Health & Wellness in Fire & Emergency Services

The fire service is full of people who will sprint toward danger without hesitation, but we rarely talk about what the job quietly takes from us over 20 or 30 years. Host Kevin Ferrara dives into the culture of wellness in fire and rescue, and why the old “tough it out” mindset is not just outdated, it is costing careers and lives.

We break down the physical realities that outsiders never see: the constant redline of adrenaline when the tones drop, the heavy gear and awkward movements that destroy backs and shoulders, and the cardiovascular risk that remains one of the leading causes of firefighter line of duty deaths. Sleep deprivation gets a hard look too, not as a bragging point, but as a health and safety problem that wrecks immune function, slows reactions, and piles onto other concerns like PFAS exposure and cancer risk.

Then we move into the part many stations still avoid, the mental load. Using the “backpack of rocks” metaphor, we talk about cumulative trauma, burnout, depression, and the heartbreaking suicide reality among first responders. A real firefighter wellness program cannot treat behavioral health like an afterthought. It needs peer support, trusted access to culturally competent clinicians, and routine check ins that are as normal as checking your SCBA.

Finally, we get practical: what a structured, comprehensive health program looks like on the ground, built on occupational medical screening, functional fitness and injury prevention, behavioral health, and nutrition that fits station life. We also make the cost argument for chiefs, city managers, and policymakers: the real question is not “how much does it cost,” but “how much is doing nothing already costing” in workers’ comp, overtime, and lost expertise. If this hits home, subscribe, share it with your crew or a decision maker, and leave a review with one change you want to see in your department.

DISCLAIMER

The views, information, or opinions expressed by guests during this podcast are solely those of the individuals involved and do not necessarily represent those of AFSO21's Weekend Wrap-up Podcast and its hosts. Furthermore, any views or opinions expressed by guests are their own alone and unless otherwise stated, do not reflect the opinions, beliefs, or official policies of any organization, institution, or employer they may be associated with or employed by. 

Transcript

SPEAKER_00 0:04

Welcome everybody. You're listening to Episode 21's Weekend Wrap Up Podcast. Here is your host, Kevin Ferrar. Welcome everyone to another episode of the Weekend Wrap Up Podcast. I'm your host, Kevin Ferrar. Folks, grab a coffee, pull up a chair, or if you're listening to this on a long drive or a walk, welcome to the show and thanks for listening. Today we're diving into something that,

Why Wellness Now

SPEAKER_00 0:33

well, hits incredibly close to home for anyone in the fire emergency service world. And quite honestly, should matter to anyone who cares about the people who show up on their worst day. We're talking about the culture of wellness in the fire and rescue services. More specifically, why we absolutely have to move past the old school mentality of just, well, toughing it out and embrace a structured, comprehensive health program. Now, I know what some of the old Salts out there listening are going to think when they hear wellness program. They're probably picturing right now someone handing out a bag of kale chips and making them do yoga in the apparatus bay. But that's not what this is about. It's about survival, period. It's about ensuring that the people who risk their lives to save others, those of you listening to this podcast right now, actually live long enough and healthy enough to enjoy their own lives when they put put the gear away for good. So as we break this down, let's look at the physical toll, the hidden mental battles, how the culture is changing, and what a real working structured wellness program might look like on the ground. So let's get started with the obvious stuff, the physical grind. When you see a firefighter, what do you typically see? Heavy gear, tools, apparatus? Looks pretty heroic, right? But what people don't see is the compound interest that the job takes on the human body. Compound interest? We talk in financials, Kev? What are we what are we talking about? Think

The Physical Grind And Heart Risk

SPEAKER_00 2:23

about it like an old pickup truck. If you take that truck and you constantly redline the engine, slam on the brakes, drive that truck through the mud, never change the oil, what happens? Well, it's probably going to break down way before it's it's time, right? In fire emergency services, we live in a state of constant, unpredictable redlining. You're sitting at the station, maybe you're midway through a meal, maybe trying to get 20 minutes of shut eye in. Suddenly the tones drop. Your heart rate doesn't just climb. It skyrockets from zero to a hundred in seconds. That sudden spike, well, that causes a massive rush of adrenaline. Doing that once or twice, sure, your body can probably handle it. But doing that thousands of times over a 20, maybe 30 year career, well, that changes the game. Historically, we've treated our people like expendable machinery, asking, hey, are you hurt? No? Well then get your ass back on the rig. The data about our bodies is finally catching up with us, and it's telling a pretty stark story. Firefighters are facing cardiovascular events at a rate that should shock everyone. In fact, heart issues are consistently one of the leading causes of line of duty deaths amongst firefighters. It's not always the fire itself that takes a firefighter, it's the intense strain the fire puts on the heart. And then there's the sleep factor. Sleep deprivation is almost treated like a badge of honor in some stations. How many times have you heard, man, we ran 10 calls last night, didn't sleep a wink? Bet you'd just laugh it off, wouldn't you? But would it surprise you to know that chronic lack of sleep destroys your immune system, messes with your metabolism, and slows your reaction times. You've heard it in another episode, Dr. Graham Peasley and I speak about PFAS and turnout gear. Something I often speak about is how PFAS attacks and destroys the immune system in the human body. So if chronic lack of sleep can destroy your immune system, and then you put on turnout gear that contains a substance that destroys your immune system, what do you think is eventually going to happen? That's right. You're more prone to become sick, might even develop cancer at a younger age. So if a commercial airline pilot or a semi-truck driver work the hours some firefighters and EMS personnel work without mandatory rest, it'd probably be illegal, right? Yet we expect our first responders to make split-second life or death decisions while running on fumes and maybe their third energy drink. A structured wellness program can changes the narrative from reactive to proactive. It means we stop waiting for someone to have a cardiac event on the fire ground before we start talking about cardiovascular health. It means putting tools in place to monitor health before it becomes a crisis. So let's shift to the part we often don't like to talk about as much, the mental side. For decades, the unwritten rule in emergency services was simple. Leave the job at the door. You see something terrible. Well, you may head out and wash the truck, you probably make a joke, and then you move on to the next call. It was a coping mechanism, sure, but it's a toxic one long term. So imagine your

