Joseph Ravenell: How barbershops can keep men healthy | TED

譯者: Yolanda Wei 審譯者: Regina Chu

What do you see?

你看到什麼？

Most of you see a barbershop,

多數人看到的是理髮店，

but I see an opportunity:

但是我見到一個機會：

an opportunity for health,

一個促進健康的機會，

an opportunity for health equity.

一個促進人人都可以 享受健康的機會。

For black men, the barbershop is not just a place

對黑人來說，理髪店不單只是

where you get your hair cut or your beard trimmed.

你剪頭髮或剃鬍子的地方。

No, it's much more than that.

它有更重大的意義。

Historically, the barbershop has been a safe haven for black men.

自古理髪店就是黑人的安樂窩。

It's a place where we go for friendship,

那裡是可以結交朋友，

solidarity and solace.

大家團結一致和互相安慰的地方。

It's a place where we go to get away from the stress

在那裡我們可以遠離

工作的折磨，

of the grind of work

and sometimes home life.

避開家庭的壓力。

It's a place where we don't have to worry

我們在那裡不用擔心

about how we're being perceived by the outside world.

外界怎樣看待我們。

It's a place where we don't feel threatened,

不怕受到別人脅迫，

or threatening.

或者覺得身處險境。

It's a place of loyalty and trust.

那是一個充滿忠誠和信任的地方。

For that reason,

因此，

it's one of the few places where we can fearlessly be ourselves

那裡是我們少數可以自在做自己，

and just ... talk.

無憂無慮地聊天的地方。

The talk, the shop talk, the conversation,

聊天、傾行話、閒扯，

that is the essence of the black barbershop.

都是黑人理髮店的精髓。

I can remember going to the barbershop with my dad as a kid.

我記得少時跟爸爸到理髮店。

We went to Mr. Mike's barbershop every other Saturday.

每隔一個星期六， 我們到麥克的理髪店。

And like clockwork, the same group of men would be there

好像發條鐘錶一樣，每次到那裡

都是同一批男子，

every time we went,

either waiting on their favorite barber

他們要不是在等自己喜愛的理髮師，

or just soaking up the atmosphere.

就是純來感受這裡的氣氛。

I can remember the jovial greeting that warmly welcomed us

我記得每次我們來到小店

都會受到愉快親切的歡迎。

every time we went.

"Hey Rev," they would say to my dad.

「嗨，老牧！」 他們會這樣和我爸說話。

He's a local pastor, and they treated him like a celebrity.

爸爸是當地的牧師， 他們待他如名人。

"Hey young fella, how you doing?"

「嗨，年輕人，你好嗎？」

they would say to me,

他們就是這樣對我說話，

making me feel just as special.

讓我覺得自己 就跟爸爸一樣與眾不同。

I remember the range of the conversations was immense.

我記得他們的話題很廣泛。

The men would talk about politics and sports and music

他們會談論政治、體育、音樂

and world news, national news,

和世界新聞、國內新聞，

neighborhood news.

本地新聞。

There was some talk about women

有時談到女人

and what it was like to be a black man in America.

和美國黑人的生存現狀。

But many times they also talked about health.

但是很多時候 他們談論關於健康的話題，

The conversations about health were lengthy and deep.

而且花很長時間深入交談。

The men often recounted their doctor's recommendations

他們常常詳細地敍述醫生的建議，

to cut salt in their diet

例如減鹽飲食、

or to eat less fried foods

少吃煎炸食物、

or to stop smoking

戒菸、

or to reduce stress.

減壓。

They talked about the different ways you could reduce stress,

他們談論減壓的不同方法，

like simplifying one's love life --

例如過簡單的愛情生活——

(Laughter)

（笑聲）

all ways to treat high blood pressure.

各種治療高血壓的方法。

There's a lot of talk about high blood pressure in the barbershop.

理髮店裡有很多關於高血壓的談話。

That's because almost 40 percent of black men have it.

因為四成的黑人男士患有高血壓。

That means that almost every single black man

這意味著幾乎每一個黑人

either has high blood pressure

不是自己有高血壓，

or knows a black man who has it.

