Roland James Thorpe, Jr.

• PhD
• Managing Director at Johns Hopkins Bloomberg School of Public Health

Alzheimer’s disease related pathologies, neurodegenerative pathologies, and vascular neuropathologies are common in older adults at death. Previous studies using the National Alzheimer’s Coordinating Center (NACC) have not investigated the association between age at death and apolipoprotein E (APOE) ε4 and the prevalence of neuropathologies found a...

This paper explores the implications of the National Institute on Aging (NIA) Health Disparities Research Framework (HDRF) in understanding and addressing health disparities in aging populations. The framework provides a comprehensive lens through which researchers examine the intersection of biological, social, behavioral, and environmental factor...

Background Disparities in neighborhood food environments in the United States, attributed to numerous complex economic, social, and political factors, likely to contribute to disparities in access to healthy food and cognitive function in older adults. However, the role of food environment in cognitive function is not well understood. Accordingly,...

A likely determinant of cognitive function is incarceration. Structural racism directs adverse policing to differentially patrol groups racialized as Black increasing the chances of incarceration, leading to disproportionate representation in prisons. Direct and indirect exposure to incarceration produces chronic stress and trauma for adults racial...

Despite overall improvements in the accessibility, quality, and outcomes of care in the U.S. health care system over the last 30 years, a large proportion of marginalized racial and ethnic minority (minoritized) groups continue to suffer from worse outcomes across most domains. Many of these health disparities are driven by inequities in access to...

BACKGROUND Chronological age (CA) is independently associated with arterial stiffness, but it is not a sufficient measure of aging or the disparities related to disease risk. While biological age (BA) is considered a more accurate indicator of disease risk, the relationships among BA, CA, and arterial stiffness remain inconclusive. METHODS In 222...

Importance: Discrimination in healthcare disrupts trust and can negatively influence patients. However, the impact of experiencing discrimination on long–term patterns of healthcare utilization is unknown. Objective: To assess how perceived discrimination in healthcare settings is associated with longitudinal patterns of doctor visits among middle–...

Black/African American individuals experience high rates of posttraumatic stress disorder (PTSD), which is frequently chronic and undertreated in this population. Intimate relationships are a salient resource for Black/African American adults’ psychological well-being. To help advance health equity, this study serves as an initial, proof-of-concept...

Background Hypertension and obesity are major public health problems in the United States and Maryland. Objectives To assess the impact of Medication Therapy Management (MTM) on controlling hypertension and obesity in a sample in Southern Maryland: Prince George’s, Calvert, Charles, and St. Mary’s counties. Methods 171 patients with high blood pr...

Prior disparities in obesity research emphasize socioeconomic status as a potential driver of White-Black differences in obesity prevalence, but there is a paucity of research examining the influence of education on the observed racial difference among men. The objective of this study was to determine whether the relationship between race and obesi...

The objective of this study was to determine if racial differences exist between older Non-Hispanic Black (NHB) and White (NHW) men in incident dementia over 11 years (2011–2022) in the National Health and Aging Trends Study (NHATS). The analytic sample included 2395 community-dwelling NHB and NHW men free of dementia at baseline who self-identifie...

Objective The objective of this study was to examine the interrelationships between cognitive performance, race/ethnicity, discrimination, health behaviors, and physiological dysregulation. Methods We used data from the Multi-Ethnic Study of Atherosclerosis (MESA) ( N = 1667). We used path analyses to examine the association between discrimination...

Objective This study examines the longitudinal relationship between subjective memory problems (SMPs) and timed instrumental activity of daily living (IADL) performance while considering the effects of depressive symptoms and the moderating role of the social determinants of health (SDHs). Methods Data from 2622 older adults in the Advanced Cognit...

Objective This article introduces a special issue on advancing Alzheimer’s disease (AD) and AD-related dementias (ADRD) research drawing from research conducted by the Johns Hopkins Alzheimer’s Disease Resource Center for Minority Aging Research (JHAD-RCMAR). Method We describe the JHAD-RCMAR, highlighting work of early career investigators in the...

Objective The objective of this study was to examine the association between religious practices, beliefs, and cognitive impairment among Black and White men with modest incomes in the 2016 Health and Retirement Study. Methods Data were drawn from Black and White men who reported annual incomes at or below $50,000 ( n = 926). The primary outcome w...

Background Strokes are a leading cause of death and disability among African Americans in the United States. Biological markers to predict stroke remain elusive; thus, our objective was to investigate whether inflammation, as measured by high-sensitivity C-reactive protein (hs-CRP), was associated with stroke incidence among African Americans enrol...

