Emergency Medical Services (EMS) is provided in a variety of different ways in the United States. Methods of service delivery range from the purely private to the completely public and include mixtures that are not clearly one or the other. Based on a review of the literature, this variation is hypothesized to reflect, in part, variation in community characteristics. Using localities in the Commonwealth of Virginia, this hypothesis is tested by examining the characteristics of forty-seven communities in which emergency medical services are provided. Survey research was used to explore the association between public or private provision of EMS and five variable clusters: socioeconomic, medical resources, geographic, governmental, and unique local resources. Analysis of these variable clusters resulted in the conclusion that there is a statistically significant difference between the characteristics of communities with public service provision and the characteristics of communities with private provision. Thus, it seems highly likely that the public-private variation in EMS service delivery reflects to a certain extent differences in the communities themselves. Socioeconomically advantaged, urban communities with quick access to a large number of medical facilities are more likely to provide EMS through private means. On-the-other-hand, relatively socioeconomically disadvantaged, rural communities with fewer medical resources are more likely to publicly provide EMS service. The fact that this relationship between the characteristics or nature of the community and the method of service provision exists raises several issues. It indicates that rural communities are carrying the burden of public service provision while more urban areas have been able to recover some costs. It also raises the issue of service provision to the indigent in urban areas, since we are unsure as to whether or not a fee structure inhibits utilization by the poor. The relationship between access to the EMS system and the selection of a financing strategy of service provision deserves investigation. Perhaps most importantly, this effort points out how little we know about emergency medical services in the larger context of municipal services. / Master of Urban and Regional Planning