What are the biggest challenges to male health in Tennessee? As one of the only states that publishes regular reports on the topic, Tennessee is in a unique position to tell males exactly what they need to look out for — if they’ll heed the warning.

“I think we tend to feel bulletproof, at least until our 40s or 50s,” says Dr. Ian Bushell, a family medicine physician and medical director for BlueCross BlueShield of Tennessee. “We don’t think or worry too much about maintaining our health until we have a problem or a loved one steps in.

“We can change that — we need to change that — starting by talking about it. We’ve got to make it normal for males to find a primary care provider (PCP) they trust. If it helps, think of it as an insurance policy. You probably get your car maintained regularly, and you know exactly where to take it when there’s a problem or emergency. We’ve got to be doing the same for our bodies and our health. But for the roughly 30% of males in Tennessee who don’t have a PCP, we know that’s not happening.”

Here are 7 key findings from the most recent Tennessee Men’s Health Report Card, as well as advice from Dr. Bushell on how you can use that information to improve your health.

1. Heart disease is still the #1 cause of death for White, Black and Hispanic males in Tennessee.

Heart disease is the leading cause of death for males in East, West and Middle Tennessee. Twenty-five percent of men die from heart disease in Tennessee — a statistic that’s remained steady for the past 10 years.

1 thing males can do to decrease their risk of heart disease

Dr. Bushell: If you smoke or use any kind of tobacco products, get some help stopping. Quitting will decrease your risk of heart disease, as well as stroke and cancer. If you’re overweight or have high blood pressure, those are also key things to try to change.

2. Black males are more likely to die of colon or rectal cancer than White males in Tennessee.

Forty years ago, Black and White males were equally likely to die of colon or rectal cancer but this changed overtime according to this 2020 Tennessee health report. Today, Black males in Tennessee are more likely to die of those cancers, as well as lung or bronchus cancer.

1 thing males can do to decrease their risk of colon cancer

Dr. Bushell: Ask your PCP when you need to get screened.

• The latest guidelines reduce the age for a first colonoscopy to 45 from 50, but other factors play in.
• For example, you may need to get screened early if you have a first-degree relative (mom, dad, sister, brother) who had colon cancer. Typically your first screening would be set 10 years prior to when your relative was diagnosed.
• If you’re African-American, consider asking your provider as early as your 30s.

The death of actor and playright Chadwick Boseman at age 43 is a relevant story. If colon cancer is caught early, it’s curable, so it’s always better to go as soon as you have a concern. The other thing to remember is that cancer treatment has advanced dramatically in recent years. People used to have a sense that ‘the C-word’ meant the end, but that’s never been farther from the truth.

3. The gap in prostate cancer mortality rates between Black and White males has decreased.

The mortality rate for Black males in Tennessee, however, is still nearly 2X the rate for White males.

1 thing males can do to decrease their risk of prostate cancer

Dr. Bushell: Know your risk, and get screened — especially if you’re high-risk.

High-risk candidates for prostate cancer include males who:

• Are African-American
• Are older than 69
• Have a father or brother with prostate cancer
• Abuse or have abused alcohol
• Have been exposed to cadmium, a toxic metal found in some industrial workplaces
• Eat a diet high in fat, especially animal fat
• Are farmers, painters and tire plant workers (possibly due to exposure to chemicals)

How to know if you need a prostate screening

4. Males in Tennessee are more likely to die from opioid overdoses than females.

As reported in this 2020 Tennessee health report card, from 2012 to 2018, males had higher rates of dying from opioid overdoses than females, and this difference grew by 68% in recent years.

Males in East Tennessee have the highest rates of opioid overdose death, and White males are nearly 2X as likely to die from opioid overdose as Black males. From 2014-2018, males had higher rates of dying from opioid overdoses than females.

1 thing males can do to decrease their risk of opioid abuse

Dr. Bushell: If you have health insurance, reach out to a care manager. If not, use the resources online. The Substance Abuse and Mental Health Services Administration (SAMHSA) is a great place to start. Call them anytime at 1-800-662-4357. It’s completely confidential.

