Health / Strong Enough to Live — Part 3 — By Jeff Thomas
KEY POINTS — SCREENINGS EVERY BLACK MAN NEEDS
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Health Screenings Black Men Need by Age: Plain Language, No Medical Jargon
By Jeff Thomas | Black Source Media | Strong Enough to Live, Part 3 | May 2026
In Part 1 of this series, we established why Black men die younger. In Part 2, we looked at the gap between Black men and white men — and why that gap is a policy failure, not a personal one.
Now we get practical.
Health screenings for Black men are not complicated. They are not expensive. They do not require a medical degree to understand. What they require is that you show up — and that when you show up, you know what to ask for.
Most Black men do not skip preventive care because they do not care about their health. They skip it because nobody ever sat down and told them exactly what they need, when they need it, and why it matters. Consider this that conversation.
What follows is a plain-language, age-organized guide to the screenings every Black man in America should be getting — with specific notes on where Black men’s risk diverges from the general population guidelines, which were largely developed using white male health data.
Your Five Numbers: Know These Before Anything Else
Before we get into the age-by-age breakdown, there are five numbers every Black man should know. These are the early warning system. If you do not know all five, your next doctor’s appointment has a clear agenda regardless of your age.
1. Blood pressure. Normal is below 120/80. High blood pressure — anything consistently above 130/80 — is called the silent killer for a reason. No symptoms. No warning. Just damage accumulating in your heart, kidneys, and brain until something breaks. Nearly 60% of Black men have hypertension. Most are not managing it effectively.
2. Blood sugar (fasting glucose or A1C). Normal fasting blood sugar is below 100 mg/dL. Between 100 and 125 is prediabetes — a warning window where lifestyle changes can reverse course. Above 126 is diabetes. Black men develop Type 2 diabetes at higher rates than white men and experience worse complications, including amputation and kidney failure, at significantly higher rates.
3. Cholesterol (lipid panel). You want to know your total cholesterol, your LDL (bad), your HDL (good), and your triglycerides. High LDL is a primary driver of heart disease — the number one killer of Black men. Your doctor should be able to give you this panel in a routine blood draw.
4. PSA (Prostate-Specific Antigen). This is a blood test that screens for prostate cancer risk. Black men develop prostate cancer at 1.7 times the rate of white men and die from it at twice the rate. The standard guidelines say start discussing PSA testing at 50 for average-risk men. For Black men, the conversation starts at 40.
5. BMI and waist circumference. Body mass index is an imperfect measure, but excess abdominal weight specifically is linked to elevated cardiovascular and diabetes risk. Know your number and understand what it means for your health profile.
In Your 20s: Build the Habit, Know Your Baseline
Your 20s are not too early. They are exactly when the baseline gets established — and when the habits that will determine your health at 50 and 60 get locked in.
Blood pressure: Check it at least every two years if it is normal. Every year if it is on the higher end of normal. Many pharmacies offer free blood pressure checks. Use them.
Cholesterol: If you have risk factors — family history of heart disease, obesity, diabetes, smoking — get a lipid panel now. Otherwise, your first panel by age 35.
Sexually transmitted infections: HIV screening is recommended at least once for all adults 15–65. If you are sexually active with multiple partners, annual testing is appropriate. Syphilis, gonorrhea, and chlamydia screening depends on behavior and risk. Talk to your doctor honestly — they have heard it all.
Mental health: Depression and anxiety screenings should be part of your annual visit. They rarely are, because Black men rarely bring it up and doctors rarely ask. You can bring it up. You are allowed to say “I have been feeling low” or “I have been under a lot of stress.” That is not weakness. That is information your doctor needs.
Dental and vision: Annual dental visits and eye exams every one to two years. Glaucoma — a leading cause of blindness — disproportionately affects Black men and often presents without symptoms. An eye exam catches it.
In Your 30s: The Decade That Decides Everything
Your 30s are where the data gets serious. This is when the conditions that were quietly developing in your 20s start showing up — and when catching them early makes the biggest difference in long-term outcomes.
Blood pressure: Every year, without exception. If you are already managing hypertension, every visit.
Diabetes screening: The American Diabetes Association recommends screening beginning at age 35 for all adults. For Black men with additional risk factors — overweight, family history, sedentary lifestyle, history of high blood sugar — start earlier. A fasting glucose test or A1C is a simple blood draw. There is no reason not to know.
Cholesterol: Full lipid panel by 35, and every five years if results are normal. More frequently if you have risk factors.
Prostate cancer conversation: At 40, you should be having an informed conversation with your doctor about PSA screening. Not necessarily getting the test — having the conversation. Understanding your family history, your risk factors, and what the test can and cannot tell you. Black men who are diagnosed with prostate cancer in their 40s and 50s have dramatically better outcomes than those diagnosed in their 60s and 70s. The window matters.
Skin checks: Black men are diagnosed with melanoma at later, more advanced stages than white men — in part because the myth persists that Black skin does not get skin cancer. It does. Annual full-body skin checks should be part of your routine by your mid-30s.
