Most of you see a barbershop,

你看到什麼？

but I see an opportunity:

多數人看到的是理髮店，

an opportunity for health,

但是我見到一個機會：

an opportunity for health equity.

一個促進健康的機會，

For black men, the barbershop is not just a place

一個促進人人都可以 享受健康的機會。

where you get your hair cut or your beard trimmed.

對黑人來說，理髪店不單只是

No, it's much more than that.

你剪頭髮或剃鬍子的地方。

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

它有更重大的意義。

It's a place where we go for friendship,

自古理髪店就是黑人的安樂窩。

solidarity and solace.

那裡是可以結交朋友，

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

大家團結一致和互相安慰的地方。

of the grind of work

在那裡我們可以遠離

and sometimes home life.

工作的折磨，

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

避開家庭的壓力。

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

我們在那裡不用擔心

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

外界怎樣看待我們。

or threatening.

不怕受到別人脅迫，

It's a place of loyalty and trust.

或者覺得身處險境。

For that reason,

那是一個充滿忠誠和信任的地方。

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

因此，

and just ... talk.

那裡是我們少數可以自在做自己，

The talk, the shop talk, the conversation,

無憂無慮地聊天的地方。

that is the essence of the black barbershop.

聊天、傾行話、閒扯，

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

都是黑人理髮店的精髓。

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

我記得少時跟爸爸到理髮店。

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

每隔一個星期六， 我們到麥克的理髪店。

every time we went,

好像發條鐘錶一樣，每次到那裡

either waiting on their favorite barber

都是同一批男子，

or just soaking up the atmosphere.

他們要不是在等自己喜愛的理髮師，

I can remember the jovial greeting that warmly welcomed us

就是純來感受這裡的氣氛。

every time we went.

我記得每次我們來到小店

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

都會受到愉快親切的歡迎。

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

「嗨，老牧！」 他們會這樣和我爸說話。

"Hey young fella, how you doing?"

爸爸是當地的牧師， 他們待他如名人。

they would say to me,

「嗨，年輕人，你好嗎？」

making me feel just as special.

他們就是這樣對我說話，

I remember the range of the conversations was immense.

讓我覺得自己 就跟爸爸一樣與眾不同。

The men would talk about politics and sports and music

我記得他們的話題很廣泛。

and world news, national news,

他們會談論政治、體育、音樂

neighborhood news.

和世界新聞、國內新聞，

There was some talk about women

本地新聞。

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

有時談到女人

But many times they also talked about health.

和美國黑人的生存現狀。

The conversations about health were lengthy and deep.

但是很多時候 他們談論關於健康的話題，

The men often recounted their doctor's recommendations

而且花很長時間深入交談。

to cut salt in their diet

他們常常詳細地敍述醫生的建議，

or to eat less fried foods

例如減鹽飲食、

or to stop smoking

少吃煎炸食物、

or to reduce stress.

戒菸、

They talked about the different ways you could reduce stress,

減壓。

like simplifying one's love life --

他們談論減壓的不同方法，

(Laughter)

例如過簡單的愛情生活——

all ways to treat high blood pressure.

（笑聲）

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

各種治療高血壓的方法。

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

理髮店裡有很多關於高血壓的談話。

That means that almost every single black man

因為四成的黑人男士患有高血壓。

either has high blood pressure

這意味著幾乎每一個黑人

or knows a black man who has it.

不是自己有高血壓，

Sometimes, those conversations in the barbershop

就是認識另一個患有高血壓的黑人。

would be about what happens when high blood pressure

有時這些人在理髮店的對話

is not adequately addressed.

會講到當人們不重視高血壓

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

會發生什麼事。

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

「你有沒有聽到吉米的消息？ 他中風了。」

Massive heart attack.

「你聽說艾迪的事情沒？ 他上星期去世了，

He was 50."

因為嚴重的心臟病發。

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

他才 50 歲。」

even though decades of medical wisdom and science have demonstrated

黑人高血壓死亡率要高於其他疾病，

that death from high blood pressure can be prevented

雖然數十年來醫學的 智慧和科學已經證明

with timely diagnosis and appropriate treatment.

及時的診斷加上適當的治療 可以預防病人死於高血壓。

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.

但是為什麼？

But why?

我們有一些早期關於 黑人健康狀況的調查，

Some of our earliest research on black men's health

表明對於很多黑人來說， 診所都讓人聯想到恐懼、

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

缺乏信任、

mistrust,

不受尊重、

disrespect,

還有不愉快。

and unnecessary unpleasantness.

