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 chartbook analyzes 41 states in 2021-2022 and
identifies places and people that are more than 25
minutes from an ambulance station, also called an
- 4.5 million people lived in an ambulance desert (AD); 2.3 million (52%)
of them in rural counties.
- Four out of five counties (82%) had at least one AD.
- Rural counties were more likely to have ADs (84%)
than urban counties (77%).
- Areas with the highest share and number of people
living in ADs include the Appalachian region in the
South; Western states with difficult mountainous terrain;
coastal areas across the U.S.; and the rural mountainous
areas of Maine, Vermont, Oregon, and Washington.
- Eight states had fewer than three ambulances covering
every 1,000 square miles of land area (the Western
states of Nevada, Wyoming, Montana, Utah, New Mexico, and
Idaho; and the Midwestern states of North Dakota and
This report presents data on ADs by state and county.
Included are maps of AD locations and health care
facility locations for every state with available data.
Nine states lack data on ambulance locations so the
results in this report are likely an undercount of the
people and places that are more than 25 minutes from an