title: A Longitudinal Description of Emergency Medical Services Professionals by Race/Ethnicity.
abstract: OBJECTIVE
  The objective of this paper was to compare demographics, employment variables, satisfaction, and motivation for entering the field of Emergency Medical Services (EMS) between members of under-represented races/ethnicities and members of the majority group.
  
  
  METHODS
  A cohort of nationally certified EMS professionals was followed for 10 years through annual surveys; however, race/ethnicity was only available for 9 years (2000-2008). Descriptive statistics and 95% confidence intervals (CIs) were calculated and significance was determined by lack of CI overlap.
  
  
  RESULTS
  From 2000 through 2008, the range of proportions of nationally certified EMS professionals by race/ethnicity was as follows: whites: 83.5%-86.0%, Hispanics: 4.2%-5.9%, and African-Americans: 2.5%-4.6%. There were no significant changes in the proportion of minority EMS professionals over the study period. Hispanics and African-Americans combined increased slightly from 6.7% of the population in 2000 to 9.9% in 2008. Likewise, the proportion of all under-represented races/ethnicities increased slightly from 2000 (14.0%) to 2008 (16.5%). Females were under-represented in all years. Nationally certified African-Americans were significantly more likely to be certified at the Emergency Medical Technician (EMT)-Basic level (compared with the EMT-Paramedic level) than whites in all but one survey year. The proportion of Hispanics registered at the EMT-Basic level was significantly higher than whites in three survey years. Accordingly, a larger proportion of whites were nationally registered at the EMT-Paramedic level than both African-Americans and Hispanics. A significantly larger proportion of African-Americans reported working in urban communities (population >25,000) compared with whites for nine of the 10 survey years. Similarly, a significantly larger proportion of Hispanics worked in urban communities compared with whites in 2002 and from 2005 to 2008. For satisfaction measures, there were no consistent differences between races/ethnicities. Among factors for entering EMS, the proportion of whites who reported having a friend or family member in the field was significantly higher than African-Americans in all years and significantly higher than Hispanics in four of the nine years.
  
  
  CONCLUSIONS
  The ethnic/racial diversity of the population of nationally certified EMS professionals is not representative of the population served and has not improved over the 2000-2008 period. Similar to other health care professions, Hispanics and African-Americans are under-represented in EMS compared with the US population. This study serves as a baseline to examine under-represented populations in EMS. Crowe RP , Levine R , Eggerichs JJ , Bentley MA . A longitudinal description of Emergency Medical Services professionals by race/ethnicity. Prehosp Disaster Med. 2016;31(Suppl. 1):s30-s69.
authors.affiliation: 1National Registry of Emergency Medical Technicians,Columbus,Ohio,USA.
authors.forename: Remle P
authors.initials: RP
authors.lastname: Crowe
authors.affiliation: 2Consultant,Redwood City,California,USA.
authors.forename: Roger
authors.initials: R
authors.lastname: Levine
authors.affiliation: 3Division of Epidemiology,The Ohio State University,Columbus,Ohio,USA.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Eggerichs
authors.affiliation: 3Division of Epidemiology,The Ohio State University,Columbus,Ohio,USA.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Bentley
mesh_terms: D000328:Adult; D004632:Emergency Medical Services / Q000639:trends; D004634:Emergency Medical Technicians / Q000706:statistics & numerical data*; D005006:Ethnicity; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012424:Rural Population; D014481:United States; D014505:Urban Population; D000078329:Workforce
keywords:  CI confidence interval;  EMS Emergency Medical Services;  EMT Emergency Medical Technician;  LEADS Longitudinal EMT Attributes and Demographic Study; Emergency Medical Services; paramedic; prehospital