July 2025 DEI – Why DEI and Accessibility Matter in Emergency Medical Services (EMS)
by Angela A. Oberle, ACP
with assistance from ChatGPT
Historically, Emergency Medical Services (EMS) has predominantly had white male providers. In 2019, 72% of providers were non-Hispanic white, and 65% were male.1 This does not always reflect the members of the communities being served. Evidence shows that patient outcomes improve when providers share the same gender, language, or cultural background as patients.2 A diverse workforce strengthens trust, fosters cultural competency, and reduces implicit bias in prehospital care.
There are several common barriers to DEI in EMS, such as the cost of certification. A paramedic certification can range from $1,000 to $15,000, which may contribute to the underrepresentation of women and people of color.3 Another barrier is that organizational cultures and leadership teams that lack diversity may overlook the needs of staff and the community. Delayed access to language services for non-English-speaking patients can lead to increased EMS dispatch times.4 High attrition rates (21% among paramedic students in 2019) also pose a significant barrier to diversifying the workforce.5
What can EMS agencies do to increase DEI? Some might be able to offer scholarships and tuition support to mitigate cost barriers for underrepresented groups. This is especially true in rural communities with volunteer EMS workers. They can include a resolute DEI committee to integrate inclusion into policies, hiring, training, and outreach, and ensure equity in recruitment and leadership. They could provide ongoing training for all staff and host listening sessions and public outreach events to understand community needs.
DEI in EMS is more than an HR policy. It is an ethical obligation to ensure that every patient receives equitable, culturally competent care. With increasing demands on EMS and mounting disparities in response times and accessibility, agencies that commit to DEI strategies are better positioned to succeed operationally, build trust, and serve as true community lifelines.
DEI accessibility is not optional. It is central to the mission of EMS. By investing in diverse personnel, culturally informed services, language access, and community engagement initiatives, EMS agencies can build healthier, more resilient, and just emergency care systems for all.
1 Trends in demographic and employment characteristics of US emergency medical technicians and paramedics, 2011–2019; https://pmc.ncbi.nlm.nih.gov/articles/PMC9262352/table/emp212776-tbl-0001/
2 Essential Principles to Create an Equitable, Inclusive, and Diverse EMS Workforce and Work Environment: A Position Statement and Resource Document; https://www.tandfonline.com/doi/10.1080/10903127.2023.2187103?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
3 EMS School Guide: How Long Is It and How Much Does It Cost? https://eliteamb.com/ems-school/
4 The effect of language barriers on dispatching EMS response; https://pubmed.ncbi.nlm.nih.gov/23952940/
5 Paramedic educational program attrition accounts for significant loss of potential EMS workforce; https://pubmed.ncbi.nlm.nih.gov/37034493/
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