Sunday, August 28, 2011

Surgeon General Calls for Health Over Hair

The United States surgeon general has a new message for American women: It is O.K. to have a bad hair day.


As the country’s leading spokespeople on public health, surgeons general often weigh in on issues of national importance like tobacco and disease prevention. But when the current surgeon general, Dr. Regina M. Benjamin, visited a trade show in Atlanta this month, it was to talk about what has become something of a pet cause: Too many women forgoing exercise because they’re worried it will ruin their hair.

“Oftentimes you get women saying, ‘I can’t exercise today because I don’t want to sweat my hair back or get my hair wet,’ ” she said in an interview. “When you’re starting to exercise, you look for reasons not to, and sometimes the hair is one of those reasons.”

The problem, Dr. Benjamin said, is that many women — particularly black women, like herself — invest considerable amounts of time and money in chemical relaxers and other treatments that transform naturally tight curls into silky, straight locks. Moisture and motion can quickly undo those efforts, with the result that many women end up avoiding physical activity altogether.

The trade show where she spoke, the Bronner Bros. International Hair Show, draws 60,000 hairstylists, including those who specialize in the styling needs of black women.

“I hate to use the word ‘excuse,’ but that’s one of them,” said Dr. Benjamin, the founder of a rural health clinic in Bayou La Batre, Ala., on the Gulf Coast. “We want to encourage people, and also give women the ability to look good and feel good and to be empowered about their own health.”

As the titular head of the Public Health Service, the surgeon general holds a largely ceremonial post, but it is not without its outspoken leaders and controversies. Dr. C. Everett Koop helped shift the debate over AIDS in the 1980s to respect for infected patients. A decade later Dr. Joycelyn Elders came under fire for broaching the topic of teaching about masturbation.

Today, some question Dr. Benjamin’s focus on such a “niche” issue.

“The role of the surgeon general is traditionally, and appropriately, to take on big issues,” said Jeff Stier, a senior fellow at the National Center for Public Policy Research, a conservative think tank. “I don’t know whether the surgeon general’s role is to engage in smaller issues like this. It strikes me as bizarre.”

Medical experts also note that grooming is only one of the many obstacles that can stand in the way of the treadmill. Juggling the demands of family, children and work — issues that transcend race — can make an hour of cardio seem like a luxury, and by the end of the day, “many women are just plain exhausted,” said Dr. Pamela Peeke, an assistant professor of medicine at the University of Maryland and a spokeswoman for the American College of Sports Medicine. “I hear it from my patients all the time.”

But Dr. Benjamin and other researchers say that removing any barrier to physical activity is crucial to the health of American women, and in particular black women, a group that has a higher rate of obesity than any other demographic. According to government figures, nearly 50 percent of black women over age 20 are overweight or obese, compared with 33 percent of white women and 43 percent of Hispanic women.

When researchers at Wake Forest Baptist Medical Center in North Carolina sampled 103 black women from the area, they found that about a third exercised less because they were concerned it would jeopardize their hair. Of those women, 88 percent did not meet the Centers for Disease Control and Prevention guidelines for physical activity, which is 150 minutes of moderate intensity exercise each week, or about 20 minutes a day.

Dr. Amy McMichael, a professor of dermatology who led the study, said she had noticed over the years that some of her overweight patients would mention their hair when explaining why the gym was off-limits.

“Being an African-American woman myself,” she said, “I have to go through those same trials and tribulations when I exercise, so I started to realize that this is probably a barrier for many women.”

Dr. Benjamin, whose mother was a hairstylist, has visited the Bronner Bros. show two years in a row. She notes that studies have shown that black men and women are more likely to see a doctor and pay attention to their health when prodded by their barbers and hairdressers and that they see hairstylists as health ambassadors of sorts.

“When they have that customer in their chair they build up a rapport with them, they build up a trust,” she said. “We want them talking about health issues.”

Since being confirmed as surgeon general, Dr. Benjamin has begun new fitness initiatives, released a report on tobacco smoke and unveiled a new icon to replace the food pyramid. But it is her unusual stance on hair and health that is likely to garner the most attention.

“It’s not just African-American women,” she said. ” I’ve talked to a number of people, and I saw it with my older white patients too. They would say, ‘I get my hair done every week and I don’t want to mess up my hair.’”

Dr. Rebecca Alleyne, a breast cancer surgeon in Los Angeles, said she ran, cycled or swam six days a week until a year and a half ago, when she stopped wearing hair extensions, which required little maintenance, and began pressing her hair.

“I noticed I would stop for two or three days when I got it pressed,” she said. “The barrier for me was the $60 and two-and-a-half-hour investment in a hair salon that kept me wanting to preserve my hairstyle.”

Within six weeks, she said, she had gained five pounds. She eventually switched to wearing her hair naturally.

Jackie Gordon, 47, an executive secretary at a predominantly white law firm in Columbus, Ohio, started straightening her hair as a teenager. Her company allows longer breaks to those who visit the building gym, but Ms. Gordon does not join her colleagues for their lunchtime spin classes.

“It’s just too much of an effort to take care of my hair afterward,” she said. “When I tell them, I see the underlying look: ‘You’re just making excuses, you’re lazy,’” she said.

“I have to blow-dry my hair and then curl it. At a minimum that’s another good hour,” she said. “Other women at the office can wash and let their hair dry naturally. If I do that without a relaxer in my hair, it will look like an Afro.”

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