TITLE:
The Paradox of Pre-Crash Determinants: Analyzing the Disconnect between Ambulance Response Times and Traffic Fatality Rates in Saudi Arabia
AUTHORS:
Md. Mazharul Hoque
KEYWORDS:
Road Traffic Fatalities, Ambulance Response Time, Pre-Crash Determinants, Emergency Medical Services (EMS), Traffic Safety Paradox, Saudi Arabia, Regional Disparities, Road Safety Infrastructure, Primary Prevention, Secondary Prevention
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.14 No.2,
February
11,
2026
ABSTRACT: This study investigates the paradoxical relationship between ambulance response times and traffic fatality rates across Saudi Arabia’s 13 administrative regions in 2024. Contrary to conventional expectations of a positive correlation, the analysis reveals a weak to moderate negative association, indicating that faster emergency medical services (EMS) responses do not necessarily translate into lower mortality from road traffic collisions. The “Aseer-Tabuk Paradox” exemplifies this disconnect: regions with rapid ambulance responses (e.g., Aseer) recorded among the highest fatality rates, while slower-response regions (e.g., Tabuk) also exhibited elevated mortality. Instead, the findings underscore the dominant role of pre-crash determinants—such as road design, driver behavior, and accident severity—in shaping fatality outcomes. Additionally, a strong positive correlation was observed between investment in internal road safety infrastructure and faster in-city ambulance response times, highlighting infrastructure’s dual function in accident prevention and emergency access facilitation. The study advocates for a holistic, two-pronged road safety strategy that equally prioritizes primary prevention (pre-crash interventions) and secondary response (post-crash care optimization). By shifting policy focus from EMS-centric approaches to integrated, regionally tailored measures, this research provides evidence-based insights for enhancing national traffic safety frameworks in Saudi Arabia and similar contexts.