September 14, 2009

Greensboro barber Ed Hooker tells a client about the benefits of cancer screenings.

Greensboro barber Ed Hooker tells a client about the benefits of cancer screenings.

Ed Hooker has been a barber for more than 20 years. He knows that keeping his customers healthy is good for them — and it’s also good for business.

“I want to make sure my clients are healthy and let them know someone cares about them,” he says. “I also need to keep my clientele alive and teach them how to stay out there in the world so I can continue to make a living with them!”

Hooker, owner of E-Style Barbershop in Greensboro, N.C., has been an active advisory board member in several UNC barbershopbased research projects, including “Trimming Risk in Men” (TRIM) and “Cancer Understanding Today” (CUTS), that engage men in conversations about their health and urge them to get preventive health care.

Laura Linnan, ScD, associate professor of health behavior and health education at the UNC Gillings School of Global Public Health, leads the research teams working on these studies. They are offshoots of a successful project she started six years ago in beauty shops (N.C. BEAUTY and Health Project), which targeted African-American women to eat healthier, get more physical activity and obtain recommended screening tests. “African-American men die, on average, seven years before white men, and most men often wait until they are really sick before they talk with a health care provider,” says Linnan. “If you look at most of the leading causes of death — heart disease, stroke, diabetes, cancer — it would show that African- American men are suffering higher rates than any of those groups.”

The BEAUTY, TRIM and CUTS studies are grounded in a strong partnership with directors of cosmetology and barbering schools, barbers/stylists, health care advocates and others who help guide all aspects of the research. In fact, the barbershop outreach idea came from the advisory board members. Hooker is helping researchers train barbers to help promote health in their shops, with their clients.

“Our men are very private,” he says. “When you start digging or come on too strong, you can actually push them away. A lot of barbers would rather just give him a haircut and let him leave than pester him to get check-ups. That’s when I remind the barbers that if they don’t have these men, they are going to lose business.”

The BEAUTY Project enrolled 40 beauty salons and more than 1,000 women in the study. So far, Linnan’s team has worked with more than 20 African-American Canbarbershops and nearly 500 of their customers as part of the TRIM and CUTS studies. The TRIM study is funded by the Centers for Disease Control and Prevention. Preliminary results demonstrate that barbers can be trained to encourage clients to make informed decisions about getting colorectal and prostate cancer screenings, and that clients are enthusiastic in their support of receiving health information in the barbershops. Preliminary results from CUTS showed that African-American men were more aware of (and had increased calls to acquire) the free, lifesaving information available through the National Cancer Institute’s Cancer Information Service.

Linnan says these studies have continued to build the evidence base for promoting health in beauty salons and barbershops and that they are willing partners in working toward eliminating the health disparities that exist. Perhaps most importantly, “we have clearly demonstrated that barbershops are a great place to reach men, as long as we don’t overwhelm them with too much information,” she says. “The average age of our CUTS participants was 35 years, and there are very few settings where we can reach young African-American men with information about health. The barbershop is a unique place in that regard.”

Hooker agrees with that assessment.

“Men will listen to their barber,” he says.

Cancer U nderstanding Today (CUTS) is a two-year National Cancer I nstitute project designed to increase calls from African-American men to its cancer hotline, 1-800-4CANCER . Linnan is encouraged by early indications from the study, which relies on barbershops to promote the health education information.

“The good news is that we definitely are seeing trends toward increased calls” after a recent education campaign about cancer and the hotline, Linnan says.

— Kim Gazella

Carolina Public Health is a publication of the University of North Carolina at Chapel Hill Gillings School of Global Public Health. To view previous issues, please visit

Last updated September 14, 2009