Who Can Afford to Call 911?

by Olivia Zhu

As I wrote in a post back in June, reporting bias is a phenomenon that significantly detracts from the efficacy of potential predictive policing measures. Simply put, if underserved communities don’t trust the police and are less likely to report crime as a result, the resulting data is incomplete, inaccurate, and therefore useless when considering measures such as hotspot analysis or setting new patrol routes. This month, I’d like to explore a particular reason why underreporting of crime might occur, with a particular focus on socioeconomic factors that drive who can or is willing to call 911. PSAP_wide

It’s easy to make two major assumptions about 911. First, that 911 services are free, or at least are public services paid for by taxpayer money. And second, that they are consistent across the nation. After all, there’s a whole alphabet soup of government agencies that establish standards and rules for dialing 911, among them the Federal Communications Commission and the National Highway Traffic Safety Administration. Consider also organizations such as the National Emergency Number Association and any number of police, fire, and emergency medical service professional organizations to increase oversight and regulation of the service.

The first assumption is proven false by the fact that most states charge a 911 service fee. In theory, fees such as these feed into a Universal Service Fund intended to normalize 911 service across a coverage area, thereby reducing socioeconomic effects. However, the FCC collects this fee from mobile service providers, and while the “FCC does not require this charge to be passed on to you… service providers are allowed to do so.” That’s just for standard 911 calls. For Enhanced 911 (E911) calls, which provide latitude and longitude data for callers using cell phones instead of land lines, service providers may charge a fee as well. E911 calls are especially important given that most 911 calls today are made from mobile phones, not land lines, and without E911, it’s difficult for first responders to accurately locate callers. Let me add onto that.

The second assumption, that 911 services are consistent across the nation, hinges on the availability of E911 and the more advanced Wireless 911 Phases I and II across the nation. NENA’s county-by-county 911 deployment map (with color legend here) indicates significant swathes of the country only have basic, or possibly even no 911 services. That doesn’t even begin to speak to the fact that some public safety answer points (PSAPs), the call centers that handle 911 calls, may not be equipped with dispatch software that is E911 compatible. That is, even if someone calls 911 and location information is available, it may not be recorded or usable if the PSAP is running legacy software.

It’s actually this second point—about the consistency of 911 resources across the country—that I think is more critical here, for the simple reason that I assume all service providers are going to want to pass on those 911 service fees to their customers. This is a topic I’d like to explore further, but my guess would be that it’s the wealthier cities and counties (with the higher-earning tax base) that can afford E911 and Wireless 911 enhancements along with better PSAP equipment. So, already there are going to be socioeconomic inequalities here based on where a 911 caller lives.

Let’s add on to that the fact that there are cities and councils that are charging people who call 911 an additional first responder service fee—on top of what is already paid to the service provider—sometimes in the hundreds of dollars.

Now, there are startups that are trying to address the gaps in 911 service (related to location-finding or other infrastructural flaws) by providing location data via an app. BlueLight, the manufacturers of eponymous emergency call phones on campuses, have launched an app that connects dispatchers to callers faster in rapidly-gentrifying Oakland, and they are charging a $20 annual subscription for it. Essentially, BlueLight stratifies rapid 911 access to those who can afford a smartphone, its data plan, and the app subscription while taking pressure off local authorities to improve connectivity and location-identification—a double whammy. Then there’s BlueLight’s fast-emerging competitor, RapidSOS, which offers its location-providing emergency app for a monthly subscription of $2.99 for an individual (an annual subscription of $35.88). RapidSOS does provide fee waivers, but again, the issue of smartphone access and taking pressure off city and county governments still stands.

These factors add up. It’s noted in some studies that there’s correlation between insurance and employment status regarding willingness to call 911 for a stroke, although the main study at the link found no significant association between financial factors and willingness to call 911. Another study found that poorer communities that do call 911 for stroke treatment do experience “statistically significant delays in prehospital times,” although these time differences were relatively small and “living in a poorer area does not appear to delay access to acute care for stroke in a clinically significant way.” I’ll add a quick note to these studies to say that they do have to do with a critical medical emergency, not those regarding criminal activity or less serious medical concerns, so it’s possible that there are socioeconomic differences that manifest more clearly under those conditions.

In sum: 911 service is not equal across the country, and may depend on the wealth of a particular region. Individuals can be served an additional first responder service fee that may be too costly for poorer callers. On top of that, faster and more accurate 911 service can be obtained through expensive apps, and all these factors may contribute to socioeconomic imbalances that skew who calls 911 when they really need to.