就是認識另一個患有高血壓的黑人。

Sometimes, those conversations in the barbershop

有時這些人在理髮店的對話

would be about what happens when high blood pressure

會講到當人們不重視高血壓

is not adequately addressed.

會發生什麼事。

"Say, did you hear about Jimmy? He had a stroke."

「你有沒有聽到吉米的消息？ 他中風了。」

"Did you hear about Eddie? He died last week.

「你聽說艾迪的事情沒？ 他上星期去世了，

Massive heart attack.

因為嚴重的心臟病發。

He was 50."

他才 50 歲。」

More black men die from high blood pressure than from anything else,

黑人高血壓死亡率要高於其他疾病，

even though decades of medical wisdom and science have demonstrated

雖然數十年來醫學的 智慧和科學已經證明

that death from high blood pressure can be prevented

及時的診斷加上適當的治療 可以預防病人死於高血壓。

with timely diagnosis and appropriate treatment.

So why is high blood pressure so differentially deadly for black men?

為什麼高血壓對黑人特別致命？

Because too often, high blood pressure is either untreated

這是因為黑人常常不是沒有看醫生

or under-treated in black men,

就是沒有接受足夠的治療，

in part because of our lower engagement with the primary healthcare system.

部分的原因是我們很少參與健保。

Black men, in particular those with high blood pressure,

尤其是那些患高血壓的黑人

are less likely to have a primary care doctor

比起其他群體更可能沒有家庭醫生。

than other groups.

But why?

但是為什麼？

Some of our earliest research on black men's health

我們有一些早期關於 黑人健康狀況的調查，

revealed that for many, the doctor's office is associated with fear,

表明對於很多黑人來說， 診所都讓人聯想到恐懼、

mistrust,

缺乏信任、

disrespect,

不受尊重、

and unnecessary unpleasantness.

還有不愉快。

The doctor's office is only a place that you go when you don't feel well.

診所只是在你感到不適時 要去的地方。

And when you do go, you might wait for hours

你真的去了那裡，可能要等很久，

only to get the run-around

只聽到一輪託詞，

and to be evaluated by a stoic figure in a white coat

然後接受一個面無表情、 穿著白袍的醫生看診，

who only has 10 minutes to give you

他只給你 10 分鐘時間看病，

and who doesn't value the talk.

而且並不重視你們之間的對話。

So it's no wonder that some men don't want to be bothered

所以難怪有些人懶得麻煩，

and skip going to the doctor altogether,

根本不去看醫生，

especially if they feel fine.

尤其是他們感覺精神不錯的時候。

But herein lies the problem.

但是這裡存在一個問題。

You can feel just fine

即使你的高血壓威脅著 你重要器官的時候，

while high blood pressure ravages your most vital organs.

你也不會感覺不適。

This is Denny Moe,

這是丹尼 · 默，

owner of Denny Moe's Superstar Barbershop in Harlem.

紐約哈林區「丹尼 · 默 超級明星理髮店」的店主。

I've been lucky enough to have Denny as my barber for the last eight years.

最近八年，我都很幸運地 有丹尼做我的理髮師。

He said to me once,

他有一次跟我說：

"Hey Doc, you know,

「嗨，醫生，你知道嗎，

lots of black men trust their barbers more than they trust their doctors."

比起相信自己的醫生， 很多黑人更相信自己的理髮師。」

This was stunning to me,

這一開始真的讓我很驚訝，

at first,

but not so much when you think about it.

但當你仔細想想的時候 好像就是這樣。

Black men have been with their current barbers

平均而言，黑人和他們的 理髮師認識的時間，

on average as long as I've been with Denny,

就和我和丹尼認識的時間一樣長，

about eight years.

就是差不多八年。

And black men see their barbers about every two weeks.

而且黑人差不多每兩週理一次髮。

Not only do you trust your barber with your look and with your style,

你不僅相信髮型師能夠 照顧好你的髮型和外貌，

but you also trust him with your secrets and sometimes your life.

你還願意和他分享你的秘密， 甚至有時以生命信任他。

Denny, like many barbers, is more than just an artist,

和很多髮型師一樣， 丹尼不僅僅是一個藝術家，

a businessman and confidant.

