Growing Diversity: Do race & culture matter in EMS? - Administration and Leadership - @

Growing Diversity: Do race & culture matter in EMS?


Gary Ludwig, MS, EMT-P | | From the November 2008 Issue | Tuesday, October 28, 2008

Back in the early _90s, when the phrase ˙diversity trainingÓ was the management buzzword, I was subjected to what I consider one of the dumbest forms of diversity training. The ˙experts,Ó who were contracted by the city ofSt. Louis, where I was working at the time, had a unique way of conducting this kind of awareness training.

The training included an exercise in which we all formed a circle. Whoever didn_t have brown eyes (including me) had to get in the middle of the circle. Anyone who had brown eyes got to call people in the middle of the circle any name they wanted. Those outside of the circle were encouraged to be as mean and crude as they could.

Those of us inside the circle weren_t allowed to say anything. We had to quietly listen to all the negative comments, including those about our families.

The exercise was supposed to continue for about 10 minutes, but we didn_t make it to that mark because one of the people inside the circle broke down in tears and had to be escorted out. Once the commotion died down, we talked about our reactions, and some of those who formed the outside circle said the entire exercise was inaneƒjust what I was thinking. Many refused to comment at all.

The exercise was intended to allow those of us with blue or green eyes to understand what it_s like to be disrespected based solely on a physical characteristic and to encourage an honest discussion about diversity.But having grown up in a diverse neighborhood insouth St. Louis, I didn_t like the insinuation that I treated people, regardless of their heritage, in a disrespectful manner.

The lesson the experts failed to impart was that when a workforce becomes diverse and understands diversity, it becomes stronger. Diversity isn_t about simply recognizing that we_re different; it_s about understanding how much stronger and better we can be because of our diversity.

Our Changing Culture

One of the toughest challenges for anyEMS manager is to recruit and maintain a workforce that mirrors the population of their service area.In fact, statistics from the National Registry of EMTs reflect that less than 10% of theEMS workforce identifies themselves as minorities.

Why should our workforce reflect the communities we serve? Well, in the absence of a diversified workforce, you can have language barriers, decreased opportunity for positive relationships, lack of trust between the patient and care provider, and lack of knowledge on the part of the provider about how cultures perceive emergencies and death.

Of these obstacles, a language barrier may be the most significant. When my grandparents migrated fromGermany around 1900, they were forced to assimilate into American society, including learning English, in order to survive. But assimilation is no longer as crucial. Although English is the predominant language of theUnited States, you won_t ever hear a word of English in many neighborhoods.

Like the sound from a train rumbling down the track, it should be clear that a major culture change is headed our way. According to a recent report by thePewResearchCenter, minorities in theU.S. will become the majority by or before 2050, with non-Hispanic whites sliding to about 47% of the population.

Further, the Hispanic/Latino and Asian populations are projected to increase nearly threefold, with Hispanic/Latinos comprising 29% and Asians making up about 9% ofAmerica_s total population. The African-American population is projected to nearly double and make up about 14% of the total population.

Although our country continues to change culturally, it seems minorities aren_t drawn in great numbers to attend EMT or paramedic school. Look at who_s graduating from your local EMT and paramedic programs. Think about who_s attending regional and national conferences.

What You Can Do

Some urbanEMS organizations have begun outreach programs targeting high school students. Also, some communities have developed specialized high school programs that prepare young people for careers not only inEMS, but also the fire service and law enforcement. One program inFairfax County,Va., prepares high school students for the real world by offering five certifications, including EMT, prior to graduation.

Such projects as the EMS Workforce for the 21st Century and Fire 20/20 are assessing the future needs of the emergency service workforce. (For more on these initiatives," target="_blank"> and

As theU.S. becomes more diverse, our workforce must do the same.JEMS



Gary Ludwig, MS, EMT-P, is a deputy fire chief with theMemphis (Tenn.) Fire Department. He has 30 years of fire and rescue experience. He_s chair of the EMS Section for the International Association of Fire Chiefs and can be reached

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Related Topics: Administration and Leadership, Leadership and Professionalism, Training, Jems Leadership Sector

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Gary Ludwig, MS, EMT-P

Gary Ludwig, MS, EMT-P, is a well-known author, lecturer and consultant who has successfully managed two large award-winning metropolitan fire-based EMS systems. He has 37 years of fire, rescue and EMS experience and has been a paramedic for over 35 years. He’s also past chair of the EMS section for the International Association of Fire Chiefs and has a master’s degree in management and business. He can be reached at


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