The provision of emergency medical services (EMS) is an inherently stressful job. Depression, anxiety, and posttraumatic stress disorder (PTSD) are common psychological challenges affecting EMS providers. As disasters increase worldwide, the need for EMS also increases, as they are an essential part of any disaster management system. Studies have shown that EMS providers experience psychological challenges due to disaster response without receiving the needed psychological support. There is a scarcity of research focusing on EMS providers' psychological challenges in disaster times, especially in the Eastern world. This review highlights the psychological challenges faced by EMS providers in disaster times and discusses the amount of mental health care they receive. By emphasizing the need for mental health support, more research can be conducted to view EMS providers' perspectives on mental health needs before, during, and after disasters, and EMS policy makers can find programs to meet EMS providers' mental health needs, which might reflect positively on EMS and disaster management systems.

Ambulance personnel are among the groups with high mental health risks. This study aims to investigate the role of managerial support in determining the mental well-being of ambulance personnel, a group at high risk for mental health issues. A descriptive, cross-sectional survey design was conducted in Riyadh, Saudi Arabia, in February 2022, involving a convenience sample of 354 ambulance personnel. An online survey was distributed via social media platforms. Manager behavior and mental well-being were assessed using the Manager Behavior Questionnaire (MBQ) and the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS). The participants represented nearly equal-sized groups from different agencies, with 50.3% residing in the Riyadh Region and 67.5% aged between 25 and 34. The mean score for manager behavior was 2.92 ± 1.124, while the mental well-being scale’s mean score was 3.398 ± 0.8219. Variance analyses revealed statistically significant differences in manager behavior concerning gender, age, residence, and years of experience (p < 0.05), as well as in the mental well-being of ambulance personnel. Generalized linear regression analysis demonstrated a statistically significant relationship between manager behavior and mental well-being (p < 0.01). Focusing on improving organizational management behaviors is a promising strategy for enhancing mental health interventions among ambulance personnel. Further research is recommended to monitor the mental health of these professionals and develop evidence-based interventions to support their well-being.

BACKGROUND: Emergency medical services (EMS) play an essential role in treating and transporting patients to hospitals or between hospitals. EMS providers must be distributed wisely across all regions of the country to meet healthcare needs during normal times and disasters. No previous study has investigated the characteristics and distribution of the EMS workforce in Saudi Arabia.OBJECTIVES: Examine the characteristics and distribution of the EMS workforce in Saudi Arabia to identify gaps and areas in need of improvement. Also, explore the sociodemographic and educational characteristics of licensed EMS providers in Saudi Arabia.DESIGN: Cross-sectionalSETTINGS: EMS in Saudi ArabiaMETHODS: We included all licensed EMS providers in Saudi Arabia as of 23 December 2020 who were registered in the Saudi Commission for Health Specialties (SCFHS) database. Sociodemographics, where they earned certification, and their job affiliations were collected and categorized.MAIN OUTCOME MEASURES: EMS workforce distribution, gender, and EMS provider-to-population ratio.SAMPLE SIZE: 18 336 EMS providers; 8812 (48.1%) with documented job affiliations.RESULTS: The EMS provider-to-population ratio is very low. In Saudi Arabia, in general, the ratio is 1:3871 (based on n=8812 providers), which is low compared to the 1:1400 ratio for Australian EMS provider-to-population, for example. That makes it a challenge for EMS providers to meet the population’s needs, especially in times of disaster. The low ratio may have contributed to the delayed response time in Saudi Arabia (13 minutes for critical cases) which does not meet the international standard response time (8 minutes maximum). Also, only 3.5% of the total EMS providers registered were females, and the clear majority of all EMS providers were technicians.CONCLUSIONS: The growth in the EMS workforce, including the recruitment of more females into the workforce and more EMS specialists compared to EMS technicians and health assistants, is critical to reaching a satisfactory EMS provider-to-population ratio.LIMITATIONS: Most noteworthy of the limitations of this research are the insufficient statistics describing EMS distribution in Saudi Arabia, the lack of previous studies on the research topic in Saudi Arabia, and job affiliation not accurately recorded in the SCFHS database.CONFLICT OF INTEREST: None.

Access to healthcare-defined as the ability to obtain timely and necessary medical services - is critical during public health emergencies. The Coronavirus Disease 2019 (COVID-19) pandemic (2020–2021) substantially disrupted routine healthcare delivery in the United States, particularly affecting racial and ethnic minority groups who already face barriers to care. While previous studies have examined disparities in COVID-related outcomes, fewer have assessed racial differences in access to care for non-COVID-19 conditions over an extended pandemic period. This study investigated whether race and ethnicity were associated with limited or delayed access to non-COVID-19 healthcare services during the COVID-19 pandemic in the U.S. We used cross-sectional, nationally representative data from the National Health Interview Survey (NHIS) from July 2020 to December 2021. The analytic sample included 40,955 U.S. adults aged 25 years and older. Survey-weighted logistic regression models accounting for the NHIS complex sampling design (strata and primary sampling units) were used to estimate associations between race/ethnicity and 2 binary outcomes: inability to obtain needed non-COVID-19 medical care and delays in receiving such care, adjusting for demographic, socioeconomic, and health-related covariates. Complete-case analysis was used due to minimal missingness. Sensitivity analyses using alternative weight rescaling produced substantively similar results. All results are based on the weighted sample; however, unweighted results are provided in the appendix. Among respondents, 13.8% reported being unable to access needed care, and 21.5% reported delaying care during the pandemic. After adjustment, American Indian/Alaskan Native and multiracial individuals were significantly more likely to experience barriers to care, with lower odds of receiving needed care (odds ratio [OR] = 0.64; 95% confidence interval [CI]: 0.534–0.782) and higher odds of delay (OR = 1.5; 95% CI: 1.247–1.813). Non-Hispanic Asian respondents were least likely to delay care (OR = 0.67; 95% CI: 0.585–0.774). Racial and ethnic disparities in access to non-COVID-19 healthcare were observed throughout the pandemic period. The observed disparities are consistent with prior literature on inequities in healthcare access during public health emergencies and may help inform future research and policy discussions regarding healthcare access during future emergencies.