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Rapid Access to Emergency Medical Services Within Historically Redlined Areas
Cherisse Berry1, Joseph Obiajulu2, N Clay Mann3
1Department of Surgery, Rutgers Health, New Jersey Medical School, Newark.
Historically redlined neighborhoods, particularly those graded D, show significant disparities in rapid emergency medical services (EMS) access compared to historically desirable areas (grade A). These findings highlight structural inequities in prehospital care, necessitating strategic interventions.
Area of Science:
- Public Health
- Health Services Research
- Health Equity
Background:
- Inequities in rapid access to emergency medical services (EMS) are a critical gap in prehospital care.
- Delays in EMS response are linked to increased mortality and known disparities in historically redlined areas.
Purpose of the Study:
- To assess the association between historically redlined areas and rapid EMS access (defined as ≤5-minute response time) across the United States.
Main Methods:
- Retrospective, cross-sectional study analyzing EMS centers' geographic distribution against 2020 US Census block groups and Home Owners' Loan Corporation (HOLC) grades (A-D).
- Included 236 US cities with redlining data; analyzed 5-minute drive times from population-weighted block group centroids.
Main Results:
- Over 5% of the population in analyzed cities lacked rapid EMS access.
- Historically redlined areas (Grade D) had a significantly higher proportion of residents without rapid EMS access compared to Grade A areas (7.06% vs. 4.36%).
- Grade D areas showed 1.67 times higher odds of lacking rapid EMS access and had a higher percentage of non-Hispanic Black residents and greater population density compared to Grade A areas.
Conclusions:
- Structural disparities in rapid EMS access are significantly associated with historically redlined areas.
- Strategic resource allocation and system redesign are crucial to address these prehospital care inequities.
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