Cumulative Trauma And Suicide Reality

SPEAKER_00 6:18

mind is a backpack. Every bad call, every difficult medical scene, every loss, those are rocks. You put a rock in the backpack, you carry it for a while, and you might even feel strong carrying it. But if you keep adding those rocks and you never take the backpack off to empty it out, eventually your shoulders are going to begin to drop, your legs are starting to weak, your knees will buckle, and suddenly you find yourself laying flat on the ground. First responders witness more trauma in a single year than the average person does probably in their entire lifetime. We're engineered to handle acute stress, the immediate fight or flight response. What we aren't built for is chronic cumulative trauma without a release valve. So that leads to burnout, anxiety, depression, and worse. The rate of suicide among first responders is a heartbreaking reality that the industry is finally starting to confront. For a long time, asking for help was viewed as a weakness. If you admitted you were struggling with a call, you worried your crew might not trust you on the next, or that leadership might pass you over for promotion. So what did you do? You kept it contained, you kept it to yourself. But the true strength isn't pretending you're bulletproof. True strength is recognizing when the backpack is getting too heavy. A structured wellness program must have mental health poured directly into its foundation. It can't be an afterthought. It shouldn't be a phone number on a dusty break room bulletin board for an anonymous hotline that, well, a lot of people may not trust. It needs to be peer support teams, people on your own shift who know the smell of smoke, who have been there, who can say, hey man, you look a little off today. You want to talk? It needs culturally competent clinicians who actually understand what a firefighter's daily reality is, that being vastly different from a typical corporate office environment. If these programs are so obviously necessary, then why doesn't every department have one, especially our volunteer departments? Well, if you spent five minutes in a fire station, you know the old joke. The two things firefighters hate most are the way things are and change. Tradition is the backbone of the fire service. It keeps us connected to the history of the craft, and it builds incredible camaraderie. But tradition can also

Culture Change And Trust

SPEAKER_00 9:00

be an anchor that holds us back. There's still a lingering culture of machismo that views wellness initiatives with suspicion. When a department introduces a wellness program, the initial reaction from the floor is often, great, what are they trying to catch us on now? Is this a fitness test to the fire to fire the older guys? Or is this just management trying to micromanage my life? Trust is the currency of the station. If the leadership wants a health program to succeed, it can't be handed down as a top-down punishment. It has to be built collaboratively. You need the buy-in of the local union, the shift captains, and well the respected veterans of the bay. We also have to change how we talk about fitness. For a long time, fire department fitness meant lifting heavy weights in a poorly ventilated station gym while listening to 80s rock music. But being strong in a static gym, well, that doesn't necessarily mean you're fit for the job. Firefighting requires functional capacity. It's often mobility, flexibility, core strength, and endurance. It's about being able to crawl on your stomach with 80 pounds of gear while dragging a hoseline, maybe a victim, without tearing your shoulder or throwing out your lower back. When you show that 20-year-old rookie that learning proper lifting mechanics will keep them from having a chronic back injury by age 35, they're likely to listen. When you show a 50-year-old captain that working on mobility will let them play with their grandkids when they retire, they're likely to listen. It's all about framing it around longevity, not just compliance. So let's get practical for a moment. If we were to build the ultimate gold standard health and wellness program for a department tomorrow, what do you think it may include? Well, at its core, it should rest on four distinct pillars. The first being functional medical evaluations. And we're not talking about just a standard doctor's visit where they check your reflexes and send you on your way in less than 15 minutes. We

