The health disparities run the gamut for African Americans from birth to death. They have the highest infant mortality rates, heart disease and diabetes, among other chronic illnesses, as well as the shortest life expectancy at 72 years. Gregory Hall, MD, a native of Cleveland from the Glenville community and a second-generation medical professional, has committed his career to finding solutions.
“I didn’t know what minority health was. I didn’t know about disparities, even though I lived it,” says Hall, an internal medicine physician who works at University Hospitals as the medical director for the Cutler Center for Men. He has treated a predominantly African American clientele for more than 25 years. For over a decade, he’s served on the Cuyahoga County Board of Health and is currently its president.
Hall learned about these health issues while serving on the Ohio Commission on Minority Health. While researching, he discovered the bad news always pointed toward Blacks.
“I found this isn’t a minority problem. This is an African American problem, and no one was talking about it,” says Hall. “This minority health thing does not impact minorities as people think. It impacts Black people.”
Hall went on to educate himself about the disparities, then wrote about hypertension, stroke prevalence and other high-risk health conditions plaguing African Americans to post on his website. From there, he wrote a book for doctors and other health care providers to educate them on best practices for treating African Americans. Patient-Centered Clinical Care for African Americans: A Concise, Evidence-Based Guide to Important Differences and Better Outcomes covers best practices for treating conditions such as high blood pressure and other common conditions disproportionally found in African Americans.
It also cleared the pathway for him to create products and a nonprofit to improve African American health.
GNetX Sequence Multivitamins
While writing his book, Hall devoted a chapter to laboratory result differences that varied by race or ethnicity. For example, there are some instances when African Americans’ white blood cell (WBC) counts are dramatically lower. This normal variation runs in some families of people of African descent, but many doctors remained unaware of this condition and initiated additional and unnecessary testing.
“It’s called benign ethnic neutropenia. It’s not a disease. There is no increased risk for anything. It’s just a lab result,” says Hall. “If medical providers know about it, they can recognize it and move on.”
Finding a wide range of lab differences in his research, Hall reviewed them more critically.
For example, he knew vitamin D levels tended to be dramatically lower in African Americans. He later learned that zinc, magnesium, potassium and vitamin C tended to be significantly lower. Making a supplement that uniquely addresses these deficiencies in a population with poor health outcomes might make a positive difference. But what he discovered about vitamin E startled him the most.
“Some research found that vitamin E was associated with an increased risk of prostate cancer,” says Hall.
Hall explains that one pill of vitamin E with 400 international units (IU) a day is associated with worse outcomes than if you didn’t take one of those a day. Selenium was also found to be associated with increased cancer
risk in some studies. Other research has subsequently been conflicting in risk conclusions, but none shows an advantage to taking vitamin E or selenium.
Until the controversy regarding vitamin E and selenium’s risk is settled, Hall determined he would create a multivitamin and deliberately leave these out. To date, this is something no other major multivitamin company has done. And, following medicine’s central tenet to “first do no harm,” Hall turned to vitamin K, which is essential for blood to clot.
“African Americans have no evidence of vitamin K deficiency,” Hall says. “However, we do have the highest rates of stroke (blood clot in the brain), heart attack (blood clot in the heart) and deep vein thrombosis (clots in the legs). While there is no direct evidence that increased vitamin K causes these deadly clots in African Americans, why risk taking more, particularly if there is no deficiency?”
Hall went on to tailor GNetX Sequence multivitamin to the published research specific to African American health to maximize the benefit while minimizing any risk, and GNetX Sequence multivitamins hit the shelves in lare 2020 with four formulas: African American men, women, men over 50 and women over 50.
“Half of the people who try them continue to buy them, and a lot of people are very proud that I took the time to put this formula together,” he says.
Richard Andrews, 77, is the publisher/editor of The Real Deal Press and has been a patient of Hall’s for about eight years. He’s a consumer of the multivitamin formulated for Black men over 50. He says there are no immediate benefits he can detect, as with all multivitamins. Still, as one who writes and edits health-related stories, when he comes across ingredients essential for someone of his age and stage, he wants to see if they are included. In the GNetX sequence, they are.
“I find it reassuring that there’s a product designed for me,” says Andrews, who also notes it’s the only medication he takes.
The National Institute of African American Health
While working as co-director with the Cleveland State University (CSU)/Northeast Ohio Medical University (NEOMED) Partnership for Urban Health, Hall spent a lot of time thinking about increasing the number of minority doctors.
“We had a great record for getting students into medical school, about an 80% ultimate acceptance rate, but I was always a little frustrated that there weren’t enough African Americans taking advantage of the program,” he says.
That inspired him to establish the National Institute of African American Health (NIAAH), with great intention of refraining from the use of the words “minority” and “urban.”
“Why does everything have to be minority or urban?” he asks. “Again, people of color don’t have the worst health outcomes. African Americans have the worst outcomes. Those words muddy the intended focus.”
There are four pillars of focus for NIAAH: mentorship, a trusted source of online information, patient advocacy and research. NIAAH also provides an opportunity for health care providers to become NIAAH-certified. An NIAAH-certified provider spends time learning about bias, health disparities and research-based best treatments for African American patients. NIAAH has partnered with the Boston-based PriMed medical education company to offer educational modules directly addressing best practices in health care for the Black community.
NIAAH is about two years old and is a national initiative. It received a $250,000 grant from The Cleveland Foundation to launch. “They are introducing us to others across the nation due to our unique design and laser focus, and we appreciate it,” says Hall.
Dr. Edgar B. Jackson Jr., MD, endowed chair for Clinical Excellence and Diversity at University Hospitals, is an NIAAH board member and the acting medical director. He’s very excited about NIAAH.
“It focuses the energy where the energy is needed in terms of addressing health disparities. The greatest need is among Blacks,” says Jackson. “I think it has tremendous potential.”
Jackson hopes to extend the national reach. “We can recommend to the nation what works and what needs improvement. We can provide the mechanisms for best practices,” he says.