Background Psychosocial stressors such as childhood trauma have been associated with an increased risk of hypertension. The impact of childhood trauma on vascular dysfunction in Black adults remains less clear. We examined the association between childhood trauma and vascular function in Black adults. Methods and Results Childhood trauma exposure...

High allostatic load (AL), a measure of physiological dysregulation, has been linked with premature morbidity and mortality. There is a paucity of research assessing AL among non-Hispanic Black (NHB) and non-Hispanic White (NHW) American men of various age groups. This study investigated racial differences in AL among NHB and NHW adult men and asse...

Background and Objectives Social isolation is an increasing public health concern. Older residents in subsidized housing may be susceptible to isolation given high rates of chronic illness/disabilities, low income, and living alone. This cross-sectional study examined correlates of social isolation among over 3,000 older adults from nearly 100 subs...

Objective We sought to identify the subgroups regarding the school environment (desegregated or segregated), educational attainment, occupation type, income, and cognition among older Black adults. Methods Data from older Black adults (n=602; age range: 48 to 95 years) from the Baltimore Study of Black Aging—Patterns of Cognitive Aging (BSBA-PCA)...

Social connection has been consistently shown to influence health status and recent research findings suggest that an absence of relationships with significant others can increase risks for cognitive impairment. Few studies have examined how the presence or absence of social connections have implications for cognitive impairment and even fewer have...

This study explored associations between spirituality and cognitive performance within Black and White adults in the HANDLS Sleep Study (n=85; 52% Black adults; age range: 46-82). The Spirituality Transcendence Scale-Short Form measured overall spiritual transcendence orientation and three subscale scores (Prayer Fulfillment, Universality, and Conn...

Purpose Discrimination in healthcare settings significantly impacts population health, affecting individuals of racial and ethnic minoritized identities, sexual and gender minoritized identities, and individuals with disabilities. Most measures of discrimination are derived from instruments assessing everyday discrimination experiences and do not a...

There is increased awareness among basic and clinical scientists that psychological and social stress can have detrimental effects on physical, cognitive, and mental health. Data have been published indicating that social, economic, psychological, and physical environmental stress can influence behavior that has biological and physiological consequ...

Background: Arterial stiffness is a precursor of hypertension and hallmark of vascular aging. Chronological age (CA), a robust determinant of arterial stiffness, is considered an insufficient indicator of aging and disparities associated with disease risk. Biological age (BA), the true age based on physiological decline, is recognized as a better i...

To examine the interaction between minimum wage policy, income inequality, and obesity rates among U.S. counties, and how this relationship is shaped by policy, place, and racial/ethnic composition in a county. We used the County Health Rankings Data for obesity ratio (measured by Body Mass Index ≥ 30 kg/m2) in US counties and combined it with the...

Objective To evaluate the potential of using specific biopsychosocial instruments in capturing data on the relationship between stress and obesity and determine if job satisfaction influences the effect estimate. Participants Fifty-three Black employees at a Historically Black College and University (HBCU). Methods Logistic regression analyses we...

Cognitive ability and cognitive decline are related to mortality in older adults. Cognitive interventions have been found to improve cognitive performance and slow cognitive decline in later life. However, the longitudinal effects of cognitive interventions on mortality in older adults remain unclear. Using twenty-year follow-up data from the Advan...

Background Loneliness is a biopsychosocial stressor linked to poor health outcomes including dementia. Few studies have focused on this association among men and even fewer have examined racial disparities in loneliness and cognitive functioning among this group. The purpose of this study was to examine racial differences in the association between...

Objective In this study, we examined associations between county-level measures of structural racism and county-level cancer incidence and mortality rates between race groups while accounting for factors associated with cancer rates and county-level measures of environmental burden. Methods To explore this relationship, we conducted multiple linea...

Maternal separation with early weaning (MSEW) is a popular early life stress (ELS) model in rodents, which emulates childhood neglect through scheduled mother-offspring separation. Although variations of ELS models, including maternal separation and MSEW, have been published for the mouse species, the reported results are inconsistent. Corticostero...

Background and Objectives: Older patients diagnosed with chronic kidney disease (CKD) have a higher risk of all-cause mortality than the general population. However, there is limited information available on how CKD relates to all-cause mortality among Black adults in the United States. We aimed to investigate how CKD relates to all-cause mortality...

Objectives: While existing research has shown that Black adults have worse cognitive functioning than their White counterparts, the psychosocial correlates of cognitive functioning for Black older adults are understudied. The objective of this study was to investigate the relationships among perceived neighborhood characteristics, psychosocial res...