診所只是在你感到不適時 要去的地方。

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

你真的去了那裡，可能要等很久，

And when you do go, you might wait for hours

只聽到一輪託詞，

only to get the run-around

然後接受一個面無表情、 穿著白袍的醫生看診，

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

他只給你 10 分鐘時間看病，

who only has 10 minutes to give you

而且並不重視你們之間的對話。

and who doesn't value the talk.

所以難怪有些人懶得麻煩，

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

根本不去看醫生，

and skip going to the doctor altogether,

尤其是他們感覺精神不錯的時候。

especially if they feel fine.

但是這裡存在一個問題。

But herein lies the problem.

即使你的高血壓威脅著 你重要器官的時候，

You can feel just fine

你也不會感覺不適。

while high blood pressure ravages your most vital organs.

這是丹尼 · 默，

This is Denny Moe,

紐約哈林區「丹尼 · 默 超級明星理髮店」的店主。

owner of Denny Moe's Superstar Barbershop in Harlem.

最近八年，我都很幸運地 有丹尼做我的理髮師。

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

他有一次跟我說：

He said to me once,

「嗨，醫生，你知道嗎，

"Hey Doc, you know,

比起相信自己的醫生， 很多黑人更相信自己的理髮師。」

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

這一開始真的讓我很驚訝，

This was stunning to me,

但當你仔細想想的時候 好像就是這樣。

at first,

平均而言，黑人和他們的 理髮師認識的時間，

but not so much when you think about it.

就和我和丹尼認識的時間一樣長，

Black men have been with their current barbers

就是差不多八年。

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

而且黑人差不多每兩週理一次髮。

about eight years.

你不僅相信髮型師能夠 照顧好你的髮型和外貌，

And black men see their barbers about every two weeks.

你還願意和他分享你的秘密， 甚至有時以生命信任他。

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

和很多髮型師一樣， 丹尼不僅僅是一個藝術家，

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

一個商人和知己。

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

他還是一個促進社區健康的 領袖和熱情的倡導者。

a businessman and confidant.

我第一次走進丹尼的店時，

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

他不僅在理髮，

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

他還在為他的顧客和社區發聲 而安排選民登記運動。

he wasn't just cutting hair.

因為黑人理髮店的典型特徵 是這種積極精神和社區投資，

He was also orchestrating a voter registration drive

難怪理髮店會成為談論高血壓

to give a voice to his customers and his community.

及社區其他健康問題的首選場所。

With this kind of activism,

首先，理髮店不是醫療環境，

and community investment that typifies the black barbershop,

所以不會給人帶來負面的心理負擔。

of course the barbershop is a perfect place

當你在理髮店的時候，

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

你在自己的地盤，

First, the barbershop is not a medical setting,

有知道你的過去和艱辛， 及健康風險的朋友陪伴。

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

第二，因為理髮店是個充滿 聯繫、忠誠和信任的地方，

that comes along with that.

在這裡你能更輕鬆地談論健康話題，

When you're in a barbershop,

尤其是高血壓。

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

畢竟，有關高血壓的談話 有所有店裡閒聊的要素：

who share your history,

壓力和高血壓，

your struggle and your health risks.

食物和高血壓，

Second, because the barbershop is a place of connection,

人際交往和高血壓，

loyalty and trust,

噢還有，在美國 當黑人的感受和高血壓。

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

但是在理髮店裡你不僅能 談論高血壓，你還能做更多。

and especially about high blood pressure.

你能採取具體的行動。

After all,

現在我們有一個和世界上 其他丹尼 · 默合夥的機會，

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

去啟發社區重視 其獨特的健康不平等問題。

stress and high blood pressure,

在 1960 及 1970 年代，

food and high blood pressure,

當高血壓篩檢從診所和醫院 擴大到社區時，

relationships and high blood pressure,

像巴爾的摩的伊利 · 桑德斯 和新奧爾良的肯斯 · 芬迪南德

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

這樣的黑人醫生，

and high blood pressure.

把提倡健康活動帶到城市中 黑人街區的社區中心前線。

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

這些先驅為我專注於 理髮店和健康關係的專業道路奠基，

in the barbershop.

這事業開始於芝加哥的醫學院。

You can concretely take action.

作為醫學生， 我進行的第一個研究計劃

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

就是去協助設計能吸引到 黑人的醫保創新。

and empower communities to address the health inequities

我們對 12 組焦點團體做實驗， 其中有各個階層的黑人，

that uniquely affect it.

