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How Sprawl Impacts Emergency Medical Services Delivery and Traffic Fatalities

Do you know how long it would take for an Emergency Medical Services (EMS) vehicle to reach your home in an emergency?  Or to your workplace if there was an emergency there?  For most people, the answers to these questions are probably unknown and rarely contemplated.  When choosing a place to live, many home buyers consider the quality of local schools and neighborhood security but may not think about how far they are from the nearest EMS or fire department. 

Within an urbanized county, like Miami-Dade for example, average EMS run times can vary from an average of 5.9 minutes in the more urbanized areas to 7.2 minutes in less populated, fringe, ex-urban areas.  In fact, for the 2000 Census, around 80 percent of Miami-Dade's land area was classified as rural but non-farm, indicating that the population density was low enough to classify many areas as rural although they were not being used for agricultural production or sales.   In the course of some of my research over the years (Lambert and Meyer 2006, 2008) and the research of others (American Farmland Trust 1998, Trowbridge et al 2009), EMS run times in many suburban and ex-urban areas of metropolitan counties have been found to be 1.5 to 2 times greater than the run times in the older and more densely settled areas of a metro county, or those neighborhoods which are typically closer to the original downtown or central business district of a city.

Longer EMS response times result from the fact that low density development means longer travel times from a fire or EMS station to get to a crisis situation.  There is often a lag between new development and the construction of new facilities for police, fire, and EMS deployment, giving rise to response delays.  Sprawled regions have also been shown to have higher per capita traffic fatalities (Ewing, et al, 2003, Lambert and Meyer 2006).  More sprawled areas have higher speed limits, hence resulting in more fatalities when car collisions occur.  And these areas typically have fewer sidewalks and pedestrian/bicycle friendly paths, which increases the chances of fatalities occurring to pedestrians as well. 

With these consequences of sprawl documented in recent research efforts, and with weight and obesity problems and respiratory problems connected to sprawl as well (Frumkin 2002), many urban planners and proponents of sustainable development are not only seeing sprawl as something aesthetically displeasing and wasteful and leading to less community cohesion but also now see it as a threat to individual and public health.  Any 'benefit-cost" analysis of new residential or commercial development as well as federal housing policies should now consider these health problems as well.    


American Farmland Trust.  1998.  "Living on the Edge: The Costs of Scattered Development." March, 1998.

Ewing, Reid, Richard A. Schieber, and Charles V. Zegeer.  2003.  "Urban Sprawl as a Risk Factor in Motor Vehicle Occupant and Pedestrian Fatalities." American Journal of Public Health 93 no. 9 (2003): 1541-1545.


Frumkin, Howard.  2002.  "Urban sprawl and public health."  Public Health Reports 2002 May-Jun; 117(3): 201–217.


Lambert, Thomas E. and Peter B. Meyer.  2006.  "Ex-Urban Sprawl as a Factor in Traffic Fatalities and EMS Response Times in the Southeastern United States."  Journal of Economic Issues, Vol. 40, No. 4, December 2006, pages 941-953.

Lambert, Thomas E. and Peter B. Meyer.  2008. "New and Fringe Residential Development and Emergency Medical Services Response Times in the United States."  State and Local Government Review, Vol. 40, No. 2, August 2008, pages 115-124.

Trowbridge, Matthew J., Matthew J. Gurka, and Robert E. O'Connor.  2009.  "Urban Sprawl and Delayed Ambulance Arrival in the U.S."  American Journal of Preventive Medicine, Volume 37, Issue 5, November 2009, Pages 428-432.