Firefighters are some of the most cherished members of the community.
They are heroes, putting their lives on the line in order to save people, property, and the environment. The job can be dangerous—even fatal—but firefighters willingly accept the risks to serve the public. Unfortunately, firefighters are more likely to die from lifestyle-related heart attacks than from any other job-related death.1
No one should ever have to question whether the death of a firefighter was due to an unhealthy lifestyle. The community expects firefighters to be physically fit, mentally fit, and ready to respond to any emergency or rescue anyone in need. Unfortunately, not all firefighters meet that expectation.2
Read More: Operational Intelligence for Health, Wellness, and Leadership
There are organizations around the United States addressing the health of firefighters, specifically trying to prevent heart disease, cancer, and suicide. For example, some organizations have advocated for firefighter deaths from cancer or suicide to be treated as job-related deaths (heart attacks are already treated this way). Fire departments and firefighters, however, must demonstrate that they are doing everything they can to stay healthy. This will ensure that fatalities are not the result of poor mental or physical health.
Firefighters are passionate about their job, as well as protecting and serving their community. Firefighters may naturally have more interest in one specialty over another, like enjoying search and rescue more than emergency medical services (EMS), but all firefighters should share one thing as a common passion—health and wellness.
Why is Health and Wellness Important?
We are what we repeatedly do. Excellence, then, is not an act, but a habit. —Will Durant
Durant’s quote, which paraphrases Aristotle’s teachings, sets the foundation for how you should think about health. To help us understand how this works, let’s break this quote down into two parts:
1. We are what we repeatedly do. This phrase describes that, as people, our present condition is the result of our actions.
2. Excellence, then, is not an act, but a habit. We don’t become excellent from one act; rather, it is from repeatedly choosing the right behaviors over time.
Firefighters should consider their health through the lens of Aristotle’s teaching. Health is not decided from one decision or action. It comes from a pattern of behavior repeated over time. We could easily rewrite Durant’s quote to read, “We are what we repeatedly do. Health, then, is not an act, but a habit.”
Defining Health and Wellness
Health is a snapshot of your body, mind, and soul, which is the result of your wellness efforts.
Health and wellness are not the same things. Merriam-Webster defines health as being sound in body, mind, or spirit.3 When you go to your primary care physician for a checkup, your physician will record metrics of your physical body at that moment in time. These metrics are used to determine if you are within a normal range or whether there is an indication of disease. Humans of all backgrounds, sizes, shapes, and conditions of physical fitness can have health metrics that fall within a normal range. Similarly, a mental health professional or spiritual counselor can make determinations as to whether a person is within a normal range or if there are abnormalities that may need to be addressed.
Wellness refers to the efforts you make to improve or maintain your health. Wellness efforts might include an exercise routine (physical activity); adherence to certain dietary standards (nutrition); habits that increase your knowledge, motivation, concentration, or mindfulness (psychology); and habits of love, forgiveness, and connection (spirituality). In other words, wellness is what determines the health of your component parts as a human. Wellness is the input, and health is the outcome.
The idea that health is brought about by wellness habits may sound too simple. It is true that some elements of life cannot be controlled, and in some instances no amount of wellness efforts will change a person’s health outcome. Some tragedies occur due to genetic mutations or exposure to toxins. However, your wellness efforts play a major role in your health, and as we hope to demonstrate in this book, the control you have over your health outcomes is worth knowing.
Defining Resilience
Resilience has become a buzzword in the health and wellness industry, as well as in the fire service. Resilience is related to health and wellness, but has its own specific meaning as well. Merriam Webster offers two definitions for resilience.4 The first pertains to the science of physics and defines resilience as the capability of a strained body to recover its size and shape. The second definition is more applicable to humans and defines resilience as the ability to recover from or adjust easily to misfortune and change. Perhaps because the word resilience is used for both physics and humans, different uses of the word have been adopted. Three common uses of resilience include the following:
1. The ability to bounce back5
2. Having more in the tank (i.e., reserves)6
3. The ability to overcome a challenge7
Bouncing Back
When we talk about resilience in terms of humans, it becomes clear that the first common use of the word is incomplete. Firstly, humans naturally change with age, but they can also change through wellness efforts. Steel might also change with age over time but cannot become more resilient like humans through wellness efforts. But “bouncing back” as a definition of resilience must be understood as a snapshot in time—like the definition of health—that can change since humans are dynamic, as opposed to steel which is relatively static.
