PurposeThis study aims to investigate the relationship between emergency response times and crash severity in New York City, focusing on spatial disparities and their implications. It examines how these disparities impact disadvantaged neighborhoods, particularly regarding traffic safety and emergency service accessibility.Design/methodology/approachThe research uses comprehensive spatial analysis techniques, including hotspot mapping, network analysis for travel time modeling, local bivariate correlation analysis and service area calculations. It maps crash data alongside emergency facility locations, considering peak-hour traffic. The Area Deprivation Index (ADI) is integrated to evaluate socioeconomic factors influencing accessibility. This approach provides a nuanced understanding of how emergency response times correlate with crash severity at the census block level, accounting for socioeconomic disparities.FindingsThis study reveals significant disparities in emergency response times across New York City. In high-poverty, predominantly minority areas, response times are 2–3 min longer than average, correlating with a 15% increase in severe injury rates. Over 20% of neighborhoods show correlations between response times and crash severity, with positive linear (5.51%), negative linear (10.72%), concave (2.44%) and convex (2.80%) relationships. Blocks with positive linear relationships have a mean ADI rank of 3.918. During peak hours, 69.7% of Manhattan blocks show negative relationships, the highest among boroughs.Originality/valueThis research highlights spatial justice issues in urban emergency response systems, emphasizing the need for localized, data-driven planning and infrastructure adjustments. By integrating the ADI, the multifaceted approach reveals the complex dynamics of socioeconomic factors and emergency service accessibility that have not yet been investigated in diverse urban communities.