Applying the MANifest Health Theory to Male Firefighter Lifestyle: A Conceptual Review Using the FANTASTIC Lifestyle Assessment

Abstract

Firefighters face substantial long-term health risks related to cardiovascular disease, sleep disruption, occupational stress, inconsistent preventive care, and lifestyle behaviors shaped by fire-service culture. Although firefighter health research has traditionally emphasized acute injury, sudden cardiac events, toxic exposures, and psychological trauma, less attention has been given to the broader lifestyle patterns through which chronic risk accumulates in both volunteer and career firefighters. This conceptual review argues that firefighter lifestyle should be understood as a men’s health issue shaped not only by individual behavior, but also by masculinity-linked role expectations, peer culture, organizational support, stigma, and the perceived legitimacy of self-care. The MANifest Health Theory is proposed as a useful framework for interpreting these dynamics because it centers the interaction of identity, social role, environment, and preventive health behavior. The FANTASTIC Lifestyle Assessment is further proposed as a practical multidimensional tool for operationalizing firefighter lifestyle within this framework. This paper advances a firefighter-specific conceptual model and outlines implications for research, prevention, and nurse-led men’s health practice.

The authors' abstract, as published at the source. American Journal of Lifestyle Medicine, 2026 · DOI ↗