TED2016
Joseph Ravenell: How barbershops can keep men healthy
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The barbershop can be a safe haven for black men, a place for honest conversation and trust -- and, as physician Joseph Ravenell suggests, a good place to bring up tough topics about health. He's turning the barbershop into a place to talk about medical problems that statistically affect black men more often and more seriously, like high blood pressure. It's a new approach to problem solving with broad applications. "What is your barbershop?" he asks. "Where is that place for you where people affected by a unique problem can meet a unique solution?"
Joseph Ravenell - Physician and men’s health advocate
Using unexpected channels like the pulpit and the barber’s chair, Dr. Joseph Ravenell delivers basic health care information to an at-risk demographic -- African-American men. Full bio
Using unexpected channels like the pulpit and the barber’s chair, Dr. Joseph Ravenell delivers basic health care information to an at-risk demographic -- African-American men. Full bio
Double-click the English transcript below to play the video.
00:14
What do you see?
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Most of you see a barbershop,
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but I see an opportunity:
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an opportunity for health,
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an opportunity for health equity.
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For black men, the barbershop
is not just a place
is not just a place
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where you get your hair cut
or your beard trimmed.
or your beard trimmed.
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No, it's much more than that.
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Historically, the barbershop
has been a safe haven for black men.
has been a safe haven for black men.
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It's a place where we go for friendship,
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solidarity and solace.
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It's a place where we go
to get away from the stress
to get away from the stress
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of the grind of work
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and sometimes home life.
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It's a place where we don't have to worry
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about how we're being perceived
by the outside world.
by the outside world.
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It's a place where we don't
feel threatened,
feel threatened,
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or threatening.
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It's a place of loyalty and trust.
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For that reason,
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it's one of the few places
where we can fearlessly be ourselves
where we can fearlessly be ourselves
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and just ... talk.
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The talk, the shop talk, the conversation,
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that is the essence
of the black barbershop.
of the black barbershop.
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I can remember going to the barbershop
with my dad as a kid.
with my dad as a kid.
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We went to Mr. Mike's barbershop
every other Saturday.
every other Saturday.
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And like clockwork,
the same group of men would be there
the same group of men would be there
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every time we went,
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either waiting on their favorite barber
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or just soaking up the atmosphere.
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I can remember the jovial greeting
that warmly welcomed us
that warmly welcomed us
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every time we went.
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"Hey Rev," they would say to my dad.
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He's a local pastor,
and they treated him like a celebrity.
and they treated him like a celebrity.
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"Hey young fella, how you doing?"
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they would say to me,
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making me feel just as special.
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I remember the range
of the conversations was immense.
of the conversations was immense.
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The men would talk about politics
and sports and music
and sports and music
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and world news, national news,
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neighborhood news.
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There was some talk about women
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and what it was like to be
a black man in America.
a black man in America.
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But many times they also
talked about health.
talked about health.
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The conversations about health
were lengthy and deep.
were lengthy and deep.
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The men often recounted
their doctor's recommendations
their doctor's recommendations
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to cut salt in their diet
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or to eat less fried foods
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or to stop smoking
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or to reduce stress.
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They talked about the different ways
you could reduce stress,
you could reduce stress,
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like simplifying one's love life --
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(Laughter)
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all ways to treat high blood pressure.
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There's a lot of talk about
high blood pressure in the barbershop.
high blood pressure in the barbershop.
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That's because almost 40 percent
of black men have it.
of black men have it.
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That means that almost
every single black man
every single black man
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either has high blood pressure
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or knows a black man who has it.
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Sometimes, those conversations
in the barbershop
in the barbershop
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would be about what happens
when high blood pressure
when high blood pressure
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is not adequately addressed.
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"Say, did you hear about Jimmy?
He had a stroke."
He had a stroke."
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"Did you hear about Eddie?
He died last week.
He died last week.
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Massive heart attack.
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He was 50."
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More black men die from high blood
pressure than from anything else,
pressure than from anything else,
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even though decades of medical wisdom
and science have demonstrated
and science have demonstrated
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that death from high blood pressure
can be prevented
can be prevented
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with timely diagnosis
and appropriate treatment.
and appropriate treatment.
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So why is high blood pressure
so differentially deadly for black men?
so differentially deadly for black men?