A lot of times, people who are overusing or abusing opioids know they’re having an issue, but the addiction is so powerful, it reprograms the brain. That causes them to trade things — money, jobs, relationships — to feed that chemical addiction. The reality is that people who are misusing opioids need aggressive, long-term help.

If you’re a loved one and you notice someone is absent from family events, or that there’s money or medication missing, ask questions. So many families think there’s something going on and don’t ask and then they regret it. Trust your instincts and follow up. Yes, you can expect defensiveness and excuses, but this may save their life.

How to spot signs of opioid abuse in a loved one

5. Traumatic brain injury (TBI) has become a serious health issue for males in Tennessee.

Falls and motor vehicle crashes are the leading causes of TBI death in Tennessee, and 60% of TBI patients in Tennessee are males, who also account for 88% of deaths involving motorcycles.

1 thing males can do to decrease their risk of TBI

Dr. Bushell: Wear a helmet on motorcycles or ATVs, and install a roll cage on tractors or 4-wheelers. Also, consider if any of your actions are substance-related. If you’re using opioids or alcohol, particularly if you’re struggling with depression or anxiety, you’re more likely to put yourself in risky situations.

Alcohol use and abuse: 5 things to know

6. The rates of males diagnosed with HIV in Tennessee increased for every racial and ethnic group.

Non-Hispanic White males make up the largest number of males living with HIV in Tennessee. Non-Hispanic Black males make up more than half of new HIV diagnoses, despite making up only 16% of the male population in the state.

1 thing men can do to take control of their sexual health

Dr. Bushell: Practice safe sex, get tested and get treated. Also, know that HIV today is a manageable chronic condition. There are medicines that can make signs of the virus nearly nonexistent, which means you’re low-risk to pass it to someone you care about. Just look at Magic Johnson. He was diagnosed 30 years ago and he’s still doing well. That should be very empowering for people with HIV, or people who are concerned they may have it. But you have to get tested to get the help you need.

7. Suicide is one of the top 5 causes of death for males ages 18-54 in Tennessee.

In 2018, suicide was the #8 cause of death for males of all ages in Tennessee. Another report showed that the suicide rate for people ages 10-24 rose 15% since 2015.

1 thing males can do to decrease their risk of suicide

Dr. Bushell: Find a primary care provider (PCP) you can talk to. It’s just as confidential as a pastor or therapist.

If we know one thing now about mental health that we didn’t know 10 or 20 years ago, it’s that “toughing it out” doesn’t work. We need to start talking about stress, fears and coping skills in the teenage years to avoid playing catch up. Otherwise, we’re trading in a healthy future for an outdated stereotype of what a man should be. It might help to think of it this way: Treat yourself with the same care you would a loved one.

Other notable facts about male health in Tennessee

According to the 2018 health indicator data used to create the Report Card:

• The life expectancy at birth for males in Tennessee is 5 years shorter than for females.
• Black males are the only group of Tennesseans with a life expectancy of less than 70 years.
• The percent of males who report binge drinking increased by more than 20% while those who report using tobacco declined by 20%.
• Males are less likely to die of cancer but more likely to die from accidents, chronic lower respiratory diseases, diabetes and Alzheimer’s disease.
• The number of males who received flu shots decreased more than 18% in recent years.

The bottom line: Find a provider

Dr. Bushell: The best piece of advice I can give males in Tennessee is to know your health and know your risks. That’s what a primary care physician will do for you.

It’s interesting when you look at female health where screenings and annual visits have played a role for a while. On the male side, we haven’t had specific guidelines that were as prevalent, but that’s why we have to have these conversations now.

As a provider, I just want to say, “Come see us. Establish a relationship so we can be here for you. Talk about everything that’s going on in your life — emotional and physical — get screened when you need to, and let us help you live your life in the best shape possible. It’s easier to do than you think.”

A complete guide to men’s health screenings

More articles from Dr. Bushell 

Get more information about specific health terms, topics and conditions to better manage your health on bcbst.com. BlueCross BlueShield of Tennessee members can access wellness-related discounts on fitness products, gym memberships, healthy eating and more through Blue365®. BCBST members can also find tools and resources to help improve health and well-being by logging into BlueAccess and going to the Managing Your Health tab.