Emergency Equity: Access and Emergency Medical Services in San Francisco

TL;DR

This study analyzes emergency response times and access disparities in San Francisco, revealing significant inequities in emergency service proximity for low-income ZIP codes using logistic regression analysis.

Contribution

It provides a data-driven assessment of emergency service access disparities based on income levels, informing policy for equitable emergency response.

Findings

Lower-income ZIP codes have significantly lower probability of meeting response time and distance benchmarks.

Calls from the lowest income bracket are much less likely to be within 1 mile of an emergency room.

Response disparities are most pronounced in emergency room access for low-income communities.

Abstract

In 2020, California required San Francisco to consider equity in access to resources such as housing, transportation, and emergency services as it re-opened its economy post-pandemic. Using a public dataset maintained by the San Francisco Fire Department of every call received related to emergency response from January 2003 to April 2021, we calculated the response times and distances to the closest of 48 fire stations and 14 local emergency rooms. We used logistic regression to determine the probability of meeting the averages of response time, distance from a fire station, and distance to an emergency room based on the median income bracket of a ZIP code based on IRS statement of income data. ZIP codes in the lowest bracket ($25,000-$50,000 annually) consistently had the lowest probability of meeting average response metrics. This was most notable for distances to emergency rooms, where calls from ZIP codes in the lowest income bracket had an 11.5% chance of being within the city's average distance (1 mile) of an emergency room, while the next lowest probability (for the income bracket of $100,000-$200,000 annually) was 75.9%. As San Francisco considers equity as a part of California's "Blueprint for a Safer Economy," it should evaluate the distribution of access to emergency services. Keywords: fire department, emergency medical services, emergency rooms, equity, logistic regression