TED2016
Joseph Ravenell: How barbershops can keep men healthy
Joseph Ravenell: 理发店如何促进男性健康
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理发店是黑人的避风港，他们可以真诚地交谈，互相信任。内科医师 Joseph Ravenell 认为，理发店也是提出敏感的健康话题的好地方。他把附近的理发店变成讨论医疗问题的地，数据显示，这能更频繁更有效帮助黑人改善健康问题，比如高血压。这个解决问题的新途径还可以拓展它的用途。“你的理发店是什么？”他问。“对你来说，那个能够帮助面对独特难题的人找到独特解决方法的地方是哪里？”
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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这是什么？
00:17
Most of you see a barbershop,
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大部分人看到的是理发店
00:20
but I see an opportunity:
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我看到的却是机会
00:23
an opportunity for health,
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促进健康的机会
00:26
an opportunity for health equity.
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促进健康平权的机会。
00:30
For black men, the barbershop
is not just a place
is not just a place
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对黑人来说，理发店不仅仅是
一个帮你剪头发、刮胡子的地方。
00:33
where you get your hair cut
or your beard trimmed.
or your beard trimmed.
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00:37
No, it's much more than that.
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不，远远不止如此。
00:40
Historically, the barbershop
has been a safe haven for black men.
has been a safe haven for black men.
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历史上，
理发店是黑人的避风港
理发店是黑人的避风港
00:45
It's a place where we go for friendship,
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是我们获得友谊
相互支持和安慰的地方
00:48
solidarity and solace.
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00:52
It's a place where we go
to get away from the stress
to get away from the stress
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是我们排解压力
00:55
of the grind of work
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从繁重的工作和家庭压力
解脱出来的地方。
00:58
and sometimes home life.
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01:02
It's a place where we don't have to worry
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在这里我们不用担心外界眼光
01:04
about how we're being perceived
by the outside world.
by the outside world.
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01:08
It's a place where we don't
feel threatened,
feel threatened,
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在这里我们不会感到威胁
01:11
or threatening.
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和被他人威胁的地方。
01:15
It's a place of loyalty and trust.
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一个充满忠诚和信任的地方。
01:18
For that reason,
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因为这些原因
01:20
it's one of the few places
where we can fearlessly be ourselves
where we can fearlessly be ourselves
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它是少数几个
我们可以毫无顾虑地做自己
我们可以毫无顾虑地做自己
01:24
and just ... talk.
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轻松聊天的地方。
01:28
The talk, the shop talk, the conversation,
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闲扯、乱聊、谈心
01:31
that is the essence
of the black barbershop.
of the black barbershop.
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这就是黑人理发店的本质。
01:35
I can remember going to the barbershop
with my dad as a kid.
with my dad as a kid.
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我记得小时候和爸爸去理发店
01:39
We went to Mr. Mike's barbershop
every other Saturday.
every other Saturday.
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我们每隔一个周六去麦克先生家的理发店
就像钟表发条一样，每次我们去
01:43
And like clockwork,
the same group of men would be there
the same group of men would be there
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都会有同样一群人在那里
01:47
every time we went,
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01:48
either waiting on their favorite barber
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要么在等他们最喜欢的理发师
01:51
or just soaking up the atmosphere.
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要么沉浸在那种氛围中。
01:55
I can remember the jovial greeting
that warmly welcomed us
that warmly welcomed us
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我记得每次去的时候
都受到热情的问候。
01:59
every time we went.
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02:01
"Hey Rev," they would say to my dad.
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“嘿，小雷。” 他们向我爸打招呼。
02:05
He's a local pastor,
and they treated him like a celebrity.
and they treated him like a celebrity.
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我爸是当地的牧师
他们像对待名人一样对待他。
他们像对待名人一样对待他。
02:09
"Hey young fella, how you doing?"
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“嘿，小家伙，你好。”
02:12
they would say to me,
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他们向我打招呼。
02:13
making me feel just as special.
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这让我觉得自己很特别。
我记得谈话的主题无所不包。
02:17
I remember the range
of the conversations was immense.
of the conversations was immense.
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02:22
The men would talk about politics
and sports and music
and sports and music
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男人们会谈论政治、体育和音乐
02:27
and world news, national news,
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国际新闻、国内新闻
02:30
neighborhood news.
