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ImageTrend Connect: About Your Health…

Problems like stress and suicide risk continue to imperil first responders. As we struggle to get our hands around them, a crucial step is the development of data to more fully identify their causes, contributors, correlates, and manifestations. Obviously, we can’t manage what we don’t understand.

To that end ImageTrend last year released CrewCare, a mobile app designed to elicit “insight into life factors that may play a role in anxiety, burnout, depression, PTSD, and suicide.” At the ImageTrend Connect conference Thursday, the company released a report summarizing its first 15 months of resulting data.

More than 3,600 respondents characterized relevant aspects of their careers, physical health, support networks, sleep, stress, engagement, finances, and more. The results, described in various sessions by company epidemiologist Morgan Anderson, MPH, had some alarming aspects. Some high- and lowlights:


  • 88% of respondents delivered EMS; 43% indicated being in the fire service (multiple answers were allowed). Just 8% came from law enforcement and 1% were dispatchers.
  • 32% were divorced or separated.
  • 11% were veterans.


  • 75% reported having had someone act violently toward them at work.
  • 86% worked more than 40 hours a week on average.
  • Almost two-thirds had more than one job (in the general population that figure is less than 5%).
  • Of EMS providers, 18% characterized their job stress as severe or very severe.
  • Among EMS, 92% had struggled with mentally difficult calls; 36% still do.
  • Among firefighters, just 13% had never worried about cancer related to job exposures, while 29% reported doing so always or frequently.


  • Only 11% weren’t stressed about money.
  • 59% were “somewhat” or “really” stressed.
  • More than half weren’t comfortable with what they were saving for retirement.

Physical Health

  • More than a third said their overall wellness was fair or poor.
  • Almost a third used nicotine products.
  • Based on self-reported height and weight, 50% of respondents were obese by CDC standards.
  • 82% wanted to lose some weight.


  • More than half of respondents reported not belonging to any social groups; over a quarter rarely participated in social activities.
  • 50% reported having two or fewer close friends.


  • 36% felt they had the full support of their family; another 31% said their family was mostly supportive. But 13% said their families offered little or no support.
  • 20% felt they had little or no support from their coworkers and colleagues.
  • 30% felt they had little or no support from their boss.


  • 77% of respondents said they got less than the recommended 7-9 hours of sleep a night.
  • 15% averaged less than four hours.
  • 73% said they felt exhausted or burned out at least two days a week.


  • On a 0-10 scale with 10 being the highest, 56% of respondents rated the stressfulness of their job at 7 or higher.
  • 28% rated the stressfulness of their home life that high.
  • Main reported stressors were work/career (44%), finances (29%), and family (19%).
  • To cope with stress, 26% said they drank alcohol, 15% used tobacco, and 32% ate.

Mental Health

  • More than 30% rated their overall mental health as fair or poor.
  • Fewer than half felt their agencies offered sufficient mental health/EAP services.
  • 70% reported feeling down, depressed, or hopeless in the last 14 days.
  • 61% reported feeling bad about themselves, like failures, or that they’d let themselves or their family down.
  • 32% feared a negative impact if they asked for help; another 31% weren’t sure.
  • Only 41% would feel comfortable talking to a coworker about a mental health issue; for talking to supervisors, the number dropped to 30%.

Exhaustion and Disengagement

  • Using the Oldenberg Burnout Inventory, 72% of respondents had scores indicative of burnout.

Some standard caveats apply: All questions were optional, and not every respondent answered every question. The responding sample of emergency workers may not be indicative of the overall picture, and results may vary locally. All data were self-reported.

Still, there’s plenty to be concerned with in the results. ImageTrend continues to seek responses through the app to more fully flesh out these issues. For more, see

John Erich is senior editor of EMS World. 

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