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Urban sprawl and delayed ambulance arrival in the U.S
Matthew J Trowbridge1, Matthew J Gurka, Robert E O'Connor
1Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, VA 22908-0699, USA. mtrowbridge@virginia.edu
American Journal of Preventive Medicine
|October 21, 2009
Summary
Urban sprawl is linked to longer emergency medical service (EMS) response times and a greater chance of delayed ambulance arrival for motor-vehicle crashes. Promoting smart growth and managing sprawl may improve EMS reliability.
Area of Science:
- Urban planning and public health
- Transportation and emergency response systems
- Environmental science and community development
Background:
- Minimizing emergency medical service (EMS) response time is crucial for prehospital care.
- The impact of built environment features, like urban sprawl, on EMS performance is often overlooked.
Purpose of the Study:
- To measure the association between urban sprawl and EMS response times.
- To test the hypothesis that sprawling development increases the likelihood of delayed ambulance arrival.
Main Methods:
- Utilized data from 43,424 motor-vehicle crashes in 2008 from the Fatal Analysis Reporting System.
- Measured urban sprawl using a continuous county-level index and analyzed the association with delayed ambulance arrival (> or =8 minutes) using generalized linear mixed modeling.
Main Results:
- A significant association was found between urban sprawl and increased EMS response time (p=0.03).
- The probability of delayed ambulance arrival increased quadratically with sprawl severity, even when controlling for other factors.
- For example, sprawling counties had a 69% probability of delayed arrival compared to 31% in smart-growth counties.
Conclusions:
- Urban sprawl is significantly associated with increased EMS response times and delayed ambulance arrivals after motor-vehicle crashes in the U.S.
- Community design promoting smart-growth principles and regulating urban sprawl may enhance EMS performance and reliability.
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