If Stephen Thomas has his way, patrons of African American-owned barbershops and salons in the Washington area can someday get a shave, haircut and test for COVID-19, the disease caused by the coronavirus.
The coronavirus pandemic is killing African Americans at double the rate of Whites, according to the U.S. Centers for Disease Control and Prevention. Health officials are looking for allies who can help knock down those disparities.
Barbershops are institutions with deep reservoirs of trust in the Black community, Thomas said. He directs the University of Maryland Center for Health Equity, where he has already built a network of barbers and stylists, who help their clients with heart disease, cancer and other health issues that affect minorities more than Whites.
"Throughout our history, Black barbershops have been a place of refuge," he said. "They're like a sacred place."
They're a place of social connection, where conversations among clients and barbers are frank and wide ranging, Thomas noted.
He is tapping into that reservoir of trust now, arming barbers and stylists with COVID-19 facts to combat misinformation. He is working to make testing available in barbershops and salons. He is telling barbers to tell their clients to get flu shots, so that the coming influenza season doesn't compound the devastation the coronavirus pandemic is causing.
Legacy of racism
Blacks have the highest death rate from the coronavirus infection of any ethnic group in the United States.
"Is it because of the color of their skin? No. It's because of the color of their skin and the way society treats them," Thomas said.
After centuries of discrimination, Blacks are more likely to work at low-wage jobs that put them in harm's way: in grocery stores, public transit and child care, for example. They have less access to health care and healthy foods.
Plus, Thomas noted, Blacks have faced discrimination in health care and been the subjects of unethical medical experiments, most famously the Tuskegee syphilis study. For 40 years, scientists followed 400 Black men with the disease without treating them in order to learn the long-term effects of syphilis on the body.
That's one major reason why Blacks are the least likely to say they will take a COVID-19 vaccine right away.
Polls show that roughly two-fifths say they would not get a shot if it were available today, compared with about one-fifth to one-third of Americans overall.
"For many African-Americans, it is part of the oral tradition that you don't trust people in white coats who come into your neighborhood who say they want to help you," Thomas said.
More credible than a cardiologist
Thomas said he had an epiphany about the power of Black barbers one day in the early 2000s, long before the coronavirus, he said, sitting in a barbershop in Pittsburgh.
A client with heart disease was talking with his barber about his medication. The barber told him, in colloquial terms, that the pills cause erectile dysfunction and would kill his love life.
"And I looked at (the client's) face," Thomas said. "He's not taking those pills. And his cardiologist has no idea there's somebody in the community with this kind of credibility who can overturn his doctor's orders.
"It's at that moment that I said, 'What if these barbers were our partners?'"
Barbers "have been known as community leaders going all the way back to slavery," said Joseph Ravenell, associate professor of population health at New York University Grossman School of Medicine.
Some pioneering programs to train barbers as health advocates started in the 1990s, Ravenell said, but it wasn't clear how effective they were.
Ravenell and colleagues published studies showing that these programs could make a difference in conditions that afflict Blacks at higher rates than Whites. When barbers were trained as health educators and connected to healthcare professionals, they helped clients lower their blood pressure and increased rates of cancer screenings.
Fred Spry has seen the difference these programs can make. He's a barber in Thomas's network who encouraged his clients to get screened for colorectal cancer.
"Once you realize it's a major problem, you have to address it," Spry said. "If you don't address it, it's going to sneak up on you silently. And before you know it, it'll be too late."
He said one of his clients underwent screening and discovered he had an early-stage tumor, which his doctor removed.
"It felt good because I may have saved his life," Spry said, "and I may have saved his family from having to mourn over him much earlier than they had to."
"I think we've been able to demonstrate that this concept works," Ravenell said. "The challenge is in how we sustain it."
Thomas has gained backing from insurance companies to expand his network. Right now, he said, one of his priorities is raising disproportionately low rates of flu vaccination among Blacks before the influenza season kicks in.
"We need to be working on that right now. The reasons why people are not taking the flu shot may be the same reasons they won't take a COVID vaccine when the time comes. Fear. Mistrust."