In Barbershop Clinics, a Cleveland Doctor is Diagnosing Arterial Disease in Black People Who Don't Seek Routine Health Screenings

“If y’all out in the community, that might show somebody they shouldn’t be afraid to get themselves checked out"

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click to enlarge In Barbershop Clinics, a Cleveland Doctor is Diagnosing Arterial Disease in Black People Who Don't Seek Routine Health Screenings
Hannah Manocchio

Most people have never heard of the disease which affects more Americans than breast and colon cancer combined.

In Cleveland, Dr. Khendi White-Solaru has worked hard in a non-traditional way to educate those people most at risk for this disease, called peripheral arterial disease (PAD), by setting up makeshift clinics in local barbershops.

It was in one of those that she met Darron, a 60-year-old guy always hanging out in the shop. He agreed to meet with Dr. White-Solaru and she quickly diagnosed him with PAD. Darron was shocked. He had never heard of this disease and wondered why his doctor that he sees yearly never checked for it. Once Darron learned more, he had good reason to change some of his habits.

Dr. Khendi White-Solaru is a cardiologist, but she chooses to focus much of her research on the arteries outside of the heart. Coronary artery disease, colloquially called heart disease, overshadows PAD despite their similarities in that they both involve clogging of arteries.

The three arteries that feed the heart are named after the Latin word for ‘crown,’ for the shape they take on the the heart. Any other vessels affected by plaque fall under the category of PAD. PAD commonly affects arteries in the legs, neck, and abdomen. As a plaque enlarges, less blood flows to its destination, whether it be the brain, heart muscle or other body parts like the calves. This can cause symptoms like cramping in the legs or be silent, part of the reason Dr. White-Solaru thinks it goes unrecognized.

While in medical school, Dr. White-Solaru read an article that blew her mind. A doctor went into a barbershop to check the customers for high blood pressure. Many Black Americans have had bad experiences with the medical field, and so going to where people are comfortable, like a barbershop,  made sense to Dr. White-Solaru.

Years later, Dr. White-Solaru, in her pursuit for equitable medical care, reached out to the author of the article to ask for help implementing her own study in Cleveland that would seek to educate Black males on PAD. Did they know that PAD was more common in them than in their white counterparts? Did they know PAD could be deadly and even portend worse heart disease?

Her study in the barbershop was working. Dr. White-Solaru noticed the conversations happening around the shop. One participant said, “If y’all out in the community, that might show somebody else that they shouldn’t be afraid to get themselves checked out, because a lot of people don’t come to the doctor. They’re scared.”

Customers were open to being evaluated for PAD after the owner of the shop or people they knew vouched for Dr. White-Solaru. And people who talked with the ever present Darron started to think more intently about what could be lurking in their own bodies.

Darron had disease in his legs that explained the heaviness he experienced when walking. Just as in a heart attack, plaque in any artery can split open, causing a clot to quickly form with dire consequences, starving whatever is downstream of the blockage. Dr. White-Solaru put Darron on aspirin to make sure the platelets in the blood didn't initiate the clot forming a cascade and  subsequent “leg attack,” as Dr. White-Solaru puts it, which could ultimately lead to amputation. But there was still more that could be done to prevent progression of the disease.

Obesity, diabetes and blood pressure all contribute to PAD. These conditions can often be prevented by changing lifestyle. Dr. White-Solaru had participants watch educational videos explaining these relationships, including Darron, who has hypertension and diabetes. Afterwards, he felt empowered, understanding that for many Black men, the higher rates of diabetes and hypertension exacerbate a host of other health problems.

Perhaps Dr. White-Solaru’s research will inspire more healthcare to be integrated into barbershops or other gathering spaces. The current model fails to reach many people who deserve to have access to the same information about their health that others do. As for Darron, it was exactly this understanding about his body that encouraged him to eat healthier, take medicine regularly, and exercise more.

Dr. White-Solaru continues to work with these local barbershops, hoping that the power of information can be harnessed, aiding in closing the racial gaps that persist in medicine.

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