How Much Does Obesity Cost Your Fire Department?

By John Hofman

Sick time, modified duty, and on-line injuries are consistent staples in the fire service. Let’s face it: firefighting is a very physically demanding job, so injuries will occur. It only makes sense to have a health and wellness program to help reduce the chances of these things occurring. Yet many fire departments may not have the resource to incorporate one or, worse, still do not see the benefits of having one. During these hard economic times, it becomes difficult to justify such a program, especially when there are layoffs, cut backs, and brown-outs occurring all across the nation. So what do you do?

Most departments will spend time a lot of time developing a comprehensive wellness program that focuses on everything from policies for workout time at the station to medical screenings at the local medical center. Yet one important question usually goes unanswered: Who will oversee the program? This is an important question to answer because it will be the foundation of your program. In my experience, many departments started programs but were not able to maintain them for even one year. Fire departments usually take two approaches when determining who will oversee the program. They either place a chief, captain, or firefighter in a position to oversee the program, or they create a team of peer fitness trainers to collectively run the program. Both strategies have shown that a majority of the programs’ effects did not continue beyond one year; however, the long-term pattern of behaviors suggested these work sites as a whole were healthier more than three years following the interventions.¹ This should tell us that most health and wellness programs are not meeting their full potential. Worse yet, departments may not be getting any type of return on investment.

Do we assume that firefighters do not want to get healthier? No. In fact, they often want to know corrective strategies to help improve their health and wellness. In a study performed by the New York College of Osteopathic Medicine of the New York Institute of Technology, a total of 730 surveys were returned among a potential study population of 20,590 volunteer firefighters. More than three-quarters of respondents met the criteria for being overweight or obese, and nearly 40 percent reported having high blood pressure, high cholesterol, or both. Most respondents expressed at least some interest in attending a fire department-sponsored health lecture and participating in a fitness program.² This just proves to us that firefighters have a desire to learn more about risk-factor modifications and have fire departments take a more active role in helping them improve their health.

A comprehensive wellness program is a complex thing. It is more than just providing information to firefighters in regard to heart disease and exercise. For a program to be successful, its leader must be an individual with whom the firefighters can identify. This individual gives the program focus and a personality, which will allow him to change the culture. Researchers at Kent State University showed that physical fitness is an intricate, cultural construct, based on functional capacity and management expectations. Coronary heart disease is not a culturally relevant reason for workplace fitness program adherence. They concluded that fitness interventions must culturally adapt to the unique nature of the fire service, emphasizing functional capacity, crew dependability, and fitness/well-being strategies.

With that being said, would it make more sense to hire a certified coach to oversee the program for the long term? This idea should be approached as an investment rather than as an expense. Let’s take a closer look at how much an out-of-shape firefighter would actually cost the fire department. We know based on certain studies that there is a consistent relationship between obesity and absenteeism in the workplace. However, most studies have focused primarily on sedentary occupational groups, not firefighters. Researchers at the Institute for Biobehavioral Health Research examined the cross-sectional association between body mass index (BMI) and obesity and injury-related absenteeism.

BMI, body fat percentage, waist circumference; injury, and injury-related absenteeism were assessed in 478 career male firefighters. One hundred and fifteen firefighters reported an injury in the previous year and the number of days absent from work because of the injury. BMI was an independent predictor of absenteeism because of injury. Firefighters meeting the definition of class II and III obesity had nearly five the number of missed work days because of injury when compared to firefighters with class I obesity or those who were overweight. The attributable per capita cost of class II and III obesity-related absenteeism over the past year was $1,682.90 per firefighter, $254.00 per firefighter for class I obesity, and $74.41 per firefighter for overweight.³ This suggests that those listed in classes II and II are costing your fire department thousands or even hundreds of thousands of dollars per year.

Let’s just say for the sake of argument you were to pay a starting salary of $65,000 to a full-time, certified coach (not including benefits). All he would need to do is impact 38 employees in one year to justify the position. Now multiply that by a 30-year career. That’s a savings of $1,917,480.

Do you still think it’s an expense?

REFERENCES

¹ Long-term effects of a worksite health promotion program for firefighters,” J Occup Environ Hyg. 2010 Aug;7(8):477-82.

²Scanlon P, Ablah E. “Self-reported cardiac risks and interest in risk modification among volunteer firefighters: a survey-based study.” New York College of Osteopathic Medicine of New York Institute of Technology, Old Westbury, USA.

³ “Firefighter fitness, coronary heart disease, and sudden cardiac death risk,” Eur J Appl Physiol. 2011 Oct 29.

(4) Obesity and injury-related absenteeism in a population-based firefighter cohort. Biol Psychol. 2011 Apr;87(1):152-60. Epub 2011 Mar 5

John Hofman is the strength and conditioning coach for the Sacramento Fire Department, John oversees the Wellness Centre, coordinates the department’s medical and fitness assessments; develops recruit fitness training, pre-employment medical and fitness evaluations; and assists the department’s 20-certified Peer Fitness Trainers. In addition, John also works as the strength and conditioning coach for the California Regional Fire Academy, Sierra Fire Technology Program, Rocklin Fire Department, and South Placer Fire District. He also consults with the Fire Agency Self Insurance System of California.

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