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Workforce divergence

Taking action to evaluate, educate and integrate diversity in the EMS workplace


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EMS has historically been an industry that struggles with workforce diversity. The EMS workforce is predominantly white males, with people of color and women representing less than 28% of our front-line staffing [1].

Recruitment and retention efforts are hot topics on any given day in EMS. But the tragic death of George Floyd in Minneapolis in May and the racial inequities that have been brought to light since have set the stage for meaningful change among first-responder agencies throughout the nation.

In extraordinary times like these, we need to focus on how we can elevate, evaluate, educate and integrate racial diversity in the EMS workplace. The question is, are we willing to take the challenge and change the face of our workforce?

Evaluate current and desired staffing mix

The operations each of us has worked in over the years have experienced challenges when it comes to hiring a racially diverse workforce. Even though we represent management-level leaders across states with racially diverse populations (Georgia, New York, Virginia and Arizona), we struggle with our own limited abilities to recruit a truly diverse workforce.

Step back and evaluate the diversity of your current staff compared with the population of the communities you serve. Does your workforce closely mirror – or even resemble – your community’s population?

In our collective 68 years’ experience as frontline EMTs, paramedics and operational supervisors, we have all cared for patients who were more accepting of a provider who they believed had a similar background to their own. Unfortunately, through the course of our careers, we also have witnessed isolated incidents in which frontline caregivers have treated patients differently based on race.

A 2016 study by the Georgia Budget and Policy Institute showed that a diversified healthcare workforce can lead to improved care [2]. We also know EMS plays a large role as the entry point to healthcare for many underserved populations in racial and ethnic minority communities. It only makes sense that our workforce is a reflection of the people we serve.

Action steps to educate and support diversity

Taking action with the support of management is essential. The tone at the top of any EMS organization must reflect inclusivity and a strong willingness to make changes.

Here are four simple first steps to consider to improve EMS diversity:

  1. Create employee-driven, racially diverse committees who are empowered to develop new and creative programs to enhance workforce diversity.
  2. Implement employer-sponsored diversity training hosted by a third-party expert. The Harvard Business Review reported in July 2019 that nearly all Fortune 500 companies offer diversity training to raise awareness, identify subconscious attitudes and counter wrongful stereotypes [3].
  3. Establish minority hiring programs in partnership with local civic and community groups to actively raise awareness and attract diverse applicants for job openings.
  4. Sponsor EMT academies with full scholarships made available for minority students.


Learn more

Becoming an agency of one: DEI among the ranks

Creating a mindset to achieve diverse, equitable and inclusive hiring practices

Integrating a diversity mindset

The goal of any workforce EMS diversity measures should be to educate and grow an employee base that is more understanding, accepting, compassionate and respectful. We believe if EMTs, paramedics, leaders and others in EMS are more understanding and sensitive to the cultures of our citizens, service quality improves.

It’s also about setting our sights on the future. In our experience, young people of color who are transitioning from high school to college and careers often do not associate EMS as a career option. Now is the time to redouble efforts and to work with guidance counselors and technical schools to develop new programs to encourage the next-generation workforce to pursue EMS careers.

As you see your workforce grow in diversity, the next step is to sustain that growth. Hiring a diverse workforce inclusive of race, ethnicity, gender and socioeconomic background is only a start.

For an organization to be truly diverse, diversity must extend to the leadership team. We know competition is fierce for field providers, and potential new employees are sizing up our entire team when they are deciding which offer to accept. Diverse, inclusive organizations with opportunities for advancement are highly desirable and will beat out a stagnant, non-diverse leadership team every time.

An important step for each of us, as managers and leaders, is to promote the importance of further education for our leadership teams and identify opportunities that are specific to EMS. We are a unique cog in the total spectrum of healthcare in this country, and to foster diversity at every level of our organizations is critical.

Changing course and tearing down barriers is not a simple or quick fix. It will take tremendous perseverance from current leaders to alter the horizon for our next generation of EMS professionals. It is our collective responsibility to build and sustain a growing and diverse workforce to continue to meet EMS hiring demands and to improve overall diversity metrics for the benefit of our communities and patients. The future of our industry depends on it.

Read next: Study of underrepresented groups shows change will be slow to come in EMS diversity


  1. Madison K. Rivard, Rebecca E. Cash, Christopher B. Mercer, Kirsten Chrzan, Ashish R. Panchal. (2020) Demography of the National Emergency Medical Services Workforce: A Description of Those Providing Patient Care in the Prehospital Setting. Prehospital Emergency Care 0:0, pages 1-8.
  2. Laura Harker. Unlocking the Benefits of an Inclusive Health Workforce. (2016) Georgia Budget and Policy Institute.
  3. Does Diversity Training Work the Way It’s Supposed To? (July 9, 2020) Harvard Business Review.

About the authors

Steven Castro, operations manager at Central EMS in Roswell, Georgia; Althea Kidd, director of operations, LifeCare Medical Transport in Fredricksburg, Virginia; Susan Lananger, paramedic supervisor, Trans Am Ambulance in Olean, New York; and Adam Stockton, director of EMS, Maricopa Ambulance in Phoenix, are members of the Priority Ambulance Leadership Foundation 2020 class.

This article was originally posted Oct. 28, 2020. It has been updated.

The Priority Ambulance Leadership Foundation, a 501(c)3 non-profit, dedicated to supporting and developing professionals currently practicing in EMS and promising leaders outside of the industry who seek a career in the emergency medical industry. The Foundation’s annual flagship leadership program, EMS Leadership of Tomorrow, provides formal and informal training and education in all key areas of the ambulance industry and includes a mentorship program led by ambulance company owners and respected leaders in the ambulance industry. For more information, visit