Routine check-ups and preventive screenings for high blood pressure, cholesterol and diabetes are all important for good health. But if you are male, you are far less likely to get routine or preventive health care. Statistics from the Centers for Disease Control and Prevention show that less than 65 percent of all men have had screenings for cholesterol or diabetes, though the percentage is slightly higher for married men. In general, studies show that men are much less likely than women to schedule routine health care visits and to seek medical care for symptoms; African-American men are most at risk.
For men of all backgrounds and ethnicities, the Minority Men’s Health Fair at the Cleveland Clinic provides 40 screenings — for prostate cancer, skin cancer, diabetes, depression and other conditions — plus education on many health concerns. The health fair, which began in 2003 with 35 attendees and now serves thousands, will mark 15 years in April.
Addressing health care disparities
Charles Modlin, M.D., a urologist and kidney transplantation surgeon at Cleveland Clinic, founded the Minority Men’s Health Center and Minority Men’s Health Fair to address health care disparities in racial and ethnic minorities. Initially, the center targeted the early detection of prostate cancer in African-American males, who are twice as likely as white males to get the disease and to die from it.
Modlin says socioeconomic factors such as the lack of access to quality health care, especially preventive health screenings, as well as low health literacy and lack of knowledge, are contributing factors to the disparities. Hereditary factors account for higher incidence and death rates from prostate cancer in men of color as well as for observed higher incidence rates of colorectal cancer, diabetes, hypertension and other conditions. In addition, because of their historical distrust of the health care system, minorities have been less likely to enroll in clinical trials to test medications and treatments.
The annual men’s health fair brings together about 450 Cleveland Clinic and community volunteers. Participants interact with and are examined by primary care physicians, urologists, and other medical specialists and health care providers. The services offered at the health fair have detected unrecognized prostate disease, cancer, diabetes and more. “Our goal is to get people from the health fair into the Minority Men’s Health Center if there is an abnormality. Some come back [to Cleveland Clinic], and others go to different health systems,” Modlin says.
Men attending the health fair may be asked about voluntarily participating in Cleveland Clinic research trials. Modlin stresses the importance of such research. “We need more minority men — and women — to participate in research trials to uncover the biological basis and pathogenesis of health disparities and to facilitate discovery of new medications and interventions that are more effective in minority populations,” he explains. “We are learning that, in some cases, people from different racial and ethnic backgrounds respond better to certain medications that treat conditions such as high blood pressure, organ transplant rejection and congestive heart failure because some medications are metabolized differently in different patient populations.”
According to Modlin, clinician volunteers, including residents and fellows, “see vulnerable populations firsthand and get experience interacting with people who may have different cultural and socioeconomic backgrounds from their own. They need to focus on how they can become more culturally competent, improve the patient’s overall experience and impact the patient’s willingness to come back and engage in long-term care to comply with treatment recommendations.”
Modlin adds: “Given that the diversity of our nation is rapidly increasing, it’s a matter of national security that we address health disparities confronting our minority populations, who will soon represent the majority of our nation’s population. Shorter life expectancy and more people with chronic diseases will have overarching implications on the health, economic stability and productivity of our nation and its workforce.”
Developing trust to engage all patients
To engage specific populations, providers must develop a trusting relationship with those they seek to treat, Modlin points out. Building that trust in the community will encourage minority men and all men to undergo preventive health screenings, make changes and adopt a healthier lifestyle, Modlin says. Though many health fair participants have insurance or the ability to acquire health insurance, the health fair raises their comfort level and provides a venue for screenings and preventive care. “The onus is on us as health care providers to more effectively engage the community — to go out into the community but also design and implement these specialty services,” Modlin says.
Cleveland Clinic is the recipient of the American Hospital Association’s 2016 Equity of Care Award. Information about the medical center’s initiatives to eliminate health care disparities is available at the Equity of Care website or from the AHA's Hospitals in Pursuit of Excellence initiative.
Cynthia Hedges Greising is a communications specialist with the Health Research & Educational Trust.