Healthy crew, healthy life: The captain’s role in commercial fishing crew health

Objectives Commercial fishermen engage in one of the most dangerous professions in the United States. This qualitative study explored how the internal priorities of commercial fishermen captains influence the health and well-being of their crew members. Methods Data were collected via semi-structured qualitative interviews conducted under the 2025 Southeast and Gulf Coast Fishing First Aid and Safety Training program. Commercial fishermen and individuals working adjacent to the industry (n = 10) were recruited using purposive sampling. Using a priori qualitative coding, two coders performed a thematic analysis using ATLAS.ti. Results Overall, participants reported that crew health and wellness were affected by the captain’s attitudes. Participants (40%) explored crew preparedness as a central theme in captains’ approaches to crew well-being, with the captain’s knowledge of pre-existing conditions allowing for a proactive approach to medication management and injury/illness reduction (30%). Some (20%) highlighted a conflict of priorities between crew productivity and well-being or observed that captains’ attitudes towards zero-tolerance policy against substance use would influence substance use onboard the vessel (20%). Conclusion Preparing captains and crew members with safety knowledge and skills can mitigate predictable hazards. These findings highlight the importance of continued research and programming surrounding proactive health management among commercial fishermen captains.