Dr. Charles Modlin is on the front lines of the effort to address minority health discrepancies.
By Diana Simeon
African-American men are 66 percent more likely than their white counterparts to get prostate cancer and twice as likely to die from the disease. In fact, according to the Centers for Disease Control, African Americans are at an increased risk of dying from any number of cancers. They’re also more likely to suffer from diabetes, hypertension, heart disease, and stroke. These are just some of the health disparities experienced by minority populations that Dr. Charles Modlin is determined to change.
After I completed my medical training, I was able to step back and take a broader view of the medical landscape,” says Modlin, a urologist and kidney transplant surgeon at the Cleveland Clinic. “And I became aware of the health-care disparities that afflict African-American and other minority populations.”
What Modlin discovered was that to be a member of a minority in the United States is to be at risk for a host of adverse health outcomes. So, in 2003, Modlin launched the Clinic’s annual Minority Men’s Health Fair and, a year later, the Minority Men’s Health Center of the Cleveland Clinic’s Glickman Urological and Kidney Institute. His goal: help correct health disparities by ensuring that patients have access to care that is effective for them. “Medicine is not a cookbook,” says Modlin. “We have to individualize how we deliver care for every patient.”
A Life in Medicine
For Modlin, the journey to medicine began during his childhood in New Castle, Indiana. “When my grandmother went into a nursing home, we would visit her every day,” he recalls. “I’d bring her water, wheel her into the dining hall. It gave me an inside look into helping take care of people.”
Later, in high school, Modlin worked as an orderly at the local hospital. “You would turn patients, take vitals, things like that. That gave me an inside look into medicine.” At Northwestern University, Modlin studied chemistry, then went on to medical school, also at Northwestern, and then a six-year residency at New York University, where he met his wife, Dr. Sheryl Modlin, a pediatric anesthesiologist.
A chance encounter led Modlin to Cleveland. “I went to the annual conference of the American Urological Association and there was a group from the Clinic presenting on kidney transplantation and renal vascular surgery. They announced there was a fellowship at the Cleveland Clinic.”
He applied, was accepted, and after completing the fellowship, joined the Clinic. The family settled in Shaker. “We picked Shaker for the schools,” says Modlin, who is also executive director for minority health at the Clinic and president-elect Medical Staff Officer of the Clinic’s medical staff.
Three of the Modlin’s four children have graduated from Shaker Schools; their youngest is now a junior. Modlin regularly sponsors students in the High School’s Senior Projects program.
A Problem with Many Roots
There are many reasons for minority health disparities. “Historically, it’s been lack of access,” notes Modlin. “If someone is uninsured or underinsured, it’s hard for them to get routine care.” That said, even when minorities do have access, they can still suffer from disparities, especially when doctors are not aware of their specific needs. Take prostate cancer, which Modlin routinely treats as a urologist. “A lot of health care providers don’t know that African Americans need to start screening for prostate cancer at age 40, as compared to age 55 for white men.” The delay in screening African Americans is part of the reason they’re more likely to die from the disease.
A lack of diversity among the ranks of physicians is another factor. “Many people feel more comfortable being treated by an individual who looks like them and has a similar background,” says Modlin. Only four percent of physicians in the U.S. are African American and Modlin himself is one of just a comparative handful of African-American transplant surgeons in the country.
Meanwhile, for African Americans in particular, there’s ongoing distrust of the medical community, thanks to a legacy of mistreatment that most infamously includes the Tuskegee Syphilis Study, in which for more than 40 years African- American males were not treated for syphilis so that researchers could study the “natural progression” of the disease.
“It’s difficult to get minority patients to agree to participate in clinical research trials because of the distrust,” says Modlin. He encourages his own patients to donate to the Health Center’s biobank to help facilitate research on minority patients. “We give samples to any investigator worldwide who wants to research the pathogenic cause of health disparities,” he says.
After launching the Men’s Minority Health Center, Modlin was discouraged to find that he had few patients. But among those who did show up was Cleveland author George Fraser, who’s also founder of FraserNet, the largest African-American networking organization in the country. “I opened the door and he was sitting there,” says Modlin. Soon, Modlin was working with Fraser and other area organizations, including the United Pastors Network, to get the message out.
“I spend a lot of time in the community and it’s led to increasing trust to the point where many of these organizations are now encouraging people to come in,” says Modlin. That also includes to the annual Minority Men’s Health Fair, which last year attracted upwards of 2,000 attendees (this year, it’s on April 27). It’s open to everyone and offers up to 35 different free health screenings.
“A lot of these conditions – hypertension, diabetes – oftentimes don’t have any symptoms. If you don’t get screened, you are not going to know you have it,” says Modlin.
Up next for Modlin is ensuring that the Clinic is what he calls a Multicultural Health Center of Excellence. “We’d like to establish specialty areas of expertise in each institute to address health disparities,” he says. The Clinic’s Digestive Disease and Surgery Institute recently launched a program to help address the higher rates of colorectal cancer, pancreatic cancer, and liver disease among minorities.
Indeed, the urgency to correct health disparities has never been greater, says Modlin, noting that by 2050, the U.S. will be a majority minority country. “If more of the population is minority, then more of the population is going to be experiencing health disparities,” says Modlin. “There is a lot of work still to be done.”
Follow Dr. Modlin on Twitter @CharlesModlinMD