Variance in Emergency Services by US State

State Similarity Index - Infrastructure Category - Emergency Services

The State Similarity Index attempts to quantify how similar US states are to each other. The index is a statistically-based way to measure this. 20% of the index is based on infrastructure. 10% of a state’s technology score (2% of the overall State Similarity Index score) is based on the state’s emergency infrastructure, including medical, firefighting, and police services, as well as military presence.

Physicians per Capita

In the United States, the distribution of physicians varies significantly across its regions. Massachusetts has the highest percentage of doctors in the country. Northeastern states, including Maryland and New York, also have many doctors. In contrast, Southern states, especially Mississippi, have relatively few physicians, compared to their overall population. One reason is that states with competitive salaries and desirable work environments tend to attract more doctors. Furthermore, many of the top medical schools are located in the Northeast region of the country.

Becker’s Hospital Review

States were categorized by the number of people per physician:
190-235, 235-280, 280-325, 325-370, 370-415, 415-460

Hospital Quality

Hospital quality is another indicator of how good the medical services are in a state. Maryland is ranked as having the high quality of any state. Johns Hopkins Hospital is one prestigious hospitals in the country. Other states in the Northeast region also have excellent hospitals. In contrast, the hospitals in Midwestern states are not as highly rated. North Dakota was ranked last in terms of quality. It is a predominantly rural state with a small population, where specialized healthcare services, such as advanced surgeries or complex medical treatments, might be limited compared to more urban and densely populated areas.

US News and World Report

States were categorized by the ranking of hospital quality:
0-8.33, 8.33-16.66, 16.66-25, 25-33.33, 33.33-41.66, 41.66-50

Firefighters per Capita

Some states have more firefighters per capita than others. Maine and New Hampshire have higher ratios of firefighters, possibly due to their densely forested landscapes in rural areas. In contrast, Iowa and Nebraska a have relatively few firefighters per capita. Most of their land is occupied by farms, so they have a low percentage of forested land. Adequate resources and financial support are crucial for recruiting, training, and maintaining a firefighting team.

US Bureau of Labor Statistics

States were categorized by the number of firefighters per 1,000 jobs:
.75-1.25, 1.25-1.75, 1.75-2.25, 2.25-2.75, 2.75-3.25, 3.25-3.75

Professional Firefighters

In many states, nearly all the firefighters are volunteers. However, Hawaii has by far the lowest percentage, at less than 10%. The state is prone to many natural hazards, including volcanic activity, earthquakes, and tsunamis, in addition to the regular fire risks. Dealing with these hazards requires specialized training, equipment, and resources that are more readily available with professional firefighters.

US Fire Administration

States were categorized by percentage of volunteer firefighters:
10-25%, 25-40%, 40-55%, 55-70%, 70-85%, 85-100%

Police per Capita

New York and New Jersey have the highest number of police per capita. One reason is that urban areas tend to have higher crime rates compared to rural areas in the United States. Washington and Oregon have the lowest number of police per capita. Other states in the Western part of the country also have a relatively low amount. Policing strategies and models can vary across states. Some states may rely more on community policing, where officers work closely with communities to prevent crime and maintain order.


States were categorized by the number of people per police:
250-330, 330-410, 410-490, 490-570, 570-650, 650-730

Police Militarization

Police forces in the United States have become more weaponized in recent years. The main source of military-grade equipment is the Pentagon’s 1033 Program, which distributes surplus gear to local law enforcement agencies. Law enforcement officials argue that the equipment is necessary to combat increasingly powerful criminal elements. Police departments in Tennessee have received the most valuable military-grade weapons per capita. Police departments in Alaska, in contrast, have received little.


States were categorized by dollars of military surplus equipment per capita:
$0-3, $3-6, $6-9, $9-12, $12-15, $15-18

Military per Capita

Alaska and Hawaii have the most military personnel per capita. Both states have strategic importance so they have many military bases. Alaska is located near the Arctic region, close to Russia. Hawaii is situated in the Pacific Ocean and serves as a critical base for projecting U.S. military power in the Asia-Pacific region. The military presence in these states is driven by the need to maintain security and readiness in these strategically significant areas.

Department of Defense

States were categorized by the percentage of people in the military:
0-.15%, .15-.3%, .3-.45%, .45-.9%, .9-1.8%, 1.8-2.7%

Military Bases

Certain states host military bases for all five branches of the armed forces, whereas others do not possess any. Vermont, Minnesota, and West Virginia stand as the sole states devoid of military bases. Conversely, Hawaii, Virginia, California, and Florida are the only states that have bases representing each of the five branches. Notably, landlocked states tend to lack naval bases. However, Ohio and Pennsylvania are exceptions, since they border the Great Lakes.


Types of military bases:
Army, Air Force, Coast Guard, Marine, Navy

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