BackgroundValuable insights on the health and behavior of transit workers can be obtained from qualitative research that considers the social environment, which affects job performance and determines levels of perceived stress. MethodsUsing a grounded theory approach, semi-structured interviews were conducted with American transit workers (n=32). Recorded interviews were transcribed and analyzed using a constant comparative method. ResultsParticipants described categories related to entrenched organizational practices, particularly managements' leadership style, which created an atmosphere of distrust. High demanding work schedules, as a result of technological advances, were discussed in relation to diminished breaks, fatigue, and unhealthy diets. Transit workers also attributed increased work demands and irregular working hours to compromised time with family and friends. ConclusionsThe described barriers to positive health behaviors and social support underscore the need for interventions that ensure adequate breaks and recovery between shifts and increase safety for transit passengers. Am. J. Ind. Med. 60:350-367, 2017. (c) 2017 Wiley Periodicals, Inc.