Defibrillator Gap: Steps Toward Equitable Access

The study's authors emphasize the need for cities to address community-level inequality in PAD distribution. Current programs aimed at increasing PAD coverage should also prioritize improving equity to ensure that all communities, regardless of socioeconomic status, have access to these life-saving devices.

Some potential strategies for achieving more equitable distribution include: <ul> <li>Targeted Placement: Prioritize PAD placement in high-risk areas within less affluent neighborhoods.</li> <li>Community Engagement: Involve community members in the decision-making process to identify optimal locations for PADs.</li> <li>Increased Funding: Allocate additional resources to support PAD installation and maintenance in underserved communities.</li> <li>Public Awareness Campaigns: Educate the public about the importance of PADs and how to use them, focusing on communities with lower levels of health literacy.</li> </ul>

By addressing these inequalities and ensuring equitable access to PADs, cities can improve outcomes for all residents and create healthier, more resilient communities.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.resuscitation.2017.08.012, Alternate LINK

Title: Community Socioeconomic Status And Public Access Defibrillators: A Multilevel Analysis

Subject: Cardiology and Cardiovascular Medicine

Journal: Resuscitation

Publisher: Elsevier BV

Authors: Sun Young Lee, Young Kyung Do, Sang Do Shin, Yong Joo Park, Young Sun Ro, Eui Jung Lee, Kyoung Won Lee, Yu Jin Lee

Published: 2017-11-01

Everything You Need To Know

What exactly are public access defibrillators (PADs), and why are they so important?

Public access defibrillators (PADs) are devices designed to deliver an electrical shock to the heart to restore a normal rhythm during a sudden cardiac arrest. They are crucial life-saving tools, and programs aim to make them readily available in public places. The significance lies in their ability to increase survival rates for those experiencing cardiac arrest, which is a major public health concern. The implications of unequal distribution suggest that lives in less affluent areas may be at a higher risk due to delayed access to defibrillation.

What did the study in Seoul reveal about the distribution of PADs?

The study found that wealthier neighborhoods in Seoul have significantly more public access defibrillators (PADs) compared to less affluent areas. This disparity persists even when considering the actual risk of out-of-hospital cardiac arrest (OHCA). Specifically, neighborhoods in the highest tax quartile had almost three times as many PADs per capita compared to those in the lowest quartile, highlighting how community socioeconomic status (SES) may be a greater determining factor in PAD placement than actual risk.

What are the implications of unequal access to PADs?

The implications are significant because unequal access to public access defibrillators (PADs) can lead to health disparities. Those in less affluent neighborhoods may experience delayed access to life-saving defibrillation, potentially reducing their chances of survival from sudden cardiac arrest. This situation highlights the potential for inequities in public health resources, where community wealth influences access to critical healthcare tools, and could increase the mortality rate in less affluent areas.

What is the role of historical risk in public access defibrillator (PAD) placement?

The historical risk of out-of-hospital cardiac arrest (OHCA) is the frequency of cardiac arrest in a given area and the basis for the current guidelines for public access defibrillator (PAD) placement. The study found that the placement of PADs in Seoul was not solely determined by the risk of OHCA. Instead, community socioeconomic status (SES) played a more significant role. The study suggests that community wealth may be a greater determining factor in PAD placement than actual risk.

What steps can cities take to ensure equitable access to PADs?

Cities can take several steps to address the inequity in public access defibrillator (PAD) distribution. Current programs should prioritize equity to ensure that all communities, regardless of socioeconomic status, have access to these life-saving devices. This could involve reassessing PAD placement strategies, focusing on high-risk areas irrespective of wealth, and implementing programs that specifically target underserved communities. This ensures that all residents have equal access to these life-saving devices.