Live from TED2016

The intersection of haircuts and health: Joseph Ravenell at TED2016

Joseph Ravenell speaks at TED2016 - Dream, February 15-19, 2016, Vancouver Convention Center, Vancouver, Canada. Photo: Bret Hartman / TED

“What do you see?” asks Dr. Joseph Ravenell, as he stands in front of an image of a barbershop. “I see an opportunity — an opportunity for health equity.” He spoke onstage at TED2016 on Tuesday, February 16, 2016. Photo: Bret Hartman / TED

When physician and men’s health advocate Dr. Joseph Ravenell was a young boy, he would go with his father to the barbershop. It was a safe haven for black men, where they don’t have to worry about how they’re perceived by the outside world. “It’s a place where we don’t feel threatened — or threatening,” Ravenell says.

The barbershop is much more than a place to get a haircut, it’s a place where men go for discussion. “I remember the range of the conversations was immense,” Ravenell recalls of his childhood barbershop trips. “The men would talk about politics and sports and music and world news, national news, neighborhood news … and what it was like to be a black man in America. But many times they also talked about health.”

The men would talk about their doctors’ recommendations to cut salt, or to stop smoking, or to reduce stress, or how to simplify one’s love life — all ways to treat high blood pressure. “There is a lot of talk about high blood pressure in the barbershop,” Ravenell says.

That’s because almost 40 percent of black men suffer from it, leading to high incidences of stroke, heart attack and kidney failure. More black men die from high blood pressure than anything else, even though decades of medical wisdom and science have demonstrated that it can be prevented by timely diagnosis and appropriate treatment.

“So why is high blood pressure so differentially deadly for black men?” Ravenell asks. “Because, too often, high blood pressure is either untreated or undertreated in black men — in part because of our lower engagement with the primary healthcare system.”

For many black men, the doctor’s office is associated with fear, mistrust, disrespect and unnecessary unpleasantness. “The doctor’s office is only a place that you go when you don’t feel well,” Ravenell says. “And when you do go, you might wait for hours … to be evaluated by a stoic figure in a white coat, who only has 10 minutes to give you — and who doesn’t value the talk.”

So it’s no wonder that some men stop going to the doctor altogether, especially if they feel fine. “But you can feel just fine, while high blood pressure ravages your most vital organs,” Ravenell says.

What if there was a way to engage black men about their health in a place where they feel comfortable?

Enter Denny Moe, owner of Denny Moe’s Superstar Barbershop in Harlem, who has been Ravenell’s barber for the past eight years. Denny Moe does more than just cut hair — he’s a leader and a passionate advocate for the well-being of his community, and his customers trust him with their secrets.

One day, Denny Moe remarked to Ravenell, “Hey doc, you know, lots of black men trust their barbers more than they trust their doctors.”

Ravenell took Denny Moe’s comment to heart, He realized that the black barbershop is the perfect place to talk about high blood pressure and other concerns within the community. The barbershop has none of the negative associations that a doctor’s office has — instead, it’s a place where black men feel comfortable talking about their health. “Here, we have an opportunity to partner with the Denny Moes of the world and empower communities to address the health and inequities that uniquely affect it,” Ravenell says.

In the legacy of pioneers like Dr. Eli Saunders and Dr. Keith Ferdinand, Ravenell had been involved in research focused on designing healthcare interventions that appeal to black men since his time as a medical student. Now, he turned his research attention towards the barbershop, where the intersection of health haircuts can be cultivated, starting the Men’s Health Initiative.

In Dallas, Ravenell teamed up with a cadre of black barbers, teaching them how to test for high blood pressure and how to counsel customers to properly manage their blood pressure. “The barbers were not only willing to do it, but they were damn good at it,” Ravenell says.

Over a three-year period, the barbers measured thousands of blood pressures. The results: A 20 percent increase in men achieving target blood pressures and a 3 point drop, on average, in the blood pressure of each participant. Extrapolating these numbers to include every black man with high blood pressure in America, this type of intervention could prevent 800 heart attacks, 500 strokes and 900 deaths in one year.

The experience has been no different in New York City, where Ravenell has teamed up with more than 200 barbershops and trusted community venues to reach more than 7,000 older black men. “We’ve measured blood pressure and counseled each and every one of them,” Ravenell says.

“What is your barbershop?” he asks “Where is that place for you, where people affected by a unique problem can meet a unique solution?”