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What we’re learning about the health of Tennessee’s millennials

Originally published in The Tennessean, November 2019

As a whole, millennials are more knowledgeable, open and engaged about their health than previous generations, thanks in large part to access of information.

Why is it, then, that a third of the 73 million millennials in the U.S. don’t have a primary care provider? And why are behavioral health conditions more common in millennial Tennesseans than millennials nationwide? 

Recently, the Blue Cross Blue Shield Association released a Health of America report on millennial health, driven by data from the BCBS Health Index. The report uses the health experiences of 41 million BlueCross members, a subset of the more than 100 million people Blue plans cover nationwide.

The index assigns each state and county an index score from 1 to 100 based on how more than 300 health conditions affect individuals’ collective quality of life. It also provides the ability to filter results by age and gender.

As a mission-driven health plan, BlueCross BlueShield of Tennessee (BCBST) is studying these trends to address the challenges facing our neighbors. The BCBS Health Index is based on claims data, which can’t tell us everything — but it does help us start an important conversation.

Findings from the data

Overall, the report data indicates millennials are living at 95.1% of their optimal health. While that statistic sounds impressive, it also reveals significant challenges. Even the claims data shows millennials are less healthy than their Gen X counterparts when they were the same age. 


In Tennessee, the Health Index score for millennials (95.2%) was higher compared to millennials nationally. In Davidson and Williamson counties, millennials are healthier than their peers across the state, at 96% and 95.6% respectively. These figures represent an average spanning ages 21-36.

The BCBS Health Index shows a major decline in health beginning, on average, at age 27 across the commercially insured population. We see a similar decline when looking at millennials served by BCBST.

Six of the top 10 conditions affecting millennials — major depression, substance use disorder, alcohol use disorder, hyperactivity, psychotic conditions and tobacco use disorder — are behavioral health-associated conditions and more common among this generation.

Tennessee millennials also have a higher occurrence of substance use disorder, hypertension, tobacco use disorder and type II diabetes  compared to national trends.

What our provider partners are saying

Michael McCutchen, M.D., of Saint Thomas Medical Partners and a millennial himself, recently spoke at our millennial health forum at Lipscomb University’s Spark in downtown Nashville. He discussed how primary care can serve as a good gateway to mental wellness.

About a quarter of his patients are millennials, and many have major depression or an anxiety disorder. These conditions may not be why patients first seek care, but they’re often connected to conditions like obesity, diabetes, high blood pressure, etc.

BCBST recognizes the importance of primary care providers like Dr. McCutchen. One way we’re strengthening our partnerships is by making investments to help primary care practices improve the patient experience with things like online scheduling and telehealth services.

We’re always looking at how we can use technology to improve the experience of all of our members.

Over the past few months, we’ve been piloting a new digital care management tool that will allow our on-staff nurses to better communicate with members who have diabetes.

With the app, we can share information, offer reminders about needed screenings, answer questions and more. We recently expanded the service to support more health conditions. 

We have work to do to help improve health for not just millennials or the people of Nashville, but all of our neighbors in Tennessee. With our provider partners and community support, we’re tackling that work together.

About Dr. Andrea Willis, SVP, Chief Medical Officer

A photo of the authorDr. Willis ensures that all clinical initiatives and quality endeavors support the needs of our members, and contribute to the overall health and well-being of our communities.

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