Johns Hopkins Professor Says Include Black Males in Health Research
| April 6, 2017 | Future health research must include a sufficient number of black men, to ensure the most effective care and strategy for the minority group, said Roland Thorpe, Ph.D., an associate professor in the Johns Hopkins Bloomberg School of Public Health.
To be valid, it also must ensure that black men stay with a study as they age, Thorpe said, as well as include key societal factors that affect health.
Thorpe, director of the school’s Program for Research on Men’s Health, spoke to UAMS faculty, staff and students March 29 on his several years of work on this subject. The event was hosted by the UAMS Center for Diversity Affairs.
Thorpe was first attracted to this area of research when a slide from his presentation to an undergraduate class caught his attention. The slide showed a shorter life expectancy for black males throughout the 20th century and into the 21st century, compared to black females, white males and white females.
“I asked myself, ‘Why is that so low?’” said Thorpe. “It just struck me.”
Since then, he’s looked for reasons why black men have disproportionately higher levels of illness and chronic disease along with shorter life expectancy.
He acknowledged common explanations in health research circles, including the belief the group takes more health risks, is reluctant to disclose health issues and delays seeking medical attention. However, Thorpe said he has wondered if other factors were being ignored, such as education, housing, police brutality and discrimination.
Billy Thomas, M.D., M.P.H., vice chancellor for diversity and inclusion and director of the UAMS Center for Diversity Affairs, introduces Thorpe. The lecture was hosted by the Center for Diversity Affairs.
“Oftentimes, when we think about people’s health, we haven’t thought about how all these different things come together to affect health,” said Thorpe.
Thorpe has devoted much of his time over the last several years to looking at another factor he said has been ignored — segregation.
Thorpe referenced his home of Baltimore, Maryland, and the affluent neighborhoods that surround an “open, nice campus” at Johns Hopkins University where the life expectancy is about 84 years. Meanwhile, miles away at Johns Hopkins Hospital, Thorpe said, security guards and cameras are everywhere and the life expectancy is about 66 years.
“That’s an 18- or 19-year difference over a five-mile radius,” said Thorpe. “These are examples of how segregation has resulted in structural barriers that we oftentimes don’t think about.”
His 2003 study, Exploring Health Disparities in Integrated Communities, was designed to assess the nature of health disparities for blacks and whites in similar social and environmental conditions.
Thorpe’s study assessed nearly 1,500 black and white adult men in two, low-income areas of Baltimore through a face-to-face interview and three blood pressure measurements.
It showed the prevalence of hypertension, diabetes, stroke and obesity were similar among white and black men. This differed from the 2003 National Health Interview Survey, an annual nationwide study, that showed black men had much higher rates of hypertension, diabetes and obesity.
“The results were exciting to me because it provided an opportunity to move away from talking about racial differences in health risk profiles,” said Thorpe. “We could start thinking about interventions and health promoting strategies to focus on social environmental conditions.”
Thorpe stipulated his study’s results may differ in rural areas or higher socioeconomic regions and said he’s preparing a grant application to find results in higher income areas.
Moving forward, Thorpe said, it is important for studies to include a sufficient number of black men and retain them in the study as they age.
“If there’s a small number of participants, it can result in inappropriate treatment guidelines, policies and health promoting strategies,” said Thorpe.
He also highlighted the need to include important factors of health and health behavior for black men, such as education, sexual orientation, housing, racism, segregation, police brutality and stress.
“We have to consider these determinants when developing new health policies that meet the needs of specific populations such as black males,” said Thorpe.
Also important to future research, Thorpe said, is using a life course approach to better understand how early events in life impact health outcomes later in life, and studies that include environmental, sociocultural, behavioral and biological analyses together.