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邻居的新情况
02:33
There was some talk about women
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有时也会谈论女人
02:36
and what it was like to be
a black man in America.
a black man in America.
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以及身为黑人在美国是什么感觉。
02:40
But many times they also
talked about health.
talked about health.
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但很多时候他们还会谈论健康。
他们会长时间地深入讨论。
02:45
The conversations about health
were lengthy and deep.
were lengthy and deep.
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02:49
The men often recounted
their doctor's recommendations
their doctor's recommendations
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他们经常会详述医生的建议
02:52
to cut salt in their diet
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减少对盐的摄入
02:54
or to eat less fried foods
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少吃油炸食品
02:57
or to stop smoking
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停止抽烟
02:59
or to reduce stress.
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或者减少压力
03:01
They talked about the different ways
you could reduce stress,
you could reduce stress,
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他们会谈论很多不同的减压方法
03:05
like simplifying one's love life --
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比如简化爱情生活
03:08
(Laughter)
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（笑）
03:12
all ways to treat high blood pressure.
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还有治疗高血压的各种方式。
03:17
There's a lot of talk about
high blood pressure in the barbershop.
high blood pressure in the barbershop.
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在理发店有很多关于高血压的谈话
03:22
That's because almost 40 percent
of black men have it.
of black men have it.
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因为接近40%的黑人都患有高血压。
03:28
That means that almost
every single black man
every single black man
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这意味着几乎所有单身黑人男性
03:32
either has high blood pressure
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要么患有高血压
03:34
or knows a black man who has it.
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要么认识得高血压的人。
有时候，这些在理发店的谈话
03:37
Sometimes, those conversations
in the barbershop
in the barbershop
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03:41
would be about what happens
when high blood pressure
when high blood pressure
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是有关高血压没有得到充分治疗时
03:43
is not adequately addressed.
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造成的后果。
03:47
"Say, did you hear about Jimmy?
He had a stroke."
He had a stroke."
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“你听说杰米怎么了吗？他中风了。”
03:53
"Did you hear about Eddie?
He died last week.
He died last week.
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“你听说艾迪怎么了吗？他上周死了。
03:57
Massive heart attack.
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严重心脏病
03:59
He was 50."
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他才50岁。”
04:02
More black men die from high blood
pressure than from anything else,
pressure than from anything else,
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黑人死于高血压的人数远高于其他种族
04:06
even though decades of medical wisdom
and science have demonstrated
and science have demonstrated
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哪怕几十年来，医疗和科技进步证明
04:11
that death from high blood pressure
can be prevented
can be prevented
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只要及时诊断和正确治疗
04:14
with timely diagnosis
and appropriate treatment.
and appropriate treatment.
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高血压引发的死亡是可以避免的。
04:19
So why is high blood pressure
so differentially deadly for black men?
so differentially deadly for black men?
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那为什么黑人死于高血压的人数
如此之高？
如此之高？
04:24
Because too often, high blood pressure
is either untreated
is either untreated
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因为很多患有高血压的黑人
要么得不到治疗
要么得不到治疗
04:28
or under-treated in black men,
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要么治疗不充分
04:31
in part because of our lower engagement
with the primary healthcare system.
with the primary healthcare system.
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大多因为参加初级保健制度的黑人很少
04:36
Black men, in particular
those with high blood pressure,
those with high blood pressure,
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尤其是那些患高血压的黑人
04:40
are less likely to have
a primary care doctor
a primary care doctor
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相对于其他群体
更不大可能拥有一个保健医生。
04:42
than other groups.
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04:44
But why?
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为什么？
04:46
Some of our earliest research
on black men's health
on black men's health
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一些关于黑人健康的早期研究表明
04:49
revealed that for many, the doctor's
office is associated with fear,
office is associated with fear,
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诊所对很多黑人来说
意味着恐惧
意味着恐惧
04:55
mistrust,
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猜疑
04:57
disrespect,
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轻视
04:59
and unnecessary unpleasantness.
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以及不必要的不愉快经历。
05:03
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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诊所是你不舒服时去的地方。
05:07
And when you do go,
you might wait for hours
you might wait for hours
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当你去了诊所
你可能需要等待数个小时
你可能需要等待数个小时
05:11
only to get the run-around
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只等来各种怠慢
05:13
and to be evaluated by
a stoic figure in a white coat
a stoic figure in a white coat
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然后穿白大褂的冰冷人士
05:18
who only has 10 minutes to give you
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花十分钟来做检查
05:20
and who doesn't value the talk.
