The neighborhood barber shop isn’t just for haircuts, according to Stephen Thomas. It can also be the place where middle-aged men learn they should probably get a colonoscopy.
Thomas, a professor at University of Maryland’s School of Public Health and founding director of its Center for Health Equity, has received national attention for his innovative approach to providing health information to African-American communities in the District of Columbia. His simple, yet incredibly effective idea was to enlist the owners and employees of 11 neighborhood barber shops to encourage customers to get colonoscopies, flu shots and timely checkups.
“No self-respecting black barber would ever say ‘I will get you in and out in 15 minutes,’” said Thomas. “Unlike Supercuts, the black barber shop and black beauty shop remains a cultural center, a community center, where people are able to feel trusted.”
Thomas, who has a reputation for finding creative solutions to community gaps in health care and preventative education, has used a sports arena to host giant, free dental clinics; partnered on projects with Christian and Muslim organizations; and collaborated on research that contributed to President Bill Clinton’s 1997 decision to issue a formal apology to survivors of the Tuskegee Syphilis Study.
On Monday, Feb. 5, he will bring his ideas for more effective public health outreach to SUNY Cortland. HIs talk, “Less Talk, More Action: Accelerating 4th Generation Disparities Research to Achieve Health Equity,” is set for 5:30 p.m. in Old Main Brown Auditorium.
The presentation is free and open to the public. It is the eleventh Charles N. Poskanzer Lecture, sponsored by the College’s Health Department with support from an endowment fund named in honor of the late SUNY Distinguished Service Professor emeritus who taught in the College’s Health Department for 40 years.
Thomas’ current research focuses on studying chronic disease and how to develop community-based interventions to eliminate racial and ethnic disparities in health and health care. More specifically, Thomas has looked at how social context shapes attitudes and behaviors of underserved, poorly served and never-served segments of our society toward participation in health promotion and disease prevention activities.
Through his Center for Health Equity, Thomas applies his expertise to address a variety of conditions from which minorities generally face far poorer outcomes, including cardiovascular disease, diabetes, obesity and HIV/AIDS. The center is a part of the National Institutes of Health (NIH) Center of Excellence on Race, Ethnicity and Health Disparities Research.
Thomas launched the Health Advocates In-Reach and Research (HAIR) program among D.C.-area barbershops a decade ago. His primary intent was to reach black Americans with the message that they are 45 percent more likely than other racial groups to die from colon cancer and they should be screened for it five years sooner than is usually recommended.
“The barber and beautician have historically been trusted opinion leaders in the African American community,” Thomas said. “I’ve seen a barber have more influence than a doctor over whether the patient takes that medicine or doesn’t take that medicine. The conversations that take place in the barber shops shape social norms.”
The HAIR model trains barbers and beauticians to discuss health issues with customers but always has medical professionals dealing directly with people in the barber shops and beauty salons.
Because other similar projects around the country have been successful and with the weight of randomized clinical trials indicating that this approach works, Thomas’ center will use his grant funding through the SIGMA Foundation to launch a National Association of Black Barbershops for Health.
“In this way, we are working toward building a sustainable model for ensuring that barbershops and salons that want to be part of this health movement can do so and have access to resources and tools,” he said. “And this will give us greater confidence that the information being delivered is done in a way that is respectful and evidence-based.”
Joining the HAIR model also provides an opportunity for health professionals, many of whom don’t come from these communities, to practice their cultural competence skills to become more comfortable working with racial and ethnic minorities.
“We think that’s a very important part of this work of transforming barber shops and beauty shops into health information portals,” Thomas said.
Another major public health issue that Thomas seeks to address effectively is the epidemic of people in the U.S. with severe dental emergencies who for lack of money are turned away in conventional health care settings.
Twice under Thomas’ leadership the center has partnered with the Roman Catholic Diocese of Washington, D.C., to offer Mission of Mercy dental clinics at the University of Maryland’s 17,950-seat Xfinity Center arena. In 2013 and again in 2017, each clinic served thousands of people. Clients had lined up outside the arena the day before for a chance to get their teeth fixed, address other health care needs, and in 2017, get a free haircut.
