A shave, a cut and please roll up your sleeve

Movies have been made and treatises have been written on the role of barbershops in African American life. In the pre-Civil Rights era, they were one of the first businesses that black men, especially in the South, could own, and, outside of churches, one of the few places they could gather.

In recent years, the barbershop has continued to be a place of fellowship, where African American men meet, gossip and dissect sports and politics across generational and socioeconomic lines.

Now barbershops across South Los Angeles have been targeted as the site of lifesaving efforts, thanks to Dr. Bill Releford and a squadron of other volunteers.

Releford, a podiatrist with a Miracle Mile-based private practice, was getting a bald fade at Inglewood’s Finest Barbershop one Sunday, when the solution to a long-pondered dilemma came to him: African Americans have the highest rates of diabetes and heart disease of any group, yet black men are among the least likely to see a doctor regularly. So if the men wouldn’t come to a doctor, he would bring a cadre of volunteer doctors and nurses to the barbershop.

The Black Barbershop Health Outreach Program was born that day in Inglewood in December 2007. The response was so enthusiastic that Releford expanded the program to 50 other L.A. barbershops, and then to barbershops in other states. This year, at 750 shops in 50 cities across 13 states, men who ordinarily would go nowhere near a doctor’s office will be offered a health checkup in a setting so familiar that it will seem as routine as a haircut.

In Los Angeles alone, almost 1,200 men have been screened for diabetes and high blood pressure.

“It’s taboo to go to the doctor, so he comes to them,” said Dr. Pamela Blakely, a podiatrist and program volunteer. “The one place he can find them on a weekly basis is the barbershop.”

Many men balk at going to the doctor, and various studies have tried to get at why. They see being sick as a sign of weakness. They don’t like waiting in doctors’ offices. They’re scared of what they may find out.

“We don’t want to know,” said Inglewood’s Finest barber Dave Robinson, 62. “We’d rather go through life letting things fix themselves.”

What’s more, there are cultural barriers to medical care in the black community. Blakely points out that blacks are more likely than whites to be uninsured. Some patients feel more comfortable seeing a doctor who shares their background and culture, and only about 3% of doctors and medical students in the U.S. are African American.

And distrust of the medical system has deep roots in the black community, a legacy, Blakely says, of the infamous Tuskegee syphilis study, in which federal health officials followed 399 black men from Tuskegee, Ala., for 40 years without telling them they had the disease -- long after penicillin had been found to cure it.

Blakely sat behind a table one recent Saturday at Inglewood’s Finest, cuffing arms and pricking fingers beneath a life-sized cutout of Lakers star Kobe Bryant and posters from “Barbershop,” the 2002 movie starring Ice Cube and Cedric the Entertainer.

The shop buzzed, and not just from electric clippers. Customers chatted with barbers, each other and on cellphones. Young men milled outside the shop’s entrance.

Dropping into the chair by Blakely’s table seemed natural.

“Everybody who sits down in this chair knows someone who has diabetes, if they don’t have it themselves,” Blakely said. “You talk about six degrees of separation -- it’s more like three. Or two or one.”

Still, barbershop denizens often are shocked to find out that their blood sugar or blood pressure is high. Both diabetes and high blood pressure are silent diseases, with few symptoms early on.

So Blakely takes her time with each person she screens, dispensing advice about what to eat and how often to exercise. If necessary, she refers men to physicians or local clinics that have agreed to take part in the program. At almost every screening, at least one person’s blood pressure or blood sugar is so high he’s sent straight to a hospital emergency room.

The damage can manifest itself in several ways. Releford specializes in saving badly infected toes, feet and lower legs from amputation. Most of his patients have diabetes, the second-leading cause of lower limb amputations after car accidents.

Diabetes can cause a type of nerve damage called neuropathy in the hands and legs, resulting in numbness that allows scraped shins and stubbed toes to go unnoticed. Add poor circulation -- also related to diabetes -- and such sores can quickly become infected. More than 71,000 people with diabetes lost toes, feet or legs to the disease in 2004, according to the American Diabetes Assn. Foot problems are the primary reasons diabetics are hospitalized.

The dilemma of how to reach African American men had long dogged Releford, who often talked about the problem with Donte Kelly, his barber as well as his workout partner.

As the idea for the barbershop program took shape, Releford asked Kelly to be the liaison to shops across the country.

“Barbershops have a long tradition among African American men of being a place where everything is discussed,” said Dr. Lawrence Sanders, associate dean of clinical affairs at Morehouse School of Medicine, a historically black medical school in Atlanta. “Because of this history, it represents an opportunity to promote health and to promote behavioral change in an environment where people feel less threatened.”

Finding funding for the program was difficult; foundations are much more likely to give to programs for women and children than for men, especially black men. (The barbershop outreach project receives grants from the Abbott Fund, a foundation of Abbott Laboratories, which makes medical products, including blood-sugar monitors and insulin syringes for diabetes.) Charles Drew University of Medicine and Sciences in South Los Angeles, where Releford is an associate professor, is helping him gather statistics on high blood pressure and diabetes.

For Releford, the drive to end racial health disparities began when, as a college student at Cal Poly Pomona, he made what would become the first of many pilgrimages to Elmina Castle in Ghana, for 300 years a key stop in the Atlantic slave trade.

“I swear I think the ancestors talk to me when I’m there,” Releford said. “That’s where I recharge my spiritual batteries and ask myself, ‘What impact am I going to have? What cause am I going to embrace that’s bigger than me?’ ”

If health is his ministry, the barbershops have become his churches.

Jeanty Bourcicault, 39, a barber at Inglewood’s Finest, found out at a screening last year that he had both high blood pressure and high blood sugar.

Despite having diabetes on both sides of his family, he had not been to a doctor in years.

“Men don’t go to the doctor unless they have to,” he said. “That’s the way we are.”

Now he eats a bowl of oatmeal and a banana every morning for breakfast and has traded fast-food hamburgers and chicken for fish and vegetables.

He was amazed, he said, at how quickly his numbers dropped.

Robinson, his fellow barber, used to avoid the doctor because he didn’t want to know if anything was wrong.

“I had an attitude of being a tough old bird,” he said. “Whatever happened, I could handle it. You’ll find that in almost all men.”

But when a screening revealed he had high blood pressure, he stopped smoking. He counsels his customers to follow his example.

“I pride myself on being a wise old man now,” he said.

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mary.engel@latimes.com