Access to emergency care in rural Illinois before and after Next Generation 911 upgrades

Timely access to trauma and urgent medical care within the “golden hour” is critical for survival and recovery in emergency situations. In rural Illinois, geographic barriers, hospital closures, and fragmented emergency communication networks have historically contributed to disparities in emergency care access. This study evaluates whether the implementation of Next Generation 911 (NG911) upgrades improves spatial and temporal access to trauma and urgent care facilities across rural regions of the state. Using geospatial network analysis, service area delineation, and isochrone modeling, we compared emergency travel times under legacy 911 networks with those under NG911-enhanced systems. Road network data, address points, hospital and trauma center locations, and gridded population estimates from WorldPop were integrated into a geographic information system (GIS) environment. We measured changes in the proportion of the rural population with access to Level I and Level II trauma centers within 30, 45, and 60-minute thresholds. Results show that NG911 upgrades significantly expand coverage within the golden hour, particularly in counties with sparse populations and limited health infrastructure. Populations previously outside 60-minute travel thresholds experienced marked improvements in accessibility, although disparities remain for extremely remote communities. The findings underscore the role of NG911 in enhancing rural health equity, while also highlighting the continued need for complementary strategies such as telemedicine, air ambulance expansion, and regionalized trauma system planning. This research contributes evidence to policy discussions on rural emergency preparedness and underscores the potential of spatial analysis for evaluating health system interventions.