Barbershops in Black communities provide information on COVID-19, vaccine

Live Chair Health trains barbers to address health disparities.

A teenage boy with electric-blue glasses reached toward the handle of the barbershop entrance, trying to grab the door before it closed.

Before he could catch it, shop manager Kennard Perry swung the door open again with his left hand, extending a thermometer out with his right.

In the age of COVID-19, it's become commonplace for Perry at Nile Style Barbershop in Baltimore to start every hair cut appointment with a temperature safety check, reminding clients to wear a mask and social distance.

But the safety speech doesn't stop there.

"The [Black] population is overrepresented in almost every chronic disease category, ranging from hypertension, diabetes and lung cancer," Live Chair Health Founder and CEO Andrew Suggs told ABC News.

Even though the death rate for African Americans has decreased by 25% from 1999 to 2015, Black Americans ages 18-49 are still two times as likely to die from heart disease than white Americans, according to the Centers for Disease Control and Prevention.

"We need to go to where people are, which happens to be hair salons and barbershops in these communities," added Suggs.

Live Chair Health is capitalizing on the trusted relationship between barber and client -- something Perry knows a lot about, having worked in the industry for 26 years.

"Traditionally and historically with an African American community, the barbershop has been the epicenter of everything from politics to sports," said Perry.

"To certain people, we are a father figure, to certain people we're a big brother, a therapist, a psychologist, a psychiatrist. We take our position very seriously," he said.

It also means having a conversation about the vaccine.

"We try to use our ability and our connection with our clients to instill some confidence or some truth to a lot of the things that they may come in (with), that they've heard off the street or (in the) media," explained Perry.

"Regardless of how I personally feel, you always want to make sure your clients are informed. You have to give them all the angles and let them make an educated decision," he said.

That educated decision is something Live Chair Health is helping with by connecting clients -- sometimes for the first time in their lives -- to primary care providers, who can then look over a patient's personal health history and make knowledgeable decisions about his or her health care.

"(But) there (is) a strong hesitance and reluctance in the African American community to take this vaccine, and it's not for an answer for political reasons. There is a historical foundation within the Black community," added Perry.

That historical foundation includes the notorious Tuskegee experiments, a U.S. government-funded study that recruited over 600 Black men in 1932 to record the natural progression of syphilis. During the study, the men were not told they had syphilis -- they were only told they had "bad blood" and were being treated for it. During the 40-year experiment, the American government attempted to hide the true intentions of the researchers, even going so far as to keep the drug penicillin away from the men when it was discovered in 1945 as a successful way to treat the disease.

William English, a client of Millennium Salon in Silver Spring, Maryland, whose daughter is also a doctor, said he'll be getting the vaccine regardless of the past.

"I understand that people may have mistrust based on historical circumstances," he said, "But I think it's extremely important that those of us who understand the science communicate effectively with other people, given that we're at great risk from COVID," English said. "We have to have the vaccine."

Millennium Salon, which is 50 miles southwest of Baltimore, is also a barbershop affiliated with Live Chair Health. Owner Dexter Fields, who hosts staff meetings with Live Chair Health to educate his barbers, said the clients in his chair regularly discuss the vaccine, but they too have reservations.

"I would say that 75% of the people who come into my chair are people who understand the value of the vaccine," said Fields, who added that everything he is learning -- both about the disease and the vaccine -- he is sharing with his clients.

"People are starting to realize that this is not something that just came about in March. It's been on the horizon for a while. … The (scientists have) been working toward something like this already."

Prior to COVID-19, mumps held the record for the quickest vaccine rollout -- taking four years from development to its ultimate approval in 1967. On average, though, vaccines take 10-15 years to develop, according to The History of Vaccines, an educational resource from the College of Physicians of Philadelphia.

When Live Chair Health launched three years ago, it was originally a mobile booking app for barbershops. But when Suggs' father's health started to decline, Suggs started researching health disparities in Black communities and learned his father's condition -- congestive heart failure -- wasn't an anomaly.

"One of the things that (my co-founder and I) uncovered is the lack of trust and lack of access," for African Americans in the medical community, "and not having a relationship with the primary-care physician. And a light bulb went off when we were looking at our data and we said, 'Hey, you're engaging African American men every single day with your schedule booking tool.' And then that was the epiphany that we had to pivot the business into health care," Suggs said.

To show his business model would work, Suggs pointed to a 2018 New England Journal of Medicine study that proved "among black male barbershop patrons with uncontrolled hypertension, health promotion by barbers resulted in larger blood-pressure reduction," although this was when it was "coupled with medication management in barbershops by specialty-trained pharmacists."

Prior to COVID-19, Live Chair Health equipped barbers with blood pressure cuffs and taught them not only how to take a client's blood pressure, but also to discuss with them why having high blood pressure -- or being "hypertensive" -- was something a client should be concerned about.

In one instance, Perry took the temperature of one of the clients and discovered a BPI (blood pressure indicator) that was too high.

"We told him he had to go seek professional help immediately. The next day, he went to the emergency room, came back and said, 'I didn't even know I was that close. The doctor told me I could have stroked out,'" recalled Perry.

According to the CDC, African Americans ages 35-64 years are 50% more likely to have high-blood pressure than whites.

It's more than just setting up appointments with doctors though. According to Dr. Athol Morgan, LifeBridge Health cardiologist and Live Chair Health brain trust advisor, it's about building an ongoing relationship between the patient and the doctor.

"You have high blood pressure. Well, what does that mean? Why is that important? What can we do about it? What can you do about it? And how can I help you with it? Those are fundamental questions that are addressed in an interaction between primary care providers and patients," Morgan said.

"And to the extent that that communication may be compromised when the patient is an African American, that is what we're trying to address," he continued.

"Most African Americans go to an African American barber, but most African Americans do not go to an African American provider. We don't have enough of them, and it will be a long time for us to get to a place where we ever have enough of them. Ultimately what we would like to do is get to a place where it really doesn't matter what the race of the provider and the patient is," he said, adding that all that matters is "that we still have effective communication between the two."

In another instance of potentially saving a life, one of Perry's own barbers benefitted from the blood pressure cuffs. When Suggs showed barber Greg Pratt how to use the device, Pratt was surprised to learn he had a BPI of 170/90. Comparatively, a healthy blood pressure is anything less than 120/80, according to the CDC.

At 34-years-old, 5'7" and 215 pounds, Pratt quickly changed his lifestyle, eating healthier and working out at the gym. Today, he weighs in at 175 pounds.

"I just found out I'm athletic," laughed Pratt. The father of five kids between the ages of 7 and 16 explained he plans to keep the lifestyle change going.

"I'm trying to stay around for my babies," he said, smiling.