How Healthy Are You?
EMS providers and firefighters are known for taking care of others. That often comes at the expense of taking care of themselves.
In fact, cardiovascular disease is the most common cause of on-duty death among U.S. firefighters, and poor nutrition and physical inactivity can greatly affect cardiovascular health. However, there have been few interventions targeted at the emergency personnel population that are designed specifically to improve overall health and wellness, let alone address cardiovascular risk. A recent joint study from the Johns Hopkins Bloomberg School of Public Health and the National Volunteer Fire Council sought to change that by looking at the health habits of eight Maryland fire departments.
The 115 participants were primarily volunteer firefighters, representing a cross section of Maryland’s volunteer fire service. Eighty-five percent of participants in the three-year study were male and their average age was 41 years old. Study participants engaged in focus groups designed to identify barriers to, and facilitators of, health and wellness among firefighters, and were enrolled in a pilot intervention program that included nutritional education sessions, peer advocates and tools for healthy eating.
Heather Schafer, executive director of the Maryland-based National Volunteer Fire Council (NVFC) and a coauthor of the study, spoke with EMS World about some of the group’s findings.
There’s a public notion that firefighters are very healthy. What was the motivation for the study?
HS: To look at ways in which the health interventions could help firefighters make healthy choices. And to see which health behavioral interventions would make the most difference and offer results for the firefighters.
Was there an indication from the predominantly volunteer firefighter participants that it’s in large part because they had outside full-time employment—in addition to their volunteer duties—that it was more difficult to maintain a healthy lifestyle?
HS: In general, whether they were paid firefighter or volunteers, finding enough time in their busy schedules to exercise and maintain a healthy lifestyle was difficult. And then on top of that, you’re right, volunteer firefighters typically have another whole commitment with their full-time paid jobs in addition to volunteering, training and responding to calls. So they did find it challenging to maintain a regular physical fitness routine and healthy eating habits because they’re away from home. Those things really weren’t shocking. But knowing they were under a time constraint, what could we do to help firefighters make a healthy choice in terms of fitness and what they were eating?
Did the study participants embrace the healthy and wellness interventions or was there resistance?
HS: The general sense was people felt there’s always room for improvement, so let’s be willing participants and see what happens. We held focus groups in different fire departments across the state of Maryland and the firefighters opened up and offered very intimate details about their own health and lifestyle. They were very forthcoming, which was so important in helping us figure out what we can do to help change particular habits and make better choices.
Beyond seeing the participating departments adopt healthier habits, what other outcomes emerged from the study that other fire departments and EMS agencies can learn from?
HS: A lot of what came out of it was very interesting and not expected. What the fire departments came up with on their own was they were having difficulty in choosing what to eat at the fire station. It really came down to mealtime at the fire station and making the right choices. They were finding it was real easy to order a pizza or just eat things that were convenient—like going to the vending machines, which didn’t have the healthiest choices. A couple departments decided to partner with local farmers’ markets to provide fresh produce for the department. And because they were basically having fresh produce delivered right to them at the station, the firefighters were eating it all up. That was the big surprise and created an interesting concept—of eating locally and fresh, and working with the local community to make sure they were making healthy choices. It was really a win-win and the farmers felt good about providing their food to those who were protecting their community. It was an interesting twist on what the whole research was about. And then, just in general, we found people who followed the Heart-Healthy Firefighter Program and made healthy choices, or a couple departments really exercised, had a scheduled routine and lost weight as a group. There were definitely departments that pulled together. Making sure you have a champion within your department who heads up the health and fitness area is so important. Having the buy-in of leadership—it really is top-down—and making sure the leader is on board with allowing time for the group to exercise together, or making it a priority, is really evident in this research.
