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AnnuAl RepoRt - University of Alabama at Birmingham

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UAB UTC Fe<strong>at</strong>ured in RITA Spotlight Newsletter<br />

Each month, RITA’s <strong>University</strong> Transport<strong>at</strong>ion Centers<br />

Program publishes a much anticip<strong>at</strong>ed, widely dissemin<strong>at</strong>ed<br />

newsletter highlighting noteworthy findings or<br />

other significant accomplishments reported by one <strong>of</strong> the<br />

<strong>University</strong> Transport<strong>at</strong>ion Centers in its n<strong>at</strong>ional network.<br />

This past June, 2010, the UTC Spotlight Newsletter fe<strong>at</strong>ured<br />

findings from the UAB UTC study which examined<br />

and analyzed the impact <strong>of</strong> urban sprawl on delays emergency<br />

service providers are likely to experience while<br />

traveling to an emergency site as well as from such sites<br />

to appropri<strong>at</strong>e hospitals or trauma centers.<br />

By way <strong>of</strong> background, urban sprawl is an increasingly<br />

common development p<strong>at</strong>tern in the US, characterized<br />

by low-density construction, poor street connectivity,<br />

and single-use zoning. Urban planning and public health<br />

research show th<strong>at</strong> urban sprawl increases trip distances<br />

and traffic density for personal automobile travel, which<br />

decrease travel efficiency. These findings led researchers<br />

to hypothesize th<strong>at</strong> urban sprawl may also be associ<strong>at</strong>ed<br />

with delays in the movement <strong>of</strong> emergency medical<br />

service (EMS) personnel and equipment to a site and<br />

subsequently to a tertiary care facility such as a trauma<br />

center.<br />

As described in his recently completed research project<br />

report, Urban Sprawl and Pre-hospital Emergency Care<br />

Time, M<strong>at</strong>thew Trowbridge, MD, MPH, and his team<br />

measured the rel<strong>at</strong>ionship between county-level urban<br />

sprawl and EMS response times in the US. Dr. Trowbridge<br />

determined urban sprawl to be associ<strong>at</strong>ed with<br />

increased EMS response time and a higher probability <strong>of</strong><br />

delayed EMS arrival following motor vehicle crashes. The<br />

probability <strong>of</strong> delayed EMS arrival is nearly twice as high<br />

in counties with prominent sprawl characteristics compared<br />

to counties with less urban sprawl.<br />

UAB UTC’s research confirm<strong>at</strong>ion <strong>of</strong> urban sprawl’s<br />

associ<strong>at</strong>ion with increased EMS response times underscores<br />

the importance <strong>of</strong> considering future land use and<br />

its potential impact on the delivery <strong>of</strong> emergency care<br />

services. Moreover, we know the lagging <strong>of</strong> medical<br />

infrastructure behind residential development in sprawling<br />

suburban areas distances such communities from<br />

major trauma and tertiary care centers. Less expensive<br />

home prices in sprawling urban areas tend to <strong>at</strong>tract lower<br />

income popul<strong>at</strong>ions, including the elderly, who <strong>of</strong>ten have<br />

limited access to transport<strong>at</strong>ion. D<strong>at</strong>a have confirmed th<strong>at</strong><br />

both demographic groups are <strong>at</strong> higher risk for emergency<br />

medical issues and the need for EMS services. EMS<br />

service is increased per capita in the same sprawling areas<br />

where it is more difficult and expensive to provide.<br />

Working to reconfigure street networks in existing<br />

suburban areas to reduce their sprawling characteristics<br />

will take time. In the interim, it is reasonable to consider<br />

reorganizing pre-hospital and hospital resources to better<br />

compens<strong>at</strong>e for the impact <strong>of</strong> urban sprawl on emergency<br />

response. The results <strong>of</strong> this research, combined with<br />

inform<strong>at</strong>ion from other rel<strong>at</strong>ed UAB UTC-sponsored<br />

research projects, are being used to help develop land<br />

use and public safety recommend<strong>at</strong>ions. It is hoped these<br />

recommend<strong>at</strong>ions will help change the way communities<br />

are planned and the way hospital and other health care<br />

resources are alloc<strong>at</strong>ed.<br />

The UAB UTC is working to help achieve livable, sustainable,<br />

and healthy communities through projects like<br />

Urban Sprawl and Pre-hospital Emergency Care Time<br />

and other complementary research efforts. For a copy <strong>of</strong><br />

the UTC Spotlight Newsletter fe<strong>at</strong>uring this UAB UTC<br />

research project or for additional inform<strong>at</strong>ion about this<br />

project or the other UAB UTC-sponsored projects, we<br />

invited you to visit the UAB UTC website,<br />

www.uab.edu/utc.<br />

Specific Accomplishments 49

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