Alzheimer's disease and related dementias (ADRDs) and age‐related hearing loss are the intersection of two major public health challenges. With age as the primary risk factor for both disease processes, the burden of ADRDs and age‐related hearing loss is growing, and each field maintains significant barriers to broadscale identification and managem...

Social determinants of health encompass complex societal factors that can greatly impact individuals’ health and well-being across the lifespan. Among several proposed frameworks, the World Health Organization has conceptualized social determinants as interconnected factors that include: (1) structural determinants (health inequity, income/poverty,...

Objective Racial disparities in health outcomes are a persistent threat in gentrifying neighborhoods. A contributor to health outcomes is health services utilization, the extent to which people receive care from a medical professional. There are documented racial disparities in health services utilization in the general population. We aim to determ...

To estimate the association between income inequality and allostatic load score (AL) in adults ages 20 years and older, with a particular focus on the differential impacts across racial and gender groups. By examining this association, the study seeks to inform targeted policy interventions to mitigate health disparities exacerbated by economic ine...

Background Although racial disparities in lung cancer incidence and mortality have diminished in recent years, lung cancer remains the second most diagnosed cancer among US Black populations. Many factors contributing to disparities in lung cancer are rooted in structural racism. To quantify this relationship, we examined associations between a mul...

Background Dementia disproportionately impacts older minoritized adults with kidney failure. To better understand the mechanism of this disparity, we studied the role of racial and ethnic segregation (segregation hereafter), a form of structural racism recently identified as a mechanism in numerous other health disparities. Methods We identified 9...

Introduction: Older adults racialized as Black experience higher rates of dementia than those racialized as White. Structural racism produces socioeconomic challenges, described by artist Marvin Gaye as “hang ups, let downs, bad breaks, setbacks” that likely contribute to dementia disparities. Robust dementia literature suggests socioeconomic facto...

Background Black-White racial disparities in cancer mortality are well-documented in the US. Given the estimated shortage of oncologists over the next decade, understanding how access to oncology care might influence cancer disparities is of considerable importance. We aim to examine the association between oncology provider density in a county and...

Background This study investigated the association between previous incarceration and various geriatric and chronic health conditions among adults 50 and older in the United States. Methods Data came from the National Longitudinal Study of Adolescent to Adult Health – Parent Study (AHPS) collected in 2015-2017, including 2,007 individuals who part...

Introduction: Black women develop hypertension (HTN) earlier in life and experience higher cardiovascular disease (CVD) morbidity and mortality rates at younger ages compared to White women. Growing evidence suggests this may be due to Black women experiencing premature physiological deterioration and accelerated biological aging, true global state...

Introduction: There is a knowledge gap in the potential unequal burden and progression of cardiovascular multimorbidity. Understanding the progression of cardiovascular multimorbidity and recognizing racial and ethnic disparities are needed to develop effective strategies to achieve health equity. Our objective is to investigate racial and ethnic d...

In the United States, strokes are a leading cause of death and disabilities, especially for older adults; however, effective biological markers to predict stroke remain elusive. The objective of this study was to investigate the association between inflammation, as measured by high-sensitivity c-reactive protein (hs-CRP) and stroke incidence among...

Introduction: Understanding the progression of cardiovascular multimorbidity and recognizing differences are needed to develop effective strategies to improve health outcomes. There is a knowledge gap in the potential unequal burden and progression of cardiovascular multimorbidity. Our objective is to investigate sex differences in the progression...

Objectives: To investigate the longitudinal association of life space and neighborhood and built environment (NBE) with subjective memory among individuals 65 and older, and the mediating role of depressive symptoms, a major correlate of life space mobility, NBE, and subjective memory. Methods: We examined community-dwelling participants in the Adv...

Background and Objectives Consumer credit has shown increasing relevance to the health of older adults; however, studies have not been able to assess the extent to which creditworthiness influences future health or health influences future creditworthiness. We assessed the relationships between four-year pre- and post-morbid consumer credit history...

Importance Identifying the mechanisms of structural racism, such as racial and ethnic segregation, is a crucial first step in addressing the persistent disparities in access to live donor kidney transplantation (LDKT). Objective To assess whether segregation at the candidate’s residential neighborhood and transplant center neighborhood is associat...

Objective The primary objective of this study was to determine whether HEI and AHEI scores were associated with incident metabolic syndrome. Design This study is a secondary analysis of data from the Jackson Heart Study. HEI and AHEI scores were divided into quintiles and Cox proportional hazards regression models were analyzed for 1864 African Am...

Black American adults often report higher rates of obesity and caregiving compared with other racial or ethnic groups. Consequently, many Black American caregivers and care recipients are obese or have obesity-related chronic conditions (e.g., diabetes, hypertension). This study investigated associations between caregiving and obesity among Black A...

