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For black men with high blood pressure, the barber can be a lifesaver

October 25, 2010

A little off the top, some spirited sports commentary, neighborhood gossip and a bit of man-to-man advice on domestic affairs: it’s all there at the barbershop, an institution that plays a beloved and central role in the African American community. Increasingly, in recent years, the black barbershop owner has become an influential source of health advice too. Public health officials and researchers have been actively enlisting his help in an effort to narrow gaping disparities in healthcare access and uptake that put black men at a deep disadvantage compared with whites.

And deputizing the barber—an already respected figure in many black men’s lives—to dispense solid health advice and steer his patrons toward medical care is a strategy that works, according to a study out Monday in the Archives of Internal Medicine. The most recent study to find barbershops an effective place to address African American health issues looked at what works best. It found that for black men with high blood pressure, a barber can make some inroads just by offering to take a customer’s blood pressure and urge action if it’s high. But he can have twice the impact if he shepherds his clients toward a doctor’s care and rewards them for going.

And talk about taking a little off the top: If all of the nation’s 18,000 African American owned barbershops put in place an active program to screen clients for high blood pressure and steer them aggressively toward care, Cedars-Sinai Heart Institute’s Dr. Ronald G. Victor estimates that some 800 fewer African American men would suffer a heart attack, 550 fewer would have a stroke, and 900 fewer would die—in the first year alone.

Victor, the lead author of the study released Monday, gleaned those numbers from a trial that involved 17 African American-owned barbershops scattered around Dallas. Barbers were instructed in how to take an accurate blood pressure reading, and between March 2006 and December 2008, identified 1,300 African American men with elevated blood pressure.

At eight barbershops, those men got a blood pressure reading in the first 10 months of the study, and were sent home with the standard pamphlets encouraging them to seek further care.

The other nine barbershops gave their patrons the works: a patron would routinely be offered a free blood pressure check at each visit, and if he had a high reading, he’d be encouraged to see a doctor. But the barber didn’t stop there: if, upon his return to the shop, the customer hadn’t seen a doctor, the barber would call the study’s office and make an appointment for him to be seen by a physician. If he came back with a referral card signed by the doctor, he got a free haircut.

The result was better than getting a lollipop at haircut’s end: 10% of men who got the stripped-down reading-and-recommendation treatment had brought their blood pressure under control with medication by the trial’s end; in the group that got the works, 20% did.

For African American men, who die of diseases related to high blood pressure at a rate three times higher than that of white men, that is some potent medicine. Victor, who conducted the study while at the University of Texas Southwestern Medical Center but has since moved to Cedars-Sinai Heart Institute, plans new clinical trials using African American-owned barbershops in Los Angeles.

Other studies have looked at the role of African American-owned barbershops and beauty shops in facilitating their black customers' access to health information and care for a number of conditions that disproportionately affect American blacks, including diabetes and kidney disease, obesity and heart disease.

--Melissa Healy/Los Angeles Times

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