The idea for the dental clinic came to him by chance.
“I say to students, ‘Don’t ignore the front page of your newspaper,’ Thomas said. “Because it was a story in the newspaper where I read about this (kind of) event.” Thomas had read about a dental clinic offered at a school gym through the diocese that was so popular it couldn’t handle all the comers.
Thomas was able to take this great idea to a whole new level.
“We can cry and whine and complain about the brokenness of the health care system but there must be something we can do to address the suffering right now,” Thomas said. “While the Mission of Mercy was not perfect, it was an opportunity to deliver in many cases lifesaving services to people who would otherwise not receive it and to wrap around it the other health needs they have. I would submit that our job in health equity is to run to the problem, run to the gap, and address the needs of our most vulnerable members of society. That’s how we can make the best contribution to promote health and prevent disease in our country.”
Central to Thomas’ research is an infamous 40-year study from 1932 until 1972 in which African Americans infected with syphilis were examined at local outreach clinics run by health professions but, unknown to them, never treated.
Thomas is particularly interested in how the legacy of the Syphilis Study at Tuskegee has impacted trust and influenced the willingness of African Americans to participate in medical and public health research. His body of work, with Sandra Quinn, on overcoming the negative effects of the Tuskegee Syphilis Study, contributed to the 1997 Presidential Apology to Survivors of the Tuskegee Study.
Thomas said during his doctoral studies at Southern Illinois University, classmate Alan Sofalvi, now a SUNY Cortland assistant professor of health, sparked his initial curiosity about the Tuskegee Study’s ongoing harmful effects of keeping American racial and ethnic minorities from seeking needed health care screening and treatment.
“In that class, it was Alan who raised my attention to the Tuskegee Study,” with his project on the landmark 1981 book by James Jones about the study, Bad Blood, Thomas said. Thomas earned a doctorate in community health education at Southern Illinois.
“The history of research abuse has cast a long shadow on the African American community to this very day,” Thomas said. “This coincided with the AIDS epidemic and with the fear and mistrust. It shows you that just when you think the Tuskegee Study’s impact is all over, it continues to be relevant to this very day.”
Students in the health professions should listen to their instinct when it says something’s wrong, noted Thomas, who has received certificates in bioethics from Georgetown University and the University of Washington.
Thomas said he once met and talked to Rebecca Skloot, author of The Immortal Cells of Henrietta Lacks.
Cells collected in the 1950s from Lacks, a poor black woman dying of cancer, multiplied so rapidly that they continue to be the basis for research and treatment of major illnesses today.
The 2010 book juxtaposes health industry profit off the HeLa cell line with no consideration for even basic health care opportunities for the offspring of a poor, dying black woman whose cell line was taken and exploited without her knowledge or permission in 1951.
“Skloot was in a biology classroom and she was kind of annoyed that something this important, this significant, as the question of where the HeLa cells came from, the professor couldn’t answer,” Thomas said.
It was a forgotten fact that the HeLa cells were shorthand for the name of the unwitting donor.
“A decade later, Skloot was inspired to study and write her book about it. It’s like the topic picked her and not the other way around.
“In many ways, the legacy of the Tuskegee Study was the topic that picked me,” Thomas said.
He has been a lead investigator of multiple studies investigating racial differences in health outcomes, including an NIH study titled “Building Trust between Minorities and Researchers.”
Thomas is a principal investigator on the Center of Excellence in Race, Ethnicity and Health Disparities Research, funded by the National Institute for Minority Health and Health Disparities (NIMHD).
Additionally, he was awarded funding from the Robert Wood Johnson Foundation, the CIGNA Foundation and numerous local foundations and donors.
The Poskanzer Fund was established through the Cortland College Foundation as an endowment to support an annual, public lecture offered by the College’s Health Department in honor of its former colleague. Since Poskanzer’s death in 2010, the fund has continued to grow through donations made in his memory. The Poskanzer Lecture allows the Health Department to bring national leaders in public and community health to campus to meet with students and faculty and to deliver a public lecture on a current public health issue.