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Because too often, high blood pressure
is either untreated
is either untreated
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or under-treated in black men,
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in part because of our lower engagement
with the primary healthcare system.
with the primary healthcare system.
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Black men, in particular
those with high blood pressure,
those with high blood pressure,
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are less likely to have
a primary care doctor
a primary care doctor
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than other groups.
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But why?
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Some of our earliest research
on black men's health
on black men's health
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revealed that for many, the doctor's
office is associated with fear,
office is associated with fear,
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mistrust,
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disrespect,
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and unnecessary unpleasantness.
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The doctor's office is only a place
that you go when you don't feel well.
that you go when you don't feel well.
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And when you do go,
you might wait for hours
you might wait for hours
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only to get the run-around
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and to be evaluated by
a stoic figure in a white coat
a stoic figure in a white coat
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who only has 10 minutes to give you
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and who doesn't value the talk.
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So it's no wonder that some men
don't want to be bothered
don't want to be bothered
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and skip going to the doctor altogether,
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especially if they feel fine.
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But herein lies the problem.
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You can feel just fine
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while high blood pressure ravages
your most vital organs.
your most vital organs.
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This is Denny Moe,
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owner of Denny Moe's
Superstar Barbershop in Harlem.
Superstar Barbershop in Harlem.
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I've been lucky enough to have Denny
as my barber for the last eight years.
as my barber for the last eight years.
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He said to me once,
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"Hey Doc, you know,
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lots of black men trust their barbers
more than they trust their doctors."
more than they trust their doctors."
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This was stunning to me,
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at first,
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but not so much when you think about it.
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Black men have been with their
current barbers
current barbers
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on average as long
as I've been with Denny,
as I've been with Denny,
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about eight years.
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And black men see their barbers
about every two weeks.
about every two weeks.
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Not only do you trust your barber
with your look and with your style,
with your look and with your style,
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but you also trust him with your secrets
and sometimes your life.
and sometimes your life.
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Denny, like many barbers,
is more than just an artist,
is more than just an artist,
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a businessman and confidant.
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He's a leader and a passionate advocate
for the well-being of his community.
for the well-being of his community.
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The very first time I walked
into Denny Moe's shop,
into Denny Moe's shop,
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he wasn't just cutting hair.
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He was also orchestrating
a voter registration drive
a voter registration drive
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to give a voice to his customers
and his community.
and his community.
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With this kind of activism,
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and community investment
that typifies the black barbershop,
that typifies the black barbershop,
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of course the barbershop
is a perfect place
is a perfect place
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to talk about high blood pressure and
other health concerns in the community.
other health concerns in the community.
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First, the barbershop is not
a medical setting,
a medical setting,
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and so it doesn't have
all the negative psychological baggage
all the negative psychological baggage
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that comes along with that.
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When you're in a barbershop,
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you're in your territory,
and you're among friends
and you're among friends
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who share your history,
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your struggle and your health risks.
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Second, because the barbershop
is a place of connection,
is a place of connection,
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loyalty and trust,
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it's a place where you're more open
to have a conversation about health
to have a conversation about health
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and especially about high blood pressure.
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After all,
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conversations about high blood pressure
have all the elements of great shop talk:
have all the elements of great shop talk:
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stress and high blood pressure,
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food and high blood pressure,
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relationships and high blood pressure,
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and yes, what it's like
to be a black man in America
to be a black man in America
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and high blood pressure.
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But you can do more than just talk
about high blood pressure
about high blood pressure
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in the barbershop.
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You can concretely take action.
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Here we have an opportunity to partner
with the Denny Moe's of the world
with the Denny Moe's of the world
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and empower communities
to address the health inequities
to address the health inequities
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that uniquely affect it.
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When high blood pressure screening
expanded from clinics and hospitals
expanded from clinics and hospitals
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to communities in the 1960s and '70s,
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black physicians like
Dr. Eli Saunders in Baltimore
Dr. Eli Saunders in Baltimore
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and Dr. Keith Ferdinand in New Orleans
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were at the forefront of bringing
health promotion to community hubs
health promotion to community hubs
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in urban black neighborhoods.
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These pioneers paved the way
for my professional journey
for my professional journey
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with barbershops and health,
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which began in Chicago in medical school.
