By Steve Petrow
Social epidemiologist Roland Thorpe Jr. is on a double mission: to improve the health and extend the life
expectancy of Black men, and to do the same for himself since both of his
grandfathers died prematurely from heart disease.
An expert in minority aging and men’s
health, Thorpe is the principal investigator of the Black Men’s Health Project -
a partnership of Johns Hopkins Bloomberg School of Public Health, Tulane School
of Public Health and Tropical Medicine, and Michigan State University created
to call attention to the health crisis of Black men.
“Black men are hidden in plain sight,”
Thorpe says. “I mean, we have the worst health profile. We have premature
mortality, which means we die before the overwhelming majority of men do. We’re
often in the media either being attacked by the police, or enduring other
experiences from structural racism. There’s very little support that’s been given.
The evidence is all in front of us, but there seems to be no particular people
calling it out or moving to drive toward solutions.”
“Black men are hidden in plain sight,”
social epidemiologist Roland Thorpe Jr. says. “I mean, we have the worst health
profile. We have premature mortality, which means we die before the
overwhelming majority of men do.” (Johns Hopkins Bloomberg School of Public
Health)
For instance, he says, when it comes
to heart disease, Black men are 30 percent more likely to die than White men;
for stroke, it’s 60 percent. And they are 75 percent less likely to have health
insurance than White men. But numbers don’t tell the full story. Thorpe
recently sat down with The Washington Post for an interview. The conversation
has been edited for length and clarity.
Q: You’ve spoken openly and personally about the
fact that both of your grandfathers died of heart disease in their 60s. What’s
the message embedded there?
A: A majority of Black men don’t get preventive
care. They should establish a [relationship with] a primary care physician.
Neither of my grandfathers were engaged in the health-care system. At the time
they were coming through, they were pretty familiar with the public health
service syphilis study at Tuskegee, and so I could probably understand why they
didn’t go to doctors. [That notorious study was conducted by the U.S.
Public Health Service starting in the 1930s and involved hundreds of Black men
who were not informed about their disease and never offered any treatment, even
after penicillin had become the drug of choice for syphilis in the early 1940s.
After revelations about it, the study was canceled in 1972.]
Q: That study is infamous. Are things better
now?
A: I think we’ve come a long way since then
because there’s been some improvement within the health-care system in engaging
Black men, like listening to them when they say they have concerns, and then
engaging them in some shared decision-making about their health and health
care. But we still have a ways to go.
Q: Are you referring to the still significant
discrepancy between the average life expectancy for a Black man versus a White
man?
A: Do I think we’ve gotten better and
improved? I don’t think so. Prior to covid, we’ve extended life for Black men,
absolutely. But on the flip side, [life expectancy for] everybody else is
extended also. That means the gap hasn’t narrowed. Since covid, life expectancy
for everyone has decreased with Black people experiencing a reduction twice as
large as Whites.
Q: What other challenges do Black men face when
it comes to their health?
A: A large part of that discrepancy is based on
structural racism that Black men experience across all levels of socioeconomic
status. Stress is one of the prominent pathways by which structural racism
affects health. These accumulations of stress impact different physiologic
systems that then lead to earlier onset of chronic conditions like hypertension
and heart disease, which then contribute to our life expectancy being much shorter
than White men.
Q: Police violence is also considered an aspect
of structural racism. You’ve suggested previously that the police killings of
Black men impact the health and well-being of other Black men.
A: Police brutality also contributes to the
problem, and that’s linked to structural racism. I’m thinking about Rodney King and
the most prominent one recently was George Floyd. There have been others, as
well. Just to see another Black man die on TV, that’s very traumatic, and many
[White] people don’t think of the trauma that Black men have endured, to have
to even watch that. Black men have one of the most horrific health profiles,
and we have few resources available to us to improve that, like dealing with
that trauma.
Q: Do you mean witnessing these murders on TV
increases Black men’s stress, leading to other health issues? Or that it
increases Black people’s distrust of institutions in general, including medical
institutions?
A: Both.
Q: How do you hope that the Black Men’s Health
Project will help?
A: Our goal is to create awareness of Black
men’s health, and the social and historical issues that Black men have faced
that could possibly impact their health. One of the key things for us is to
create a Black men’s health survey, to create a cohort to better understand
their health trajectory. There is currently no study that focuses uniquely on
the specific needs of Black men.
Q: When it comes to mental health issues, what
disparities exist by race?
A: There are disparities by race, as
it relates to mental health. But the disparity is a little trickier because
Black men still fare worse because there’s [more of] a stigma associated with
Black men saying they have mental problems. Typically, when Black men do go to
the health-care system, and they try to express themselves, they feel like
they’re not heard by their health-care providers.
Q: What can Black men, and those who love them,
do now to try to improve their health?
A: If they don’t have a primary care physician,
go establish one. That’s my number one thing, and then to understand what your
basic numbers are. What is your blood pressure? What is your weight? What is
your height? What is your hemoglobin A1C? What are your cholesterol levels?
Understanding these numbers is very important. Then engage in preventive care
practices. Get your PSA checked [a marker for prostate cancer]. When Black
men do get diagnosed with prostate cancer, they are at more progressed stages
than White men. That limits our treatment options. If we’d been in the
preventive care system, some of this would’ve been picked up earlier, and we
would have had an opportunity to have additional treatment options. As you
might imagine, the chances of survival are higher. And know your family
history. Is there a family history of diabetes, prostate cancer, breast cancer
or hypertension? Knowing that information is very helpful and sharing it with
your physician helps them, too.
Q: Let me get personal for a moment. How has
your family history again, both of your grandfathers died of heart disease impacted
how you take care of yourself?
A: My father also passed six years ago of
uncontrolled hypertension that led to a stroke. I don’t want to be in that same
situation. I have a primary care physician and I go to my appointments. I also
have a dentist, podiatrist, audiologist, and optometrist. I share my family
history with all of them. Those three men dying has really had an impression on
me and me engaging in the health-care system. If my fingernail hurts a lot,
I’ll go to the doctor.
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*Black men have
the highest mortality rate from cardiovascular disease at 245 per 100,000. Moreover
Black men have the highest cancer death rate at 227.3 per 100,000.