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而且根本懒得和你谈话。
05:25
So it's no wonder that some men
don't want to be bothered
don't want to be bothered
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难怪一些人不想这么麻烦
05:28
and skip going to the doctor altogether,
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于是压根不去见医生
05:32
especially if they feel fine.
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特别是他们感觉还行的时候。
05:35
But herein lies the problem.
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但这里就会产生了问题。
05:38
You can feel just fine
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虽然你感觉无恙
05:40
while high blood pressure ravages
your most vital organs.
your most vital organs.
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高血压却在你身体的大部分重要器官里肆虐。
05:46
This is Denny Moe,
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这是丹尼摩 (Denny Moe)
05:49
owner of Denny Moe's
Superstar Barbershop in Harlem.
Superstar Barbershop in Harlem.
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纽约哈莱姆区丹尼摩超级巨星
理发店店主。
理发店店主。
05:53
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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过去八年，有丹尼做我的理发师，
我很幸运。
我很幸运。
05:58
He said to me once,
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他曾经跟我说
06:00
"Hey Doc, you know,
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“医生，你知道吗
06:02
lots of black men trust their barbers
more than they trust their doctors."
more than they trust their doctors."
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许多黑人宁可相信他们的理发师
也不相信他们的医生。”
也不相信他们的医生。”
06:07
This was stunning to me,
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起初我很震惊
06:09
at first,
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06:11
but not so much when you think about it.
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但我仔细想了一下后就不惊讶了
06:14
Black men have been with their
current barbers
current barbers
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黑人和他们的理发师认识的时间
06:17
on average as long
as I've been with Denny,
as I've been with Denny,
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平均达到八年
06:19
about eight years.
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和我认识丹尼的时间一样长。
06:21
And black men see their barbers
about every two weeks.
about every two weeks.
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黑人每两星期见他们的理发师一次
06:26
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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他们不仅在外貌和风格塑造上信任理发师
06:31
but you also trust him with your secrets
and sometimes your life.
and sometimes your life.
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而且在分享秘密、有时在私人生活方面
也信任理发师
也信任理发师
06:37
Denny, like many barbers,
is more than just an artist,
is more than just an artist,
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丹尼就像很多理发师，不仅仅是艺术家
06:40
a businessman and confidant.
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商人、密友。
06:43
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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他还是社区健康的领袖和热情的号召者。
06:50
The very first time I walked
into Denny Moe's shop,
into Denny Moe's shop,
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我第一次走进丹尼摩的理发店
06:53
he wasn't just cutting hair.
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他不仅仅在为客人理发
06:56
He was also orchestrating
a voter registration drive
a voter registration drive
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他正激励顾客去注册，成为选民
07:00
to give a voice to his customers
and his community.
and his community.
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为他的顾客和社区发声。
07:06
With this kind of activism,
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这种活动和社区投资
07:09
and community investment
that typifies the black barbershop,
that typifies the black barbershop,
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是黑人理发店的典型做法
07:13
of course the barbershop
is a perfect place
is a perfect place
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因此理发店理所当然是个完美的地方
07:17
to talk about high blood pressure and
other health concerns in the community.
other health concerns in the community.
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来讨论高血压和社区里的其他健康问题。
07:21
First, the barbershop is not
a medical setting,
a medical setting,
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首先，理发店不是一个医疗机构
07:26
and so it doesn't have
all the negative psychological baggage
all the negative psychological baggage
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因此没有随之而来的
负面心理负担。
07:29
that comes along with that.
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07:31
When you're in a barbershop,
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当你在理发店里时
07:33
you're in your territory,
and you're among friends
and you're among friends
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你在你的领地里，在朋友中间
07:36
who share your history,
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他们了解你的历史
07:39
your struggle and your health risks.
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你的挣扎和你的健康风险。
07:43
Second, because the barbershop
is a place of connection,
is a place of connection,
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第二，因为理发店是一个关系网
07:47
loyalty and trust,
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人们忠诚而彼此信任
07:49
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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所以你会在健康话题上敞开心扉
07:53
and especially about high blood pressure.
