Ambulance Deserts: Addressing Geographic Disparities in the Provision of Ambulance Services

Research center:
Lead researcher:
Project funded:
September 2020
Project completed:
May 2023

Declining numbers of rural hospitals and ambulance services imply that remaining ambulance services are being tasked to play a greater role in delivering more sophisticated emergency services in expanded service areas, yet emergency medical services have not been systematically integrated within the healthcare delivery system. Research has shown that this lack of systems planning has led to gaps in the provision of ambulance services, exacerbated across larger geographic coverage areas. These gaps—referred to as "ambulance deserts"—are steadily increasing. To assist state and regional policymakers in formulating strategic plans to address these gaps, this project employed a systematic methodology within a geographic information system (GIS) framework for identifying the adequacy of the existing sets of ambulance services (by state) to meet the needs of the communities they serve, and the extent to which states have populated areas that are not served by any ambulances within a 25-minute travel time access standard--in other words, the extent to which ambulance deserts exist within states.

Our primary research objective was to identify ambulance deserts within the 50 states from which we can obtain data and the percent of each of the state's population(s) living in ambulance deserts. Secondary objectives were to identify the service tiers for each of the ambulance service areas based on population estimates. Our research questions included:

  1. What areas of each state are ambulance deserts, how prevalent are these deserts, and are there regional differences in terms of the number and size of these deserts?
  2. What percent of each of the state's population(s) live in ambulance deserts, and how do these populations compare in terms of their socioeconomic profiles?
  3. What are the population service tiers within the 25-minute minimum access standard ambulance service areas, and how do they compare across the states as well as across regions?


  • Ambulance Deserts: Geographic Disparities in the Provision of Ambulance Services
    Maine Rural Health Research Center
    Date: 05/2023
    Access to timely ambulance service is an essential part of the emergency medical system. Yet ambulance access varies widely with significant gaps across the country. This research identifies places and people that are more than 25 minutes from an ambulance station, also called an ambulance desert.