2014 Men’s Health Report Card Shows Some Improvement, Raises New Questions
With the nation’s growing emphasis on population health, the release of the third Tennessee Men’s Health Report Card provides important data on half the state’s residents. The mixed results showed improvement in some categories, yet raised new questions regarding health disparities based on race, ethnicity, age, socioeconomic status, and geographic location across the state.
A cooperative effort of Vanderbilt University, Meharry Medical College, and the Tennessee Department of Health, the biennial report card was first released in 2010 (using data from 2007). This latest iteration pulls information from a number of state and national sources and is based on 2012 data. Grades were assigned in comparison to the Healthy People 2020 goals for the nation.
Big Picture
On average, men live five years less than women in the state (74 years compared to 79.2 years). Black men, however, have the shortest life expectancy of all at 70.8 years.
More than half of the deaths for men in Tennessee were due to heart disease (24.7 percent), cancer (24.4 percent), and lung disease (5.6 percent). The (sort of) good news is that white, black and Hispanic men all had lower rates of death from heart disease, stroke and diabetes in 2012 than they did in 2007. The not-so-good news is that those death rates remain unacceptably high. However, the report card authors pointed out all three conditions could be favorably impacted by early diagnosis and behavioral modifications.
The main cause of death for men in Tennessee varies significantly by age. The vast majority of deaths, 82 percent, occur in men ages 55 and older with well over half those deaths coming from cancer and heart disease.
In men ages 35-54, more than 40 percent of deaths are still attributable to heart disease and cancer, but another 22 percent die from motor vehicle accidents, unintentional injuries and suicide. In younger men ages 18-34, 40 percent of deaths are accidental, either through unintentional injuries or motor vehicle accidents. In this same age group, another 30 percent of deaths occur due to homicide and suicide.
Although there were many D’s and F’s, there were also quite a few A’s on the latest report card. A grade of A was given if the Tennessee data was better than or within 10 percent of the Healthy People 2020 goal. Honor roll grades were given for all men in Tennessee for receiving a colorectal cancer screening over age 50, ischemic heart disease, low rates of binge drinking, improving rates of physical activity, and having reported rates of obesity within two percentage points of the national goal (but the bar isn’t set very high with a national goal of 30.5 percent by 2020).
Disparities
A key finding in the 2014 report card was that health disparities are not limited to race and ethnicity, although those factors still play a major role … perhaps even bigger than realized … in determining health outcomes.
“The biggest thing to me that came out in the 2014 Tennessee Men’s Health Report Card was the need to think about the disparities among men within the state,” said Vanderbilt’s Derek Griffith, PhD, who chaired the 2014 report card committee. “Black, white and Hispanic men tended to have very different health profiles, and I don’t think we appreciated that to the degree that this document has illustrated.”
The findings highlighted that black men bear an excess burden of heart disease, stroke, diabetes, kidney disease, homicide, pneumonia and influenza, and AIDS. This group also had a higher rate of certain cancers, including prostate, colorectal and lung. However, between 2007 and 2012, black men saw improvement in the rates of each of these conditions.
White men had a higher rate of suicide, unintentional injuries including drug-related poisonings, motor vehicle accidents, liver disease and lung disease. With the exceptions of motor vehicle accidents and lung disease, the rates of these issues have either stayed statistically stagnant or worsened since 2007. Hispanic men, generally a younger population in Tennessee, had lower rates of death for most chronic conditions, higher grades overall, and were at or better than national goals. However, their lowest grades were given for rates of colorectal cancer, chronic liver disease, motor vehicle accidents and suicides. Death rates from kidney disease also worsened between 2007-2012 in this population segment.
Geography and age also play a huge role, as do income and education level. Some areas of the state posted much better outcomes than others leading those involved with creating the report card to call for more communication among communities to see what works to change habits and behaviors.
“The other thing we found is that we don’t have good explanations for why some areas of the state have such different rates of heart disease and cancer when compared with other parts of the state,” continued Griffith, director of Vanderbilt’s new Institute for Research on Men’s Health. “You have geographic differences and racial and ethnic differences that we just don’t have good answers for so it really does warrant bringing together communities in the state to explore why these patterns are the way they are and what we can do about them as a state.”
Conclusions
“There have been notable gains in men’s health since the first Tennessee Men’s Health Report Card was issued in 2010,” the authors wrote in their summation. “Health outcomes for men continue to vary, however, by age, place, race and ethnicity in significant ways. It is important to seek a deeper understanding of the sources of these disparities. It is also important to recognize how changes in access to education, healthcare, jobs, community resources and faith-based supports, safer recreational spaces and improved environmental quality can reduce these disparities and improve men’s health overall.”
Access the 2014 report card online at TNMensHealthReportCard.Vanderbilt.edu.
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