Are Elderly Crash Victims in Rural Areas Receiving Timely Emergency Medical Services Access?

Older drivers in rural areas face high fatality rates in motor vehicle crashes because of a combination of physical vulnerability, geographic isolation, and limited access to emergency medical services (EMS). This study focuses on estimating EMS accessibility for elderly drivers involved in rural crashes in Ohio, U.S., using the Enhanced Two-Step Floating Catchment Area method. Crash data from the Ohio Department of Public Safety (2017–2022) were integrated with EMS facility locations from the Homeland Infrastructure Foundation-Level Data and socioeconomic data from the Smart Location Database. The analysis was conducted at the census block group level using network-based travel time to define EMS catchment areas. Accessibility scores were computed to assess spatial disparities and a sensitivity analysis was conducted. Results revealed significant geographic inequalities in EMS accessibility across rural Ohio, with many block groups falling in the lowest access categories, even under relaxed time thresholds. These insights can guide state and local agencies in prioritizing EMS facility placement, optimizing response coverage, and allocating resources to high-need rural areas.