Community-Based Study for the Analysis of Cortisol in Hair (CoACH)


  • To investigate the feasibility of obtaining hair samples for analysis of cortisol in hair of clients of community-based barbershops and beauty salons and to evaluate associations of hair cortisol concentrations with socio-demographic, lifestyle, and psychosocial factors.


The impact of chronic stress on health is widely recognized. Chronic stress has been associated with various adverse health conditions including cardio-metabolic and psychiatric disorders. However, chronic stress is difficult to objectively measure. Cortisol, a steroid hormone released via the hypothalamic-pituitary-adrenal axis in response to stress, is the predominant biological marker of stress. Cortisol is present in saliva, urine and blood, but inferences obtained from these matrices are limited as they only provide indications of cortisol released in the last day or two. Moreover, cortisol concentrations obtained from these specimens are highly variable and acutely influenced by factors such as smoking and food consumption. To obtain better measurements of chronic cortisol release, investigators often have to take repeated measurements over 24 hours and/or over several days. Within the last ten years, investigators have detected cortisol in human hair. Hair shows promise of overcoming some of the limitations of saliva, urine and blood since hair grows over days, weeks, months and years, and thus can be used to retrospectively or prospectively measure cortisol concentrations over an extended period of time. Hair also requires fewer measurements, can be easily stored at room temperature, and is less invasive than blood measurements.

Study Design and Setting

A cross-sectional study conducted at Boston-area barbershops and hair salons. Using an interviewer-administered questionnaire, participants were asked about their socio-demographic, lifestyle and psychosocial characteristics. Hair samples were then collected from the posterior vertex region of the head.

Study Team

Dr. Michelle Williams, Principal Investigator
Dr. Bizu Gelaye, Co-Investigator
Ms. Adaeze Wosu, Study Coordinator