ST. LOUIS — When Robert Hibler stopped by Flotrin's Barber Shop in north St. Louis, he got a new haircut — and a wake-up call.
Two nursing students from Saint Louis University visited the shop offering to take customers' blood pressure, and Hibler's was high: 145/90.
Summary of the barbershop outreach to black men for health screenings:
THE EFFORT: The health topics vary by city. In St. Louis, nursing students have started a program called "Trimming Away Hypertension." On a recent visit, two of them spent a few hours at a barbershop, getting a basic family history from participants and asking questions to evaluate health risks. The students encourage men to visit their own doctors or clinics if follow-up is needed.
ENCOURAGING HEALTHY LIVING: The students give men a small card that shows different blood pressure readings, and what indicates normal, prehypertension and hypertension. Men can return to the shop to have additional blood pressure checks and to track their progress. The students also provide them with healthy recipes to try, tips for reducing sodium in their diet, and information about prostate cancer.
THE HOPE: Six student nurses, who got the idea from efforts in other cities, are working with 100 Black Men of St. Louis and a professional nursing sorority. Tom Bailey Jr., an executive committee member with 100 Black Men, would like the organization to adopt similar projects nationwide.
Hibler, 44, doesn't like to go to the doctor even if he's sick. That changed after what he learned at the barbershop.
"After the high blood pressure reading, I did get a whole physical, health screening — the whole nine yards," Hibler said.
From New York to Los Angeles to St. Louis, health workers are going to barbershops, long a gathering place for black men, to provide screenings to those who may not get regular checkups.
What's offered varies from city to city. In St. Louis, the nursing students have joined with the nonprofit organization 100 Black Men, which works for community improvement, and a professional nursing sorority, Chi Eta Phi, to measure blood pressure.
High blood pressure affects over 40 percent of African-Americans, and the complications can be serious, even deadly, if left untreated. The American Heart Association says compared with whites, black people have a 1.8 times greater rate of fatal stroke, a 1.5 times greater rate of heart disease death and a 4.2 times greater rate of end-stage kidney disease.
The nursing students also provide information about prostate cancer — the second leading cause of cancer death in black men. If needed, they let men know about clinics they can go to for complete hypertension checks or cancer screenings.
"We were really, really shocked in the beginning," said Saint Louis University nursing student Julie Willems, 21. "We thought people would be really resistant, but the barbershop is a place where people feel comfortable talking about just about anything. It's a very open environment."
Health educators point to a number of reasons why men, particularly black men, are hard to reach for early health screenings and preventive care.
Many men aren't in the habit of routine visits. Instead, they go to the doctor when they're in pain, or have symptoms of an illness.
For some, there's an element of mistrust in the medical establishment, or a feeling that they're better off not knowing if they feel there's not much they can do about it.
"People think what they don't know can't hurt them, but it can," said Dennis Mitchell, owner of Denny Moe's Superstar Barbershop in Harlem.
His shop has hosted several health-related events in the past three years, a decision Mitchell said was fueled by watching his own relatives struggle with health problems, especially cancer.
Barbers often help the health workers get conversations going with customers — and whoever else might be within earshot.
At Flotrin's, where pictures of Muhammad Ali and the Obamas share wall space with owner Donna F. Baker's relatives, she opened her front door last week and encouraged a handyman walking by to come in and get his blood pressure checked out.
"You ambushed me, girl," joked Wendell Steward, 54, before the students told him his reading was just fine.
Baker talked about high blood pressure issues in her own family and her own efforts to keep hers in check.
"We need our men around," she said as she used clippers to trim a customer's hair. "If you can't find black men all in one place, you can find them here in the barbershop." She encourages her female customers to get their blood pressure checked out, too, while the nursing students are at the shop.
In some cities, the checks extend way beyond the blood pressure cuff.
In New York, St. Luke's and Roosevelt Hospitals have teamed up with Abyssinian Baptist Church and Harlem barbershops for health events.
Last summer, health workers brought a mobile van to Denny Moe's for two days and checked cholesterol, blood pressure and blood glucose levels. The HIV rapid test was offered, as were blood tests and private digital rectal exams by a urologist to help diagnose possible prostate cancer.
"Every time they give me a reason why they shouldn't (be tested), I give them two reasons why they should," said Marian Scott, the director of community health education programs at St. Luke's and Roosevelt Hospitals. "There's a possibility it could save your life."
Last week, Hibler stopped back into Flotrin's when the nursing students were visiting to have his blood pressure monitored again. They told him it was back in normal range.
Recently laid off, his past military service had allowed him to visit his own doctor, who gave him a clean bill of health. But he said the barbershop visit also motivated him to cut back on fatty and salty foods.
"Reaching out any place outside the norm is a good idea," he said. "You've got to think outside the box."