13 African American Barbershops and Beauty Salons: An Innovative Approach to Reducing Health Disparities through Community Building and Health Education
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13 African American Barbershops and Beauty Salons An Innovative Approach to Reducing Health Disparities through Community Building and Health Education LAURA LINNAN STEPHEN THOMAS HEATHER D’ANGELO YVONNE OWENS FERGUSON 229 A goal of Healthy People 2020 (U.S. Department of Health and Human Services [USDHHS] 2011), the nation’s road map to achieving health equity, is the elimination of health disparities. Yet despite decades of gains in the overall health status for the general population, racial and ethnic health disparities persist (USDHHS 2011). Racial and ethnic health disparities exist across a broad spectrum of health outcomes and behavioral risk factors, and African Americans carry a greater proportion of the burden of health disparities than do other racial and ethnic groups. Compared with whites, African Americans have higher rates of overall mortality, obesity, cancer, diabetes, heart disease, stroke, and HIV and have the highest rates of infant mortality among all racial and ethnic groups (Flegal et al. 2010; National Center for Health Statistics 2010). To make progress toward eliminating racial and ethnic health disparities, communities must be engaged in exploring the context of existing health disparities , formulating solutions, and ultimately making the decisions that affect their health. Community building and community organizing are strategies that lie at the heart of addressing racial health disparities. Interventions that address “hot-button issues” identified by community members are critical when attempting to understand and affect the complex interplay of behavioral, environmental, and policy-driven factors that shape health disparities. Building community capacity by engaging with the community at each step of the process is essential for sustainability (Giachello et al. 2003; Wallerstein and Duran 2010). The involvement of community members as equals in decision-making processes can help build relationships based on trust that promote the type of changes that are the foundation of a serious effort to affect health disparities (Wallerstein and Duran 2010). Applying community organizing strategies to address health disparities is important for all populations, but particularly perhaps for African Americans, given that traditional interventions have largely failed to reduce health disparities in this population (Adderley-Kelly and Green 2005). The National Cancer Institute (2006) and the Institute of Medicine (2008) both have emphasized the importance of empowerment and working collaboratively with communities in the development of culturally appropriate, evidence-based interventions to address health disparities. Similarly, there is growing consensus at the National Institutes of Health that accelerating efforts to eliminate racial and ethnic health disparities will require innovative community-based interventions and building trust with respected community partners in priority populations, such as African Americans who reside in high-risk urban neighborhoods. A promising approach in such work is to begin in community settings that are not clinical or academic in nature, but rather shared social spaces. Every ethnic group has safe zones; community-empowered centers where people can gather, share cultural secrets, connect with their ethnicity’s historical narrative and engage in writing new chapters of that story. The African American church is one example of this approach that has been documented in the literature (Campbell et al. 2007). However, the urgency of persistent and often growing health disparities demands that we go further in finding new partners and more effective interventions to close the health disparity gap. This is the context within which partnerships with black barbershops and beauty salons have gained credibility. While the practice of working with barbershops and salons is not new, recent community-based participatory research in these settings has ushered in creative new efforts to transform barbershops and salons into reliable venues for interventions that are both scientifically sound and culturally relevant, while also fostering enhanced community building. From the perspective of culturally relevant science, for example, Victor and colleagues (2010) conducted one of the first randomized clinical trials in black barbershops focused on control of hypertension among African American men. The authors concluded that “the effect of blood pressure screening on [hypertension] control among black male barbershop patrons was improved when barbers were enabled to become health educators, monitor BP, and promote physician follow-up” (Victor et al. 2010). Clearly more research is needed if this approach is to be disseminated and scaled for large urban populations. In the African American community, however, beauty salons and barbershops have a legacy of community building and community organizing and have the potential to be places where community members and academics can come together to address health disparities in the community. This chapter will review the important social, political, and economic history of...

Subject Headings

  • Health promotion.
  • Community health services -- Citizen participation.
  • Community organization.
  • Community development.
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