Background Mexican Americans (MAs) endure racial/ethnic disparities in Alzheimer’s Disease (AD) risk, such as late‐stage diagnosis, earlier onset, and more severe forms of cognitive impairment (CI) compared to non‐Hispanic Whites (NHWs), despite low propensity for the genetic predisposition (e.g., APOE e4 has limited effect on MA AD risk). These co...

Background Black‐White disparities in cognitive test scores are well documented. Studies suggest that structural racism‐related factors like quality of education and cumulative stress exposure may contribute to disparities in inflammation and cardiometabolic health that undergird racial disparities in Alzheimer’s disease and cognitive health. Meth...

Background Previous research suggests that hypertension shape cognitive health outcomes in older Blacks (Whitfield 2008). However, few studies have explored the relation between objective and subjective blood pressure (BP) measures and cognitive decline. This study examined whether systolic, diastolic, and self‐reported BP were associated with chan...

Background Studies have suggested that neighborhood quality is associated with health outcomes beyond individuals’ socioeconomic characteristics (Kind & Buckingham, 2018; Ludwig et al., 2011). Limited research has explored how subjective neighborhood quality is associated with cognitive functioning, particularly among socioeconomically diverse Blac...

Objective We sought to understand the relationship between school setting attendance (desegregated or segregated) and the cognition among older Black men. Methods Data from older Black men (n=153; age range: 50 to 89 years) from the Baltimore Study of Black Aging—Patterns of Cognitive Aging (BSBA-PCA) was used to explore the relationship between t...

Black men experience multiple stressors linked with cognitive impairment and have higher risks for Alzheimer’s Disease and related dementias than their White peers. Yet, few studies have focused on coping resources. Religious beliefs and institutions are thought to have health benefits; however, no study to our knowledge has examined religious prac...

Remote cognitive screening modalities can be an initial step in assessing cognitive health. This cross-sectional study examined how risk and protective factors relate to cognitive performance in non-demented African Americans aged 50 and older. Participants were part of the African American-United Memory and Aging Project (AA-UMAP), a geographicall...

Limited research has explored the association between neighborhood environments and cognitive functioning using longitudinal reports of neighborhood quality. The current study examined the longitudinal association between perceived neighborhood characteristics and computerized cognitive performance among Black adults. This study included 584 commun...

Older African American women experience social determinants of health that put them at risk for experiencing comorbid pain and depressive symptoms. The purpose of our study was to tailor a preexisting evidence-based depression intervention to include pain and test it in older African American women. We conducted a randomized waitlist control study...

Previous research suggests that perceptions of stress shape cognitive health outcomes. However, few studies have explored this association longitudinally. The aim of this study was to determine whether perceived stress is associated with cognitive changes over time and if blood pressure (BP) acts as a moderator in a sample of older Blacks 48 to 95...

Objective Although typically serving higher income and younger demographic groups, meal-kit subscription services have the potential to improve food availability and dietary quality in communities experiencing low food access due to systemic discrimination. This study describes the development and characteristics of a pilot community-led meal–kit s...

A food desert is defined as a census tract with limited access to affordable and nutritious foods. Inequitable access to healthy food may contribute to disparities in cognitive health, but little is known about the role of food deserts in cognitive health. We examined association between living in food deserts and cognitive function in older adults...

The purpose of this study was to develop a deep understanding of the lived experiences of structural racism and discrimination among older Black Americans’ and their perceptions of structural racism across their lives. We also considered individual and community resilience capacity and response in the face of systemic racism. In-depth interviews we...

As we age, the ability to move is foundational to health. Life space is one measure of a person’s ability to move and engage in activity beyond the home. A separate but related concept is activity space, a measurement of a person’s spatial behaviors and visited locations that include social networks, neighborhoods, and institutions. In this article...

Obesity prevalence in the United States has increased drastically in the last two decades. Racial differences in obesity have emerged with the increase in obesity, with temporal trends because of individual, socioeconomic, and environmental factors, eating behaviors, lack of exercise, etc., raising questions about understanding the mechanisms drivi...

Importance Evidence suggests that racial disparities in health outcomes disappear or diminish when Black and White adults in the US live under comparable living conditions; however, whether racial disparities in health care expenditures concomitantly disappear or diminish is unknown. Objective To examine whether disparities in health care expendit...

Objectives: To evaluate the relationships between perceived neighborhood racial composition (PNRC), psychosocial risks and resources, and depressive symptoms among young (ages 22–35), middle-aged (ages 36–49), and older (ages 50+) Black Americans. Methods: Full sample and age-stratified linear regression models estimated the PNRC-depressive symptom...

