NEW YORK Turning his head from side to side as he checks his reflection in the barbershop mirror, Terrell Mack seems pretty pleased with his haircut -- a tight, neat crop -- but he can't get up from the chair just yet.
The hair-dusted cape is swept away with the usual toreador flourish.
Mack's sleeve is pushed up and the cuff of an electronic blood pressure machine is tightened around his right arm. It rapidly inflates, as do the numbers on the machine's digital read-out screen.
"One-twenty-six over 80," Dennis Mitchell, Mack's barber, announces, although his 19-year-old client is briefly uncertain what to make of the reading.
"That's pretty good," Mitchell explains. Smiles all around.
The news makes perfect sense to Mack: "I don't really eat fast food," he says, to Mitchell's approval.
The machines arrived at the Denny Moe's Superstar Barbershop in New York's historic African-American neighborhood of Harlem in May, making it only one of the latest examples of barbers and beauty salons in predominantly black or immigrant neighborhoods doubling up as dispensaries of informal health advice alongside more usual perms and trims.
Across the country, healthcare workers are trying to harness the unique status of the barber and the unusually intimate rapport he can develop with his regular clients. A man may be barely on nodding terms with the guy who runs his laundromat, and yet confess every hope, fear and peccadillo once he's seated in the barber's chair.
"If someone is six inches from your ear and they have seen you at your worst and your best, then who better to give a health message?" Ruth Browne, the chief executive officer of the Brooklyn-based Arthur Ashe Institute for Urban Health, said in an interview.
Although not involved in the Denny Moe's program, the Arthur Ashe Institute is one of several organizations that believe barbershops and beauty salons may be one of the best ways to reach communities where economic, cultural and linguistic barriers impede access to primary health care.
Studies have found that men with hypertension were more likely to seek treatment and bring their blood pressure under control if they regularly saw a barber who took their blood pressure rather than one who didn't.
Browne said the Ashe Institute has worked with more than 300 barbershops and beauty salons in New York City since the mid-90s, and recently carried out similar projects at 20 establishments in mostly black or Latino neighborhoods in Philadelphia, helping clients get cancer screenings and advice on asthma, diabetes and other diseases.
Joseph Ravenell, an assistant professor of medicine at New York University and a physician who has focused on black men's health issues, said that hypertension - often associated with a high-sodium diet and insufficient exercise - and colon cancer are the two biggest killers of black men.
"Black men unfortunately are overrepresented in professions that are less likely to be insured," he said. "There's also a history of a distrust of the healthcare system which we think keeps some black men from visiting the doctor. We try to overcome that barrier by going to the settings where black men are more comfortable."
He is concerned about his customer's health to the point of evangelism. Even before the blood pressure machines arrived as part of the American Society of Hypertension's community outreach project, he frequently organized charitable hair-cutting marathons to raise money for health causes.
Mitchell, 45, whose nickname is Denny Moe, talks freely about his own health issues, including a diagnosis of type 2 diabetes in 2010 when he weighed 285 pounds that galvanized him to shed 45 pounds. The transformation was not lost on his customers.
"I've got plenty of clients saying, 'Denny, you've been an inspiration to me.' I've got letters," Mitchell said.
He does not mince his message: "I tell people, 'When you're fat, you're sick.' Point blank. No sugar coating."
It seems to work. Client after client is offered a blood pressure test, and few refuse. If the reading is on the high side, Mitchell offers to put the customer in touch with Ravenell.
Above Mitchell's chair is a sign that informs customers they won't have to pay for their cut if he forgets to ask them if they want a blood pressure test.
"I never gave a free haircut yet," he said.