Four Pillars Of A Wellness Program

SPEAKER_00 11:18

need occupational medical exams tailored to the specific risks first responders face, that being early screening for cardiovascular issues and cancer screenings. Because of the materials burning in modern fires, firefighters are exposed to a cocktail of toxins. Therefore, early detection saves lives, plain and simple. The second pillar is physical fitness and injury prevention. Having designated peer fitness trainers within the department. These are regular firefighters who actually get some extra training to help their peers move better, eat better, and recovery from injuries. And folks, these these are not enemies within a department. They're not moles to target anybody. They're there strictly to help you get better. And it shouldn't be about passing or failing. It should be about continuous improvement. That's what these individuals that go to this training to get educated on and they bring it into the department. The third pillar is behavioral health support. Normalizing mental health checks. Just like we check the gauges on our SCBA, we should be checking the gauges on our mental state. This means regular training on stress management, sleep hygiene, and easy, stigma-free access to professional help. And the fourth pillar, nutrition and fueling. Education on how to fuel the body for unique demands of the job. We know station cooking is legendary, but it's traditionally heavy, greasy, comfort food. You can still have incredible station meals that don't leave the crew feeling sluggish and bloated when the tones drop 20 minutes later. So having maybe a dietitian come in. Again, these are not the enemies. They're there to improve your health and wellness. Have them come in and, you know, do some in-house cooking right there in the station with what you have and show, look, you can have these quick meals. They're still healthy. They're still going to give the give you the energy you needed for the job. And overall, you're going to you're going to to maybe lose weight. And you're, you know, you're going to reduce the risks of cardiac diseases. But, you know, at the end of the day, implementing any of this requires investment. And we're not talking about just money. We're talking about time. Departments have to give their personnel the time during their shifts to focus on these areas. So if you tell a crew they have to work out, but they can only do it after running 20 calls on an 18-hour shift, well, that's not going to work. It has to be built into the daily routine. And I know this from experience because when I was still active duty in the Air Force, they implemented workout programs that had to be done during normal duty hours. And there was a lot of pushback, especially from the civilian firefighters, that said, hey, you know, you know, I when do we have time on shift to do this during normal duty hours? You want us to do this, you want us to do that. You know, when when when are we going to have time to do this? So, you know, a lot of firefighters were doing it on their off time, but then the civilians said, Hey, hold up. Civilian unions got involved and said, Nope, that's our downtime. You can't make us work out, you know, on our on our downtime. It has to be done during normal duty hours. So it took a while. Again, it goes back to that, you know, hesitant to change mentality within the fire service. But, you know, eventually, firefighters came around. They said, hey, you know, this is great. You know, we're working out during normal duty hours. It gives us more time during our downtime to do, you know, uh professional development and some other things. So eventually it worked out, but leadership has to keep on it, and everybody has to participate in that in those programs. So now let's let's keep moving on. Let's talk to the decision makers for a second, the chiefs out there listening, the city managers, the politicians who hold the purse strings. Because whenever you propose a program like this, willing to bet the first question is always, how much is this going to cost us? And in all honesty, that's the wrong question. The real question you should be asking is, how much is not doing this costing us

The True Cost Of Doing Nothing

SPEAKER_00 16:00

right now? So every time a first responder goes out on a long-term worker's compensation due to a preventable back injury or a stress-related illness, who pays? Well, the community ultimately pays. The department pays in overtime to cover their shifts, and you may end up paying increased insurance premiums. And you also pay in lost expertise and mentorship that you simply can't buy back. You know, once those individuals are off shift, and you know, it could be short term, could be long term. You know, once the once that knowledge is gone, it's it's out of the out of the station, it's gone. You you know, it's it's very it's almost impossible to buy that back. So the the data from departments that have invested heavily in wellness programs, it's quite clear. We're seeing a massive drop in lost work days. We see fewer catastrophic events, we see workers' comp claims plummeting. And you know, so when you treat your people like elite tactical athletes, which is really what they are, they perform better, they stay healthier, and they stay on the job longer. But beyond the dollars and cents, there's a moral obligation. If a city or a community asks a group of men and women to put on a uniform, step into burning buildings, cut people out of wrecked cars, and handle humanity's absolute worst moments, the community owes it to them to protect them in return. Protection isn't just buying a shiny new fire truck. It's protecting the human being sitting inside those trucks. So as we wrap up this episode, I want to leave you with this thought. Fire emergency services are changing. We we know that, and it's changing for the better. The old days of pretending that nothing bothers us, that we don't need sleep, and that we can live on fast food and adrenaline, those days are thankfully drawing to a close. True leadership in fire emergency services today, it's not about who can scream the loudest on the fire ground

Leadership Legacy And Personal Habits

SPEAKER_00 18:13

or who can take the most punishment. It's about who takes care of the team. So if you're a chief or a captain listening, building a structured wellness program is the most impactful legacy you can leave. Long after you're gone, the culture of health that you establish will keep protecting your people long into the future. And if you're a firefighter or EMS provider out there listening, take care of yourself. Check in on your partner or partners. Excuse me, eat a little better today. Get off those recliners and move a little better. Get into the gym. You know, just walk around the station. You know, just be mobile and don't be afraid to clear out that backpack when it gets too heavy. Believe it or not, your community does need you on the line. But more importantly, your family needs you at the retirement party. Healthy, happy, and whole. So, folks, that's gonna do it for this episode. And I want you to take what you heard today and talk about it amongst your coworkers, your leadership. Hold an informal discussion in the training room or at the dinner table tonight. But no matter what, talk about wellness. So, with that, thanks for hanging out with me. Stay safe out there, take care of each other, and I'll catch you on the next one.