Objective To assess domains of social determinants of health (SDoH) and their associations with cognition and quality of life. Method This investigation uses baseline data from individuals participating in the ACTIVE trial (n = 2505) to reproduce the SDoH domains described in Healthy People 2030 (economic stability, health care, education, neighbo...

Objective: To determine the association between baseline cognition and all-cause mortality among Black men and White men. Methods: Data were from 614 Black and White men aged ≥65 years at baseline in the Advanced Cognitive Training for Independent and Vital Elderly trial and their linked mortality information. Cox proportional hazards models were u...

Objectives We assessed the relationships between pre- and post-morbid consumer credit history (credit scores, debts unpaid, or in collections) and classification of mild (or greater) cognitive impairment (MCI). Methods Generalized Estimating Equation models assessed pre-and post-morbid credit history and MCI risk among 1740 participants aged 65+ i...

Objective: We examined whether social determinants of health (SDoH) are associated with Alzheimer’s disease and related dementias (ADRD) risk and the effects of cognitive training over a 20-year follow-up period. Methods: Data were obtained from 1605 participants in ACTIVE. SDoH measures were created using baseline data at the individual and neighb...

Objective: The purpose of this article is to introduce a special issue on the ACTIVE project examining the association between race and social determinants of health (SDoH) and long-term participant outcomes and training effectiveness for older Black/African Americans and Whites in the ACTIVE (for Advanced Cognitive Training for Independent and Vit...

Objectives: The current study examines relationships between Body Mass Index (BMI) and cognitive performance and change in processing speed, memory, and reasoning, while accounting for variations by race and the influence of social determinants of health. Methods: Secondary data analysis of the Advanced Cognitive Training for Independent and Vital...

Background and Objectives The intersection of race, gender and age puts older African American women at high risk of experiencing comorbid pain and depressive symptoms. The purpose of this study was to assess feasibility and acceptability of a 12-week behavioral activation intervention to target self-selected goals related to pain and depressive sy...

Alzheimer’s Disease (AD) continues to be a leading cause of death in the US. As the US aging population (ages 65 +) expands, the impact will disproportionately affect vulnerable populations, e.g., Hispanic/Latino population, due to their AD-related health disparities. Age-related regression in mitochondrial activity and ethnic-specific differences...

Background: Pain and depression frequently co-occur among older adults with comorbidities and can exacerbate one another. The intersection of race, gender and age puts older African American women at high risk of experiencing comorbid pain and depression. The purpose of this study is to test the feasibility and acceptability of a 12-week behaviora...

Background: Households including someone with disabilities experience disproportionately high food insecurity rates and likely face disproportionate barriers accessing Supplemental Nutrition Assistance Program (SNAP) benefits. Objective: This article aims to examine the role of SNAP with regard to food insecurity disparities based on disability...

Importance: Racially minoritized people experience disproportionately high rates of food insecurity. The Supplemental Nutrition Assistance Program (SNAP) reduces food insecurity. Objective: To evaluate SNAP access with regard to racial disparities in food insecurity. Design, setting, and participants: This cross-sectional study used data from...

This study aimed to examine whether hypertension prevalence varies by race/ethnicity and within age groups in a nationally representative sample of men in the United States. Hypertension was defined as blood pressure (BP) readings of 140 mm Hg and higher for systolic BP, 90 mm Hg and higher for diastolic BP, or self-reports of taking medication for...

Alzheimer’s Disease (AD) continues to be a leading cause of death in the US. As the US aging population (ages 65+) expands, the impact will disproportionately affect vulnerable populations, e.g., Hispanic/Latinx population, due to their AD-related health disparities. Age-related regression in mitochondrial activity and ethnic-specific differences i...

Background: Disparities in diagnosis persist among persons living with dementia (PLWD); most research on delayed diagnosis relies on medical records or administrative claims. This study aimed to identify factors that delay or facilitate dementia diagnoses in racial or ethnic minoritized PLWD and elicit care partner perspectives on timing and effec...

Introduction: Hypertension (HTN) develops at a disproportionately higher rate among African Americans compared to any other racial group. Substantial evidence indicates that aerobic exercise mitigates HTN. However, only 41% of African Americans report meeting leisure-time aerobic exercise recommendations, the lowest percentage compared to other rac...

The Black-White racial employment disparity and its link to mortality have demonstrated the health benefits obtained from employment. Further, racial/ethnic mortality disparities existing among men with different employment statuses have been previously documented. The purpose of this study was to examine the association between employment status a...