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尤其是有关高血压的。
07:56
After all,
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毕竟，有关高血压的交谈
07:57
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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具备所有精彩的商店谈话的元素：
08:03
stress and high blood pressure,
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压力和高血压
08:05
food and high blood pressure,
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食物和高血压
08:08
relationships and high blood pressure,
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人际关系和高血压
08:10
and yes, what it's like
to be a black man in America
to be a black man in America
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而且没错，美国黑人生存处境
08:14
and high blood pressure.
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与高血压的关系。
08:17
But you can do more than just talk
about high blood pressure
about high blood pressure
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但除了在理发店里谈论高血压
08:20
in the barbershop.
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你还可以做更多。
08:22
You can concretely take action.
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你可以切实采取行动。
08:25
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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我们有机会与丹尼摩的理发店合作
08:30
and empower communities
to address the health inequities
to address the health inequities
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帮助社区更好地处理
08:34
that uniquely affect it.
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导致高血压的保健不公平现象。
08:37
When high blood pressure screening
expanded from clinics and hospitals
expanded from clinics and hospitals
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1960和70年代
当高血压筛查从诊所和医院扩展到社区
08:40
to communities in the 1960s and '70s,
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08:43
black physicians like
Dr. Eli Saunders in Baltimore
Dr. Eli Saunders in Baltimore
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黑人医师，
比如巴尔的摩的爱丽桑德斯(Eli Saunders)博士
比如巴尔的摩的爱丽桑德斯(Eli Saunders)博士
08:47
and Dr. Keith Ferdinand in New Orleans
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新奥尔良的基斯费迪南德(Keith Ferdinand)博士
08:49
were at the forefront of bringing
health promotion to community hubs
health promotion to community hubs
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率先在城市黑人社区的中心枢纽
08:53
in urban black neighborhoods.
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引入更好的保健措施。
08:56
These pioneers paved the way
for my professional journey
for my professional journey
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这些先驱为我的职业生涯铺平道路
09:00
with barbershops and health,
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我从芝加哥的医学院开始
09:02
which began in Chicago in medical school.
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将理发店和健康联系在一起。
09:07
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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我作为医学院学生的第一个研究项目
09:10
was to help design
healthcare interventions
healthcare interventions
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是帮助设计保健干预措施
09:13
that would appeal to black men.
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以便吸引黑人就医。
09:16
We conducted about a dozen focus groups
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我们有大约12个焦点小组
09:19
with a broad cross-section of black men,
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广泛囊括各个类型的黑人
09:23
and we learned that for them,
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我们让他们了解到
09:25
being healthy was as much about
being perceived as healthy
being perceived as healthy
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健康不仅仅是看上去健康
而且要感觉健康
09:29
as it was about feeling healthy,
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09:31
and that feeling good
went hand in hand with looking good.
went hand in hand with looking good.
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而感觉健康也会让人看起来气色更好。
09:38
This work led to the development
of Project Brotherhood,
of Project Brotherhood,
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这推动了兄弟项目(Project Brotherhood)的发展
09:41
a community clinic founded
by Dr. Eric Whitaker
by Dr. Eric Whitaker
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这是艾瑞克惠特克(Eric Whitaker)博士
创办的一家社区诊所
创办的一家社区诊所
09:44
that provided tailored
healthcare to black men.
healthcare to black men.
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为黑人群体提供量身定做的医疗保健。
09:48
Part of this tailored care
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部分特殊医疗包括
09:50
involved having a barber on the premises
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将理发师纳入其中
09:53
to reward the men who came
for needed healthcare
for needed healthcare
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为那些前来进行所需治疗的人
提供一次免费理发作为奖励
09:57
with a free haircut,
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09:59
to let the men know that we, too,
valued how they looked
valued how they looked
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让他们知道
我们就像重视他们的感受一样
我们就像重视他们的感受一样
10:03
as well as how they felt,
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重视他们的外表
10:05
and that what was important to them
was also important to us.
was also important to us.
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他们重视的东西也是我们重视的东西。
虽然兄弟项目只有一个
10:10
But while there's only one
Project Brotherhood,
Project Brotherhood,
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10:13
there are thousands of black barbershops
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但我们还有数千家理发店
10:16
where the intersection of health
and haircuts can be cultivated.
and haircuts can be cultivated.
