Rising Ambulance Life-Threatening Call Demand in High and Low Socioeconomic Areas


  • Karl Portz MSc,

    1. Yorkshire Ambulance Service
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    • Karl Portz, MSc, is the diversity and inclusion advisor to the Yorkshire Ambulance Service. His current work involves working with seldom heard communities to address some of their health inequalities. He has 25 years of experience in the ambulance service, which ranges from working as a frontline paramedic to managing operational staff. He may be reached at karl.portz@yas.nhs.uk.

  • Robert Newell PhD,

    1. British Association for Cognitive and Behavioural Psychotherapies
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    • Robert Newell, PhD, has been involved in the field of cognitive behavior therapy for the past 30 years as a therapist, teacher, and researcher. His main area of research is in diversity, with a particular focus on facial disfigurement. Although recently retired, he maintains research and clinical activity, and is also a trustee of the British Association for Cognitive and Behavioural Psychotherapies and a member of a local NHS research ethics committee. He may be reached at r.j.newell@bradford.ac.uk.

  • Uduak Archibong PhD, FWACN, FRCN

    1. University of Bradford, England
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    • Uduak Archibong, PhD, FWACN, FRCN, is professor of diversity at the University of Bradford, England, where she directs the Centre for Inclusion and Diversity and provides strategic oversight for equality and diversity across the institution. She holds visiting professorship posts at the University of Kwa-Zulu Natal in South Africa and Central University College, Miotso, in Ghana, and she is a fellow of the West African College of Nursing and of the Royal College of Nursing. She can be reached at u.e.archibong@bradford.ac.uk.


Ambulance service demand is increasing in the United Kingdom. A common speculative view makes a link between this rise in demand, deprivation, and certain medical conditions. This study explored factors influencing English ambulance service demand in two areas of differing socioeconomic status. Adopting a causal comparative design, the study compared the numbers of life-threatening calls that Yorkshire Ambulance Service receives and serves in two geographical areas within the Hull and East Riding area. The area of lower socioeconomic status generated significantly more life-threatening calls than the area of higher socioeconomic status; these calls often supported younger patients (mean age 59 years versus 71 years) for breathing difficulties (29% versus 14.5%) more commonly. Tackling inequality will require a whole-systems approach, effective leadership, and recognition of the benefits of understanding difference. A key relationship will entail engaging with seldom heard communities.