A new study reveals that Black communities in California experience significantly longer ambulance patient offload times (APOT), a critical but often overlooked measure of emergency care access. Researchers analyzed nearly 6 million ambulance offloads across 34 emergency medical service (EMS) agencies from 2021 to 2023 and found that the proportion of Black residents in a community was the strongest predictor of delayed offloads.
A 3.3% increase in the proportion of Black residents—from the 25th to the 75th percentile—was associated with an 11.8-minute longer APOT, even after adjusting for socioeconomic and EMS system factors. This delay means patients wait longer for emergency department staff to assume care, potentially worsening outcomes and reducing ambulance availability for other emergencies.
The study also found that these delays were not fully explained by poverty. While economic disadvantage was associated with longer APOT, it did not mediate the relationship between Black race and delays. “The proportion of Black residents emerged as the major independent factor associated with longer APOT,” the authors wrote.
Communities with more Black residents also tended to have fewer older adults and more minors, suggesting broader demographic patterns tied to systemic inequities. The findings raise concerns about institutional factors such as understaffed emergency departments and limited hospital capacity in areas serving Black populations.
As longer APOT is linked to increased mortality and reduced care quality, the study underscores the urgent need to address racial disparities in emergency medical services.
See “Racial and Socioeconomic Disparities in California Ambulance Patient Offload Times” (May 15, 2025)