By Betty J. Halliburton
This is part one of a series of stories called Out of Despair that was produced in partnership with Ideastream’s Connecting the Dots Between Race and Health Project.
Cleveland resident Bob Ivory drove himself to an urgent care facility last year, after suffering a few days of discomfort. The doctors discovered he had extremely high glucose levels and immediately transported him to Cleveland Clinic’s Southpoint hospital in Warrensville Heights, Ohio.
“I’ll never forget when I was being discharged, and the doctor was giving me a report about my progress, and aftercare, and shared just how sick I really was,” Ivory said.
His glucose levels were so high that Ivory could have slipped into a diabetic coma or died.
Before that trip to the urgent care, Ivory said he had no idea he was a diabetic.
It's a terrifying, yet common occurrence in the African American community. Many people are prediabetic and don’t know it, said Dr. Frederick Harris, an internist at Cleveland Clinic. Cases like Ivory’s, do not happen overnight, Harris said.
“Over 88-million people [in the U.S.] are prediabetic," he said. "Any glucose level over 100 is abnormal and should not exceed that at any point in time."
Delayed medical care for issue such as diabetes contributes to poor health outcomes especially for Black men, studies show. Between 2019 and the first half of 2020, the life expectancy for all Americans decreased, but that drop was greatest among African American men. The life expectancy at birth for that group decreased by 3.0 years from 71.3 to 68.3, according to 2021 datafrom the Centers for Disease Control and Prevention. That's particularly disturbing because life-expectancy for non-Hispanic Black men is lower than for any other group. Non-Hispanic white males, by comparison, can expect to live an estimated 75.5 years.
Dr. Harris and other Black physicians say they've seen how many African American men are reluctant to seek medical care and rarely communicate their health-related issues.
Growing up in Cleveland’s Glenville neighborhood, Ivory said there were not many Black men in the neighborhood who talked about their health. Ivory’s grandparents, who raised him, did stress the importance of eating “right” with fruits and vegetables, he said. But they did not factor in how other foods feed into health disparities like hypertension, diabetes and obesity.
“I don’t think it was ever put into context about the affects of too much salt, sugar or fat and grease,” Ivory said. Historically, Black men's distrust of a predominantly white healthcare system stems from not seeing enough physicians who looked like him, Harris said.
“There were not a lot of African American physicians — people who they could trust and depend on,” Harris said. “We all know about Tuskegee and other experimentations. And over time, we just did not fair as well in the institution of medicine as it exists right now.”
In addition to trust, social determinates of health like poverty, access to healthy foods and even racism are also linked to poor health outcomes for Black men, said Dr. Charles Modlin, a urologist and the medical director of the Office of Inclusion, Diversity and Equity at MetroHealth.
“Racism is the result of excessive generations of discrimination that communities of color have experienced," Modlin said. "It actually goes backs to our ancestors."
MetroHealth is being proactive in addressing these racial issues, he said. Every employee must go through bias training. They are focusing on health disparities in all the specialty areas and hosting a minority men’s health fair.
“To recognize what has happened in the past and let the community know we understand why, in many situations, the Black community has been reluctant to go the hospital or get a health check,” Modlin said. “We recognize the past history, and we’re to do what we can to right the wrongs that have occurred in the past.”
Modlin hopes to encourage other Black men to eliminate health disparities within their own families, something Bob Ivory is doing right now.
“As you are conscious about your own health, be mindful of how important your health is to everyone around you — the people who depend on you," Ivory said.
This project is part of Connecting the Dots between Race and Health, a project of Ideastream Public Media funded by The Dr. Donald J. Goodman and Ruth Weber Goodman Philanthropic Fund of The Cleveland Foundation.