Firefighter perspectives on occupational and behavioral causes of obesity: A qualitative study

As part of the FORWARD study (Choi et al., 2011), we investigate the work-related and behavioral causes of obesity from the perspective of firefighters. Qualitative approaches to building theory prioritize and privilege the knowledge of those living or working in their everyday worlds and as part of a participatory action research process can enhance “research-to-practice” goals. Firefighters have a unique set of working conditions and are generally considered a health-conscious population, yet rates of obesity, cardiovascular disease (CVD) risk factors and heart attacks on the job are high. Very little research has been published investigating the work-related and health behavioral causes of obesity among firefighters' and almost no research draws on firefighter knowledge of the work environment. We conducted four focus groups with a total of 20 firefighters of every rank (firefighters/engineers, captains, and battalion chiefs), from a regional fire authority in California, with the intent of generating qualitative data about the health behavior and occupation-related causes of obesity as well as developing a firefighter-specific work and health questionnaire. Firefighters responded candidly with ideas about the causes of the high rates of obesity among them. Analysis revealed five main “themes” of central importance to firefighters: 1) the culture of eating, 2) sleep interruption, 3) leadership and physical fitness, 4) sedentary work, 5) aging and generational differences. The findings suggest a strong interrelationship between occupational and behavioral causes and implications will be discussed relative to the ongoing FORWARD study and to future interventions.