Secondly, humans are not one-dimensional. Humans have a body, mind, and soul (or bio-psycho-social dimensions, if you prefer), and thus bouncing back would have to relate to more than just your physical body. Yes, you can bounce back if you push on your skin or muscles, and you can also bounce back if you get sick or injured. However, humans have a mind and a soul as well, and so the idea of bouncing back would have to account for those dimensions as well. Two individuals could have the same physical resilience but different mental or spiritual resilience, and that could determine if someone bounces back or not.
Lastly, if bouncing back is the only aspect of resilience, then the saying, “If you get knocked down seven times, stand up eight,” makes sense. But if you are in a boxing ring and Mike Tyson is the one knocking you down, then continuing to stand up may eventually lead to your death! Calling a person resilient in a situation that may lead to death, when there are better options to help you survive, misses the point. In fact, another saying may be more appropriate for that example: “Insanity is doing the same thing over and over and expecting a different result.”
Notes
1. Rita F. Fahy, U.S. Firefighter Fatalities Due to Sudden Cardiac Death, 1995–2004 (National Fire Protection Association, 2005); Elpidoforos S. Soteriades et al., “Cardiovascular Disease in U.S. Firefighters: A Systematic Review,” Cardiology in Review 19, no. 4 (2011): 202–15, https://doi.org/10.1097/CRD. 0b013e318215c105.
2. Justin Yang et al., “Sudden Cardiac Death Among Firefighters ≤45 Years of Age in the United States,” The American Journal of Cardiology 112, no. 12 (2013): 1962–67, https://doi.org/10.1016/j.amjcard.2013.08.029.
3. Merriam-Webster, s.v. “health (n.),” accessed July 14, 2023, https://www.merriamwebster.com/dictionary/health.
4. Merriam-Webster, s.v. “resilience (n.),” accessed July 14, 2023, https://www.merriam-webster.com/dictionary/resilience.
5. Merriam-Webster, s.v. “resilience (n.)”; Dictionary.com, s.v. “resilience (n.),” accessed July 14, 2023, https://www.dictionary.com/browse/resilience.
6. Peter Rapp and Molly Wagster, “Cognitive Reserve Research Reaches for the STARRRS,” Inside NIA, July 19, 2019, https://www.nia.nih.gov/research/blog/2019/06/cognitive-reserve-research-reaches-starrrs; “Home,” Reserve and Resilience, accessed July 14, 2023, https://reserveandresilience.com/; Eleanor Balme, Clare Gerada, and Lisa Page, “Doctors Need to Be Supported, Not Trained in Resilience,” BMJ 351 (2015): h4709, https://doi.org/10.1136/bmj. Carolyn Emily Schwartz et al., “Is the Link Between Socioeconomic Status and Resilience Mediated by Reserve-Building Activities: Mediation Analysis of Web-Based Cross-Sectional Data from Chronic Medical Illness Patient Panels,” BMJ Open 9 (2019): e025602, https://doi.org/10.1136/bmjopen-2018-025602.
7. “Resilience,” American Psychological Association, accessed July 14, 2023, https://www.apa.org/topics/resilience; Andrea Ovans, “What Resilience Means, and Why It Matters,” Harvard Business Review, January 5, 2015, https://hbr.org/ 2015/01/what-resilience-means-and-why-it-matters; David Fletcher and Mustafa Sarkar, “Psychological Resilience: A Review and Critique of Definitions, Concepts, and Theory,” European Psychologist 18, no. 1 (2013): 12–23, https:// doi.org/10.1027/1016-9040/a000124; Steven M. Southwick et al., “Resilience Definitions, Theory, and Challenges: Interdisciplinary Perspectives,” European Journal of Psychotraumatology 5, no. 1 (2014): 25338, https://doi.org/10.3402/ ejpt.v5.25338.
Gamaliel Baer is a firefighter/EMT and special operator for Howard County (MD) Fire and Rescue. He currently serves as a U.S. Coast Guard Reserve officer and is a volunteer for the National Fallen Firefighters Foundation. He is credentialed by the Center for Public Safety Excellence (CPSE) as a Chief Training Officer (CTO), and by the American College of Exercise (ACE) as a certified health coach and a certified personal trainer. Dr. Baer serves as adjunct faculty at Johns Hopkins University where he teaches Leading and Managing Change for the Master of Science in Organizational Leadership. Dr. Baer earned his Bachelor of Science in Marketing and International Business at the University of Maryland, College Park. He earned his Master of Science in Management from Johns Hopkins University, and he earned a Doctor of Education in Organizational Leadership from the University of Southern California. He lives in Howard County, Maryland, with his wife and four children.
