University of Southern Maine researchers identify ambulance deserts, rural healthcare needs

University of Southern Maine researchers have identified hundreds of  ambulance deserts — places across the United States where residents live at least 25 minutes away from the closest ambulance station. In Maine, researchers found that 6% of the state’s full population lives within an ambulance desert, and nearly 66% of those living in an ambulance desert reside in rural counties. 

The research was conducted by Dr. Yvonne Jonk, Carly Milkowski, Zachariah Croll, and Karen Pearson of the Maine Rural Health Research Center at USM’s Muskie School of Public Service. 

“Living within an ambulance desert implies that if you have an emergent health condition — such as a heart attack or stroke — or if you have an accident and need to go to the emergency room and/or be hospitalized, no one will come to your aid when you call 911, at least not in a timely manner,” said Jonk, Deputy Director of the Maine Rural Health Research Center. 

The research, funded by the Federal Office of Rural Health Policy, looked at 41 states in 2021-2022 and found that 4.5 million people live in an ambulance desert, 2.3 million of them in a rural county. Areas with the most limited access to ambulance services 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.

“Ambulance services play a critical role in terms of ensuring access to emergent services in rural areas, and are often the first point of contact with the health care system,” Jonk said. “Without an ambulance service, community members are less likely to survive a catastrophic event, and they are less likely to access specialized care at facilities outside the local area if there isn’t an ambulance service that can safely transport them.”

This is the second time in recent months that research from the Maine Rural Health Research Center found deeply concerning healthcare problems for people who live rurally. A report released in March found that, compared to those living in urban areas, rural working-age adults reported more cost barriers to health care, were more likely to have problems paying their medical bills, and were more likely to skip medication doses, delay prescription refills or take less of their prescription medication to save money. Women were more likely to say they had trouble paying for medical care. 

“Our research documents the fact that rural communities face significant barriers to accessing health care. They not only have to travel further than people living in urban communities to see their health care providers, they are more likely to be uninsured, they tend to pay more out of pocket for health care services, and they are less likely to have jobs with paid time off,” Jonk said. “Combined with the fact that it’s harder to attract health care workers to live and work in rural areas, this study dramatically illustrates the desperate situation rural residents are in. They struggle to afford healthcare, and one of the most basic tools of emergency care — the ambulance — isn’t available to them at any cost.”