As a young boy growing up on the South Side of Chicago, Andrew Suggs recognized early on the powerful space local barbershops serve for the Black community.
His father, struggling with addiction and imprisonment, was not present during much of Suggs’s childhood, and he missed out on many conversations a young boy would have with his father.
But he found support in his community, at his church, and local barbershop. Here, men gathered and spoke honestly in a safe space, where they learned, encouraged, and mentored each other.
After graduating college and getting a job at a Fortune 100 firm, Suggs learned his father had a heart attack and was living with congestive heart failure. This led him to discover the health disparities that still exist in Black communities in the United States.
“I started to research health disparities and was really startled that there was a huge chasm between the general population and African American men and women,” Suggs says.
Black Americans have higher rates of heart disease, stroke, and high blood pressure than any other group in the United States, according to the American Stroke Association. And some are unaware of their risks.
Suggs decided he wanted to do something about this. Thinking back on all the fond memories he’d had at the barbershop over the years, he realized barbers and hairstylists were uniquely positioned to talk with Black men and women about health conditions and wellness.
“I thought if health systems are having a hard time reaching, accessing, and influencing these people to better health, why not use the unique social space of the barbershop and hair salons to reach these communities that hadn’t been reached,” Suggs says.
In 2017, he founded Live Chair Health, an organization based in Columbia, Maryland, that equips barbers and hairdressers with blood pressure monitors and health information to help clients learn about their health risks and prevention efforts.
Suggs is being recognized by the American Stroke Association’s 2022 Stroke Hero Awards, honoring those who educate, inspire, and raise awareness about stroke locally or nationally.
Why Health Disparities Persist
The reasons behind health disparities are complex. Black Americans have higher rates of many of the risk factors for heart disease, including high blood pressure, obesity, and type 2 diabetes, reports the American Heart Association.
A lot of this can be attributed to socioeconomic status, explains Deirdre Mattina, MD, a cardiologist at the Cleveland Clinic in Ohio.
“Black Americans are more likely to live in a food desert and not have access to healthy foods,” she says. “As we know, diet is a really big part of blood pressure control.”
Physical activity is also an important part of managing stress, another risk factor for heart troubles like high blood pressure. But finding a safe space to exercise outdoors can be hard in certain neighborhoods.
“That can present a really big challenge for some of our underrepresented groups that are of lower economic status,” Dr. Mattina says.
There is also a mistrust in the healthcare system that is prevalent in the Black community, leading many individuals to forgo care.
This ranges from the medical establishment’s long history of mistreating Black people and the lack of Black physicians represented in medicine and clinical research to the racial bias and discrimination in healthcare that still persist today.
Research published in the Journal of the American Heart Association in November 2019 found racial bias influenced healthcare providers’ decisions in treating heart failure patients in hypothetical case studies. Doctors perceived Black patients as less healthy, less likely to comply with follow-up care, and less trustworthy than white patients with identical medical and social histories. Black patients were therefore less likely to be recommended for heart transplants. Another study found Black Americans are consistently undertreated for pain compared to white Americans.
“We hear these stories again and again, so naturally there’s a lot of reluctance to receive information and seek care,” Suggs says.
Athol Morgan, MD, a cardiologist at LifeBridge Health in Baltimore, Live Chair Health’s brain trust advisor, says many times, there is a communication gap between patients and providers.
“I don’t think there’s enough effort on the part of the healthcare personnel to communicate with people in a language they understand,” says Dr. Morgan, who also serves on the American Heart Association’s Greater Maryland board of directors. “Patients come to me and I ask, ‘What did the doctor say?’ And they tell me they didn’t understand.”
Dealing With Mistrust in a Safe Space
Organizations like Live Chair Health aim to bridge the gap between Black Americans and health providers by using trusted community sources like barbershops and hair salons to provide health screenings and education.
“In a lot of instances, men and women are likely to see their hairstylist or barber more regularly than a primary care physician,” Mattina says. “Many people might not even have a primary care physician.”
Experts say people are more receptive to information in spaces with a deep sense of trusted community, including churches, barbershops, and hair salons. One study, published in the New England Journal of Medicine in April 2018, found that Black male barbershop patrons with uncontrolled hypertension were more likely to reduce their blood pressure when coupled with medication management by specialty-trained pharmacists in barbershops.
“When people are in these spaces, they can take their time with processing the information,” Morgan says. “Often, when in the doctor’s office, the visit is compressed.”
Suggs, whose father died of heart failure in 2020, has expanded Live Chair Health to include community events that provide free health screenings and physician resources at community housing authorities, development centers, YMCAs, and other local organizations.
“Basically, wherever people live, work, and play, that’s where we set up our operations and do our work,” Suggs says. These events take place mostly in Maryland and California, but he has plans to expand to other states in the near future.
Live Chair Health also encourages regular primary care visits and offers a directory of trusted, culturally sensitive healthcare professionals on its website.
“Our mission is to act as a liaison and leverage trusted community spaces to raise awareness and connect people to care,” Suggs says.