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Evolution of Health and Wellness in North Carolina’s Fire Service

Evolution of Health and Wellness in North Carolina’s Fire Service

North Carolina has always strived to deliver the highest quality of fire training to its emergency service family. Year after year, we remain among the top states for offering IFSAC accredited fire and rescue certification programs. The folks at the North Carolina Office of State Fire Marshal (NCOSFM) have worked diligently to provide exemplary training to the dedicated men and women who protect and care for our communities. Throughout these endeavors, it came to our attention that perhaps we were overlooking something extremely important- protecting and caring for our own.

According to the United States Fire Administration, 1,050 firefighters lost their lives in the line of duty from 2004-2013. Of these fatalities, 45% were attributed to heart attack. 60% of those who suffered these fatal heart attacks were between the ages of 41 and 60. Even more astounding is the fact that 13.8% of heart attack deaths occurred in firefighters under the age of 40. Clearly this is, and has been an issue plaguing our emergency services nationwide for decades. Staff members of the NCOSFM investigated this data a bit further to discover North Carolina held the lamentable rank of 3rd in the nation for losing the most firefighters to heart attack over the last 10 years. We decided it was time to quit talking about statistics and take action.

The topic of health and wellness is a very personal issue.


Take one look around your organization and you will more than likely identify at least one individual whose health may be hindering their performance and/or safety. How do you tactfully address this issue? How does a chief officer advise a passionate volunteer member that he or she should seek a doctor’s approval before continuing to provide service in their beloved community? How do you avoid ridicule when offering yoga or stretching to firefighters as a preventive measure for muscle strains and sprains?


Although difficult to imagine now, when the idea of a health and wellness program for firefighters was first pitched to our state fire training administrators, it was vehemently challenged. Time and time again, our requests were met with the idea that “health and wellness is not relevant to the fire service”. Thankfully, our staff is gifted and cursed with tenacity. As with any new business idea, we knew we needed to prove several things:


1. A clear need for the training

2. Tangible interest

3. Positive results.

The first item was easy. The fact that North Carolina loses more firefighters to heart attack each year than 94% of the country is rather persuading. The second and third items took a bit of effort; however, once initiated they proved to be the stimulus for major change.

The Timeline




  • We introduced health and wellness “Quick Drills” to our online “Pocket Tools Training” resource site. These “drills” were short, informative, downloadable documents offering tips on fitness and nutrition.


  • We developed training videos geared towards a popular firehouse topic: cooking. Our “Healthy Cooking” show featured healthy modifications for common firehouse meals. Utilizing YouTube as a host for these videos, we were able to monitor the activity level and number of views. Fortunately, the numbers provided solid evidence of an interest in health and wellness training.



  • We developed a 4-hour training course titled “Firefighter Health and Wellness”. The basic outline included: physical fitness, nutrition and emotional/mental health. Staff members used items from home to make classroom props that illustrated significant nutritional lessons.


  • We invited the spouses of firefighters to attend the courses in an effort to encourage social support of healthy lifestyle change. (In retrospect, our initial classes weren’t broadly advertised). Word of mouth quickly transformed this grassroots effort into a widely accepted and demanded course. At that time, we only had one staff member providing this specialized instruction for the entire state.


  • Grant funding from the National Fire Academy (NFA) was to expand the program to include additional instructors, visual aids and a psychomotor component related to fitness. This funding is intended to offer NFA certification programs to state organizations.


  • We identified three NFA curricula that directly addressed firefighter wellness: The Incident Safety Officer, Health and Safety Officer and Department Health and Wellness courses. From those, we designed a week-long program dedicated to fire service health and wellness that included nutritional education, physical fitness education, pre-class workouts, stress management education, access to certified personal trainers and a multitude of health, wellness and safety resources for students to take home.



In 2013, the National Fire Protection Association (NFPA) released revised editions of 1001 Professional Qualifications for Firefighter and 1006 Professional Qualifications for the Technical Rescuer. As part of the NFPA revision cycle, NCOSFM staff traditionally works to update existing certification coursework to reflect changes with the respective revised standards. With the concrete evidence of interest and support for health and wellness initiatives from our state’s fire service, we saw this as an opportunity to implement something permanent.


Oftentimes in our business, it is common to see a trend, phase, or fad float through the ranks. In efforts to sidestep this fate for health and wellness training, staff members proposed the addition of an official health and wellness course to our existing firefighter and technical rescuer certification programs. In vast contrast to the attitudes of previous, our state fire training administrators accepted the proposal unanimously.


As a result, all North Carolina emergency responders seeking certification as a Technical Rescuer or Firefighter must complete the Health and Wellness course. The following modules are included in the eight hour course:


Lesson One: Injury, Death and Disease Trends

Lesson Two: Physical Fitness

Lesson Three: Nutrition

Lesson Four: Behavioral Health



Nothing has delighted the hearts of our staff more than receiving emails from firefighters who participated in our program. They continue to cite the positive difference it has made in their health, lives and job performances. Age old wisdom suggests that timing is everything. This was certainly true with our quest to require health and wellness training for North Carolina fire and rescue personnel. It is our hope that through this endeavor, our culture will change towards that of health promotion. Much like the evolution of seat belt use, we hope that future generations of firefighters will see maintenance of physical fitness and healthy food choices as the norm instead of the exception.

This article was written by Firefighter Functional Training Panel guest blogger Heidi Heavner, NC OSFM. Heidi Heavner is a 15-year member of the fire service. She currently works for the North Carolina Office of State Fire Marshal in Research and Program Development. Her specialties include development of new coursework, revision of existing programs and development of online emergency service training. Heavner holds an Associate’s Degree in Health and Fitness Science and is certified as a personal trainer through the American College of Sports Medicine. Heidi is a Level II Fire Instructor, and holds qualifications in the areas of Live Fire, L.P Gas, and Driver Operator. Heidi can be contacted via email at .

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