一個商人和知己。

He's a leader and a passionate advocate for the well-being of his community.

他還是一個促進社區健康的 領袖和熱情的倡導者。

The very first time I walked into Denny Moe's shop,

我第一次走進丹尼的店時，

he wasn't just cutting hair.

他不僅在理髮，

He was also orchestrating a voter registration drive

他還在為他的顧客和社區發聲 而安排選民登記運動。

to give a voice to his customers and his community.

With this kind of activism,

因為黑人理髮店的典型特徵 是這種積極精神和社區投資，

and community investment that typifies the black barbershop,

of course the barbershop is a perfect place

難怪理髮店會成為談論高血壓

to talk about high blood pressure and other health concerns in the community.

及社區其他健康問題的首選場所。

First, the barbershop is not a medical setting,

首先，理髮店不是醫療環境，

and so it doesn't have all the negative psychological baggage

所以不會給人帶來負面的心理負擔。

that comes along with that.

When you're in a barbershop,

當你在理髮店的時候，

you're in your territory, and you're among friends

你在自己的地盤，

有知道你的過去和艱辛， 及健康風險的朋友陪伴。

who share your history,

your struggle and your health risks.

Second, because the barbershop is a place of connection,

第二，因為理髮店是個充滿 聯繫、忠誠和信任的地方，

loyalty and trust,

it's a place where you're more open to have a conversation about health

在這裡你能更輕鬆地談論健康話題，

and especially about high blood pressure.

尤其是高血壓。

After all,

畢竟，有關高血壓的談話 有所有店裡閒聊的要素：

conversations about high blood pressure have all the elements of great shop talk:

stress and high blood pressure,

壓力和高血壓，

food and high blood pressure,

食物和高血壓，

relationships and high blood pressure,

人際交往和高血壓，

and yes, what it's like to be a black man in America

噢還有，在美國 當黑人的感受和高血壓。

and high blood pressure.

But you can do more than just talk about high blood pressure

但是在理髮店裡你不僅能 談論高血壓，你還能做更多。

in the barbershop.

You can concretely take action.

你能採取具體的行動。

Here we have an opportunity to partner with the Denny Moe's of the world

現在我們有一個和世界上 其他丹尼 · 默合夥的機會，

and empower communities to address the health inequities

去啟發社區重視 其獨特的健康不平等問題。

that uniquely affect it.

When high blood pressure screening expanded from clinics and hospitals

在 1960 及 1970 年代，

當高血壓篩檢從診所和醫院 擴大到社區時，

to communities in the 1960s and '70s,

black physicians like Dr. Eli Saunders in Baltimore

像巴爾的摩的伊利 · 桑德斯 和新奧爾良的肯斯 · 芬迪南德

and Dr. Keith Ferdinand in New Orleans

這樣的黑人醫生，

were at the forefront of bringing health promotion to community hubs

把提倡健康活動帶到城市中 黑人街區的社區中心前線。

in urban black neighborhoods.

These pioneers paved the way for my professional journey

這些先驅為我專注於 理髮店和健康關係的專業道路奠基，

with barbershops and health,

which began in Chicago in medical school.

這事業開始於芝加哥的醫學院。

The very first research project that I worked on as a medical student

作為醫學生， 我進行的第一個研究計劃

was to help design healthcare interventions

就是去協助設計能吸引到 黑人的醫保創新。

that would appeal to black men.

We conducted about a dozen focus groups

我們對 12 組焦點團體做實驗， 其中有各個階層的黑人，

with a broad cross-section of black men,

and we learned that for them,

我們從中學到了很多，

being healthy was as much about being perceived as healthy

身體健康既是各項指標正常，

as it was about feeling healthy,

也是心裡感覺到健康，

and that feeling good went hand in hand with looking good.

而且感覺愉快和外表好看 是緊密聯繫的。

This work led to the development of Project Brotherhood,

這個研究促進了 「黑人兄弟診所」組織的發展，

a community clinic founded by Dr. Eric Whitaker

由艾力克 · 維塔克醫生開辦，

that provided tailored healthcare to black men.