我們從中學到了很多，

When high blood pressure screening expanded from clinics and hospitals

身體健康既是各項指標正常，

to communities in the 1960s and '70s,

也是心裡感覺到健康，

black physicians like Dr. Eli Saunders in Baltimore

而且感覺愉快和外表好看 是緊密聯繫的。

and Dr. Keith Ferdinand in New Orleans

這個研究促進了 「黑人兄弟診所」組織的發展，

were at the forefront of bringing health promotion to community hubs

由艾力克 · 維塔克醫生開辦，

in urban black neighborhoods.

為專為黑人打造的社區醫療診所。

These pioneers paved the way for my professional journey

這個醫療的一部分包括

with barbershops and health,

有駐診理髮師給來看病的人

which began in Chicago in medical school.

一次免費的理髮服務，

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

這讓他們知道 我們既重視他們的外貌，

was to help design healthcare interventions

也重視他們的感覺，

that would appeal to black men.

對他們而言很重要的東西， 我們同樣看重。

We conducted about a dozen focus groups

儘管只有一個 「黑人兄弟診所」組織，

with a broad cross-section of black men,

卻有上千個將促進健康和理髮 結合的黑人理髮店，

and we learned that for them,

然後我的促進健康專業旅程 到了德州的達拉斯，

being healthy was as much about being perceived as healthy

我們在那裡了解到理髮師不僅願意，

as it was about feeling healthy,

還有足夠的能力捲起袖子親身參與，

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

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。

This work led to the development of Project Brotherhood,

我們和一群優秀的黑人理髮師合作，

a community clinic founded by Dr. Eric Whitaker

教會他們怎樣測量血壓，

that provided tailored healthcare to black men.

怎樣與顧客商談， 並把他們轉到診所，

Part of this tailored care

以控制和治療高血壓。

involved having a barber on the premises

這些理髮師不僅願意這樣做，

to reward the men who came for needed healthcare

他們還做得超好。

with a free haircut,

三年以來，

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

這群理髮師測量了上千人的血壓，

as well as how they felt,

讓數百位黑人轉到診所

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

接受高血壓的治療。

But while there's only one Project Brotherhood,

這種理髮師和醫生的結合方式

there are thousands of black barbershops

讓血壓控制在標準值內的 人數增長了 20%，

where the intersection of health and haircuts can be cultivated.

平均每個參與者的血壓 也都下降了很多。

The next stop on my journey was Dallas, Texas,

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，

where we learned that barbers were not only willing

就能防止 800 人次的心臟病， 500 人次的中風

but fully able to roll up their sleeves and participate

和 900 人次因為 高血壓造成的死亡，

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

在短短一年內達到。

and their community.

我的旅程最近到了紐約州， 我們與理髮店的合作同樣成功。

We teamed up with an amazing cadre of black barbers

我們優秀的隊伍有不同的研究助理，

and taught them how to measure blood pressure

社區醫療工作者和志工，

and how to counsel their customers

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 refer them to doctors

惠及超過 7000 個年老的黑人。

to help manage high blood pressure.

我們還為每一個人提供 高血壓檢測和建議。

The barbers were not only willing to do it

感謝丹尼 · 默

but they were damn good at it.

和無數的理髮師及社區領袖，

Over a three-year period,

他們共同懷有幫助社區發展的 機會和賦權的願景，

the barbers measured thousands of blood pressures

我們不僅能幫助參與者降低血壓，

resulting in hundreds of black men being referred to doctors

我們也能夠引入其他的健康指數。

for medical care of their high blood pressure.

那麼你們現在看到什麼？

These barber-doctor partnerships

你的理髮店在哪裡？

resulted in a 20 percent increase in the number of men

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？

who were able to achieve target blood pressure levels

當你能找到那個地方時， 便能看到機會。

and a three-point drop, on average,

謝謝。

in the blood pressure of each participant.

（掌聲）

If we were to extrapolate that three point drop

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

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

from high blood pressure

in just one year.

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

where my journey has currently led me.

With an incredible team of diverse research assistants,

community health workers and volunteers,

we've been able to partner with over 200 barbershops

and other trusted community venues

to reach over 7,000 older black men.

And we've offered high blood pressure screening and counseling

to each and every one of them.

Thanks to Denny Moe

and the myriad other barbers and community leaders

who shared the vision of opportunity and empowerment

to make a difference in their communities,

we've been able to not only lower blood pressure

in our participants,

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

So what do you see?

What is your barbershop?

Where is that place for you

where people who are affected by a unique problem

can meet a unique solution?

When you find that place, see the opportunity.

Thank you.

(Applause)