By Marnie Werner, VP Research, & Kelly Asche, Research Associate
Access to emergency medical services in Rural Minnesota is the topic of our latest report. In it, we analyzed data collected by the Minnesota Department of Health in their 2016 survey of EMS agencies around the state. We wanted to see how delivering EMS services might differ between the rural and urban parts of Minnesota. When we finished, we found we had a lot of interesting and somewhat alarming facts that fell mostly into three groups:
- Lack of professional management training that could be hampering small agencies.
- Revenue sources that are siloed and out of date.
- Both of these factors and others that are creating difficulty in recruiting and retaining workers.
There were a lot of reasons for this last one: no solid recruitment and retention plan; lack of funding and/or revenue, leading to a significant reliance on volunteers; an increasing number of hours of training required. We covered these in the report.
But there was one little nugget of information that didn’t make it into the report that we couldn’t pass up: a direct correlation between the size of the community and whether a lack of access to childcare was (or was not) a barrier to staff recruitment.
It’s pretty well established that a lack of childcare keeps people out of the workforce. We knew that from previous research, then the pandemic made the fact painfully obvious for anyone with children. But in 2016, before the pandemic, MDH happened to ask that very question of EMS managers.
The response rate on the survey was exceptionally good, so we know the data presents a pretty accurate picture of what was going on across the state with our EMS agencies. And so was there a connection between population density and whether access to childcare was a determining factor in being able to recruit EMS workers?
It turns out, yes, in this data set the size of the population served by an agency and whether finding child care was a barrier to staff and volunteer recruitment was definitely statistically significant.*
So the next question, of course, was whether there was any variation in how managers answered this question based on the size of their service population. To find out, we grouped the responses to this question by the population size of each agency’s service region. The responses broke down this way:
Regions responding “yes” when asked if availability of childcare was an obstacle when trying to recruit personnel.
- Regions of less than 2,500 population: 19 responses (41%)
- Regions 2,500 – 4,999: 24 responses (42%)
- Regions 5,000 – 9,999: 20 responses (67%)
- Regions 10,000 – 14,999: 10 responses (42%)
- Regions with greater than 15,000: 1 response (4%)
As you can see, in three of the groups, 40% of the managers answered yes, but the other two responded very differently. In the 5,000-9,999 group, 67% (20 out of about 30 managers) responded yes. That’s quite a leap from 42%. Then in the 15,000+ group, only one out of about 25 agencies said it was a problem. Turn that around and it says that 24 of the 25 agencies in the group didn’t find childcare to be an issue in recruiting people (at least in 2016).
This is important because not only does it show in a concrete way that there’s a connection between population density, the availability of childcare, and the ability for people with children to take a particular job. It also shows that within the larger group, the problem may not be consistent. Communities with higher population densities tend to have more childcare available because childcare providers need not just a certain number of families as paying customers within a given area—a critical mass, if you will—to have as paying customers but also families that have a high enough income to be able to pay the rates the provider must charge to stay in business. The responses to this question are a good illustration of this phenomenon.
But why is childcare a particular problem in the 5,000-9,999 population group and not the smaller communities? That’s a good question. We found that regions in this group had problems overall with recruiting and retaining EMS staff. It probably has something to do with the call volume they receive and level of funding for paying staff: there may be too many calls—too much work—for what agencies are able to pay people. But childcare may play a part in this, too.
This summer we’ll be releasing a report on the initiatives communities around the state are taking on to try and solve their local childcare shortages. Some of them may be in these EMS regions—hopefully they’ll help.