為專為黑人打造的社區醫療診所。

Part of this tailored care

這個醫療的一部分包括

involved having a barber on the premises

有駐診理髮師給來看病的人

to reward the men who came for needed healthcare

一次免費的理髮服務，

with a free haircut,

to let the men know that we, too, valued how they looked

這讓他們知道 我們既重視他們的外貌，

as well as how they felt,

也重視他們的感覺，

and that what was important to them was also important to us.

對他們而言很重要的東西， 我們同樣看重。

But while there's only one Project Brotherhood,

儘管只有一個 「黑人兄弟診所」組織，

there are thousands of black barbershops

卻有上千個將促進健康和理髮 結合的黑人理髮店，

where the intersection of health and haircuts can be cultivated.

The next stop on my journey was Dallas, Texas,

然後我的促進健康專業旅程 到了德州的達拉斯，

where we learned that barbers were not only willing

我們在那裡了解到理髮師不僅願意，

but fully able to roll up their sleeves and participate

還有足夠的能力捲起袖子親身參與，

in delivering needed health services to improve the health of their customers

為他們的顧客和社區提供必要的 醫療服務，以促進他們的健康。

and their community.

We teamed up with an amazing cadre of black barbers

我們和一群優秀的黑人理髮師合作，

and taught them how to measure blood pressure

教會他們怎樣測量血壓，

and how to counsel their customers

怎樣與顧客商談， 並把他們轉到診所，

and refer them to doctors

to help manage high blood pressure.

以控制和治療高血壓。

The barbers were not only willing to do it

這些理髮師不僅願意這樣做，

but they were damn good at it.

他們還做得超好。

Over a three-year period,

三年以來，

the barbers measured thousands of blood pressures

這群理髮師測量了上千人的血壓，

resulting in hundreds of black men being referred to doctors

讓數百位黑人轉到診所

for medical care of their high blood pressure.

接受高血壓的治療。

These barber-doctor partnerships

這種理髮師和醫生的結合方式

resulted in a 20 percent increase in the number of men

讓血壓控制在標準值內的 人數增長了 20%，

who were able to achieve target blood pressure levels

and a three-point drop, on average,

平均每個參與者的血壓 也都下降了很多。

in the blood pressure of each participant.

If we were to extrapolate that three point drop

假如我們能讓美國每個患有 高血壓的黑人的血壓都下降很多，

to every single black man with high blood pressure in America,

we would prevent 800 heart attacks, 500 strokes and 900 deaths

就能防止 800 人次的心臟病， 500 人次的中風

和 900 人次因為 高血壓造成的死亡，

from high blood pressure

in just one year.

在短短一年內達到。

And our experience with barbershops has been no different in New York City,

我的旅程最近到了紐約州， 我們與理髮店的合作同樣成功。

where my journey has currently led me.

With an incredible team of diverse research assistants,

我們優秀的隊伍有不同的研究助理，

community health workers and volunteers,

社區醫療工作者和志工，

we've been able to partner with over 200 barbershops

我們已經和超過 200 家理髮店 及其他值得信任的社區場所合作，

and other trusted community venues

to reach over 7,000 older black men.

惠及超過 7000 個年老的黑人。

And we've offered high blood pressure screening and counseling

我們還為每一個人提供 高血壓檢測和建議。

to each and every one of them.

Thanks to Denny Moe

感謝丹尼 · 默

and the myriad other barbers and community leaders

和無數的理髮師及社區領袖，

who shared the vision of opportunity and empowerment

他們共同懷有幫助社區發展的 機會和賦權的願景，

to make a difference in their communities,

we've been able to not only lower blood pressure

我們不僅能幫助參與者降低血壓，

in our participants,

but we've also been able to impact other health indicators.

我們也能夠引入其他的健康指數。

So what do you see?

那麼你們現在看到什麼？

What is your barbershop?

你的理髮店在哪裡？

Where is that place for you

在人們受到獨特問題的困擾時， 能提供獨特解決方案的地方在哪裡？

where people who are affected by a unique problem

can meet a unique solution?

When you find that place, see the opportunity.

當你能找到那個地方時， 便能看到機會。

Thank you.

謝謝。

(Applause)

（掌聲）