Social epidemiologist Roland Thorpe Jr. has a dual mission: to improve the health and extend the lifespan of black men, and to do the same for himself since both of his grandfathers died prematurely of heart disease.
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“Black men are hidden in plain sight,” says Thorpe. “I mean, we have the worst health profile. We have premature mortality, which means we die before the overwhelming majority of men. We are often in the media either attacked by the police or enduring other experiences of structural racism. Very little support has been given. The evidence is all in front of us, but there doesn’t seem to be any particular people calling it out or pointing to solutions.
For example, he says, when it comes to heart disease, black men are 30% more likely to die than white men; for stroke, it’s 60%. And they are 75% less likely to have health insurance than white men. But the numbers don’t tell the whole story. Thorpe recently sat down with The Washington Post for an interview. The conversation has been edited for length and clarity.
Q: You spoke openly and personally about the fact that both of your grandfathers died of heart disease in their 60s. What is the embedded message here?
A: A majority of black men do not receive preventive care. They should establish a [relationship with] a primary care physician. None of my grandfathers were involved in the health care system. By the time they got there they were pretty familiar with the Tuskegee Public Health Department syphilis study, so I could probably understand why they didn’t go to the 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: This 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 healthcare system to engage black men, like listening to them when they say they have concerns and then involving them in shared decision-making about their health and health care. But we still have a long way to go.
Q: Are you referring to the still significant gap between the average life expectancy of a black man and that of a white man?
A: Do I think we have improved and improved? I do not think so. Before covid, we extended the lives of black men, absolutely. But on the other hand, [life expectancy for] everyone is equally extended. This means that the gap has not narrowed. Since covid, everyone’s life expectancy has gone down, with black people experiencing twice the reduction of white people.
Q: What other health challenges do black men face?
A: Much of this gap is based on the structural racism that black men experience at all levels of socioeconomic status. Stress is one of the primary pathways through which structural racism affects health. These accumulations of stress have an impact on different physiological systems which then lead to the earlier onset of chronic diseases such as hypertension and heart disease, which contributes to making our life expectancy much shorter than that of white men. .
Q: Police violence is also seen as an aspect of structural racism. You previously suggested that police killings of black men impact the health and well-being of other black men.
A: Police brutality also contributes to the problem, and this is linked to structural racism. I think of Rodney King, and the most important recently was George Floyd. There were others too. Just to see another black man die on TV is very traumatic, and a lot [White] people don’t think about the trauma that black men have endured, to even have to watch this. Black men have one of the most horrible health profiles, and we have few resources at our disposal to improve that, like dealing with that trauma.
Q: Are you saying that witnessing these murders on TV increases stress for black men, leading to other health problems? Or that it increases black distrust of institutions in general, including medical institutions?
Q: How do you hope the Black Men’s Health Project will help you?
A: Our goal is to raise awareness about black men’s health and the social and historical issues that black men have faced that may impact their health. One of the key things for us is to create a survey of black men’s health, to create a cohort to better understand their health trajectory. There are currently no studies that focus solely on the specific needs of black men.
Q: When it comes to mental health, what disparities exist according to race?
A: There are racial disparities when it comes to mental health. But the disparity is a little trickier because black men fare even worse because there’s [more of] a stigma associated with black men saying they have mental issues. Typically, when black men go into the healthcare system and try to speak up, they feel like they’re not being heard by their healthcare 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 create one. That’s my first thing, and then figure out what your base numbers are. What is your blood pressure? What is your weight? How tall are you? What is your hemoglobin A1C? What is your cholesterol level? Understanding these numbers is very important.
Then, engage in preventive care practices. Get your PSA checked [a marker for prostate cancer]. When black men are diagnosed with prostate cancer, they are in more advanced stages than white men. This limits our treatment options. If we had been in the preventive care system, some of this would have been detected earlier, and we would have had the opportunity to have additional treatment options. As you can 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 this information is very helpful and sharing it with your doctor also helps them.
Q: Let me be personal for a moment. How has your family history – again, both of your grandfathers died of heart disease – impacted the way you take care of yourself?
A: My father also died six years ago of uncontrolled high blood pressure which led to a stroke. I don’t want to be in the same situation. I have a regular doctor and I go to my appointments. I also have a dentist, a podiatrist, an audiologist and an optometrist. I share my family history with each of them. These three men who died really marked me and me who is involved in the health system. If my nail hurts badly, I’ll go to the doctor.
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