In Your 40s: No More Waiting
If you have been delaying any of this, your 40s are the line. The conditions most likely to kill Black men — heart disease, prostate cancer, colon cancer, diabetes complications — are either fully preventable or highly treatable when caught in your 40s. They are often fatal when caught in your 60s.
PSA screening: By 40, you should have had the conversation. By 45, you and your doctor should have made a decision together about whether to begin annual PSA testing based on your personal risk profile. If your doctor dismisses the conversation, push back. If they still dismiss it, find another doctor.
Colon cancer screening: The American Cancer Society recommends that Black men begin colon cancer screening at age 45. This is five years earlier than the old standard guideline — a change driven in part by rising rates of early-onset colon cancer. If you have a first-degree relative (parent, sibling) who had colon cancer, start at 40 or ten years before their diagnosis, whichever comes first. Review the American Cancer Society’s full colon cancer screening guidelines to understand your options — a colonoscopy every ten years is the gold standard, but stool-based tests are available as alternatives if cost or access is a barrier.
Heart disease risk assessment: Your doctor should be calculating your ten-year cardiovascular risk by your mid-40s. This takes your blood pressure, cholesterol, age, and other factors and gives you a percentage that guides treatment decisions. Know your number.
Diabetes: If you are prediabetic and have not made changes, your 40s are when Type 2 diabetes tends to fully develop. If you are already diabetic, your management plan should include annual kidney function tests, eye exams, and foot exams — all of which are frequently skipped and all of which prevent the worst outcomes.
Lung cancer screening: If you are between 50 and 80, have a 20-pack-year smoking history, and currently smoke or quit within the last 15 years, you qualify for annual low-dose CT lung cancer screening. Talk to your doctor about whether you qualify.
In Your 50s and Beyond: Maintain the Momentum
The men who make it to their 70s and 80s in good health are not lucky. They are consistent. The screenings do not stop — they intensify and expand.
Blood pressure: Every visit. Every time.
PSA: Annually, in conversation with your doctor about what the results mean and how aggressively to pursue follow-up. Prostate cancer at this stage is common — what matters is whether it is the slow-growing kind or the aggressive kind. The conversation is ongoing.
Colon cancer: Colonoscopy every ten years if prior results were clean. More frequently if polyps were found.
Abdominal aortic aneurysm: Men between 65 and 75 who have ever smoked should have a one-time ultrasound screening for abdominal aortic aneurysm — a bulging in the main artery that can rupture without warning. One scan. One conversation. Could save your life.
Bone density: Men are underscreened for osteoporosis. If you are over 70, or over 50 with risk factors, ask about a DEXA scan.
Mental health: Depression in older men is dramatically underdiagnosed. Isolation, grief, chronic illness, and loss of identity after retirement are real triggers. Keep the conversation open with your doctor and with the people you trust.
What to Say When You Walk In the Door
Knowing what you need is half the battle. The other half is saying it out loud in an exam room where the appointment is twelve minutes long and the doctor already has a hand on the door.
Say this: “I want to make sure I’m getting the preventive screenings appropriate for a Black man my age. Can we go through my numbers today — blood pressure, blood sugar, cholesterol — and talk about where I stand on prostate and colon cancer screening?”
That one sentence changes the appointment. It signals that you are prepared, that you have done your homework, and that you expect the conversation to be complete. Doctors respond to patients who advocate for themselves.
If the doctor tells you it is too early, or that you do not need a particular test yet, ask them to explain their reasoning specifically — and ask whether the standard guidelines they are citing were developed using Black male health data. Often, they were not. You are allowed to know that. You are allowed to ask.
The Bottom Line
Black men are not dying because they are weak. They are dying because they are navigating a healthcare system that was not built for them, without the information they need to demand what the system owes them.
The screenings in this article are not optional extras. They are the baseline. They are what the data says Black men need in order to close the gap between the life expectancy they have and the one they deserve.
Make the appointment. Know your numbers. Say what you need out loud.
That is what strong looks like.
Sources: American Cancer Society — Cancer Screening Guidelines 2024; American Diabetes Association — Standards of Medical Care in Diabetes 2024; American Heart Association — Hypertension in African Americans 2023; U.S. Preventive Services Task Force — Screening Recommendations; Centers for Disease Control and Prevention — Health Disparities in Chronic Disease; Journal of the National Cancer Institute — Prostate Cancer Disparities in Black Men (2023); New England Journal of Medicine — Colorectal Cancer Screening in Black Americans (2022).
Internal Links: Link “Part 1 of this series” to Strong Enough to Live Part 1. Link “Part 2” to Strong Enough to Live Part 2. Link “find a Black doctor” to future installment on finding culturally competent care.
External Links: CDC Office of Minority Health (minorityhealth.hhs.gov); American Cancer Society cancer screening guidelines (cancer.org/screening); U.S. Preventive Services Task Force (uspreventiveservicestaskforce.org).
About the Author: Jeff Thomas is a contributing writer and civic commentator at Black Source Media. Strong Enough to Live is Black Source Media’s Wednesday health series focused on Black men’s health. New installments publish every Wednesday. Share this with every Black man you love.
Thanks! I am going to the doctor next week.