A growing emergency medical services problem in rural America

Between the lines: This is partially a staffing issue — which also drives the rural doctor shortage.

• Rural areas tend to be populated with older, sicker and lower-income people than urban areas.
• Not only does this create an unmet demand for health care services, but it also means there aren't many people in the community to serve — often on a volunteer basis — as emergency medical personnel.

The issue is compounded by rural hospital closures. Ambulances have to transport patients farther than they did before.

• Since EMS programs are reimbursed per call, longer drives means less calls and thus less revenue.

Go deeper: The plight of America's rural health care