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我们可以充分开发这些健康和理发的交汇点。
10:22
The next stop on my journey
was Dallas, Texas,
was Dallas, Texas,
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我行程的下一站是德州的达拉斯
10:26
where we learned that barbers
were not only willing
were not only willing
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我们发现那里的理发师不仅仅愿意
10:29
but fully able to roll up
their sleeves and participate
their sleeves and participate
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而且完全有能力卷起袖子
10:33
in delivering needed health services
to improve the health of their customers
to improve the health of their customers
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参与到传播必要的医疗服务工作中来
为促进顾客健康和提升社区做贡献。
10:38
and their community.
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10:40
We teamed up with an amazing
cadre of black barbers
cadre of black barbers
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我们将很多杰出的黑人理发师组织起来
10:44
and taught them how
to measure blood pressure
to measure blood pressure
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教会他们如何测量血压
10:46
and how to counsel their customers
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怎样为顾客提建议
10:48
and refer them to doctors
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向他们推荐医生
10:50
to help manage high blood pressure.
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帮助他们控制血压。
10:52
The barbers were not only willing to do it
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理发师们不仅愿意这么做
10:55
but they were damn good at it.
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而且他们做得太棒了。
10:57
Over a three-year period,
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在三年中
10:59
the barbers measured
thousands of blood pressures
thousands of blood pressures
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理发师们为数千人测量了血压
11:02
resulting in hundreds of black men
being referred to doctors
being referred to doctors
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介绍数百名黑人前往就医
11:07
for medical care
of their high blood pressure.
of their high blood pressure.
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接受高血压的治疗。
11:11
These barber-doctor partnerships
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这些理发师和医生的合作项目
11:14
resulted in a 20 percent increase
in the number of men
in the number of men
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导致能够达到目标血压水平的人
11:18
who were able to achieve
target blood pressure levels
target blood pressure levels
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提高了20%
11:21
and a three-point drop, on average,
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每个参与者的血压指数
11:23
in the blood pressure of each participant.
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平均降低了三点。
11:26
If we were to extrapolate
that three point drop
that three point drop
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如果我们能让每一个患高血压的美国黑人
11:29
to every single black man
with high blood pressure in America,
with high blood pressure in America,
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的血压指数都降低三点
11:32
we would prevent 800 heart attacks,
500 strokes and 900 deaths
500 strokes and 900 deaths
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我们就能在一年时间内
防止由高血压引起的
800次心脏病、500次中风
和900例死亡。
和900例死亡。
11:39
from high blood pressure
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11:40
in just one year.
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11:44
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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我们与纽约理发师的合作也一样
11:49
where my journey has currently led me.
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这也是我目前开展工作的地方。
11:51
With an incredible team
of diverse research assistants,
of diverse research assistants,
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我的队伍很出色
我们有多元化的研究助手
社区保健工人和志愿者
社区保健工人和志愿者
11:55
community health workers and volunteers,
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11:58
we've been able to partner
with over 200 barbershops
with over 200 barbershops
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我们已经与超过200家理发店
12:02
and other trusted community venues
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以及其他可信的社区场所合作
12:04
to reach over 7,000 older black men.
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接触到超过7000名黑人。
12:08
And we've offered high blood pressure
screening and counseling
screening and counseling
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我们为每个人提供高血压筛查和咨询。
12:11
to each and every one of them.
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谢谢丹尼摩等众多理发师
12:13
Thanks to Denny Moe
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12:15
and the myriad other barbers
and community leaders
and community leaders
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以及社区领导们
12:19
who shared the vision of opportunity
and empowerment
and empowerment
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他们也看到了改变社区的机遇和力量。
12:24
to make a difference in their communities,
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12:26
we've been able to not only
lower blood pressure
lower blood pressure
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我们不仅降低了项目参与者的血压
12:29
in our participants,
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12:31
but we've also been able to impact
other health indicators.
other health indicators.
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而且还影响到其他健康指数。
所以，你怎么看？
12:38
So what do you see?
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12:41
What is your barbershop?
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你的“理发店”是什么？
12:45
Where is that place for you
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你心目中的这个地方是哪里？
12:49
where people who are affected
by a unique problem
by a unique problem
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那个能够为面对独特难题的人们
12:53
can meet a unique solution?
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提供独特的解决方式的地方？
12:57
When you find that place,
see the opportunity.
see the opportunity.
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当你找到那个地方，
那就是你的机会。
那就是你的机会。
13:02
Thank you.
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谢谢。
13:03
(Applause)
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（掌声）
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