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The very first research project
that I worked on as a medical student
that I worked on as a medical student
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was to help design
healthcare interventions
healthcare interventions
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that would appeal to black men.
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We conducted about a dozen focus groups
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with a broad cross-section of black men,
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and we learned that for them,
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being healthy was as much about
being perceived as healthy
being perceived as healthy
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as it was about feeling healthy,
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and that feeling good
went hand in hand with looking good.
went hand in hand with looking good.
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This work led to the development
of Project Brotherhood,
of Project Brotherhood,
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a community clinic founded
by Dr. Eric Whitaker
by Dr. Eric Whitaker
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that provided tailored
healthcare to black men.
healthcare to black men.
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Part of this tailored care
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involved having a barber on the premises
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to reward the men who came
for needed healthcare
for needed healthcare
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with a free haircut,
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to let the men know that we, too,
valued how they looked
valued how they looked
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as well as how they felt,
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and that what was important to them
was also important to us.
was also important to us.
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But while there's only one
Project Brotherhood,
Project Brotherhood,
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there are thousands of black barbershops
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where the intersection of health
and haircuts can be cultivated.
and haircuts can be cultivated.
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The next stop on my journey
was Dallas, Texas,
was Dallas, Texas,
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where we learned that barbers
were not only willing
were not only willing
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but fully able to roll up
their sleeves and participate
their sleeves and participate
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in delivering needed health services
to improve the health of their customers
to improve the health of their customers
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and their community.
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We teamed up with an amazing
cadre of black barbers
cadre of black barbers
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and taught them how
to measure blood pressure
to measure blood pressure
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and how to counsel their customers
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and refer them to doctors
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to help manage high blood pressure.
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The barbers were not only willing to do it
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but they were damn good at it.
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Over a three-year period,
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the barbers measured
thousands of blood pressures
thousands of blood pressures
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resulting in hundreds of black men
being referred to doctors
being referred to doctors
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for medical care
of their high blood pressure.
of their high blood pressure.
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These barber-doctor partnerships
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resulted in a 20 percent increase
in the number of men
in the number of men
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who were able to achieve
target blood pressure levels
target blood pressure levels
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and a three-point drop, on average,
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in the blood pressure of each participant.
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If we were to extrapolate
that three point drop
that three point drop
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to every single black man
with high blood pressure in America,
with high blood pressure in America,
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we would prevent 800 heart attacks,
500 strokes and 900 deaths
500 strokes and 900 deaths
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from high blood pressure
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in just one year.
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And our experience with barbershops
has been no different in New York City,
has been no different in New York City,
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where my journey has currently led me.
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With an incredible team
of diverse research assistants,
of diverse research assistants,
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community health workers and volunteers,
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we've been able to partner
with over 200 barbershops
with over 200 barbershops
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and other trusted community venues
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to reach over 7,000 older black men.
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And we've offered high blood pressure
screening and counseling
screening and counseling
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to each and every one of them.
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Thanks to Denny Moe
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and the myriad other barbers
and community leaders
and community leaders
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who shared the vision of opportunity
and empowerment
and empowerment
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to make a difference in their communities,
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we've been able to not only
lower blood pressure
lower blood pressure
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in our participants,
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but we've also been able to impact
other health indicators.
other health indicators.
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So what do you see?
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What is your barbershop?
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Where is that place for you
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where people who are affected
by a unique problem
by a unique problem
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can meet a unique solution?
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When you find that place,
see the opportunity.
see the opportunity.
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Thank you.
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(Applause)
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ABOUT THE SPEAKER
Joseph Ravenell - Physician and men’s health advocateUsing unexpected channels like the pulpit and the barber’s chair, Dr. Joseph Ravenell delivers basic health care information to an at-risk demographic -- African-American men.
Why you should listen
Colorectal cancer and hypertension are the two leading causes of death among African-American males over 50, and yet these men remain underserved by basic diagnostic procedures such as blood pressure checks or cancer screening. By tapping the members of the African-American community most often trusted by men -- barbers and religious leaders -- Joseph Ravenell hopes to change that.
Working with New York University's Men's Health Initiative, Ravenell studies and implements community-based strategies to diagnose and treat these preventable and potentially deadly diseases, offering blood pressure readings at barbershops and health education at churches and mosques.
Joseph Ravenell | Speaker | TED.com