Under the Skin: The Hidden Toll of Racism on American Lives and on the Health of Our Nation

 

by Linda Villarosa, 2022, 269 pages, hardback, e-book, and audiobook.

In this powerful, carefully researched book, journalist Linda Villarosa builds on her 2018 articles on mortality among Black mothers and infants to describe the significant health challenges faced by Black American simply because they are Black. She effectively combines articles from medical journals with personal accounts to paint  a convincing picture of how Black Americans “live sicker and die quicker” than their white counterparts, no matter their income or education.

She outlines three different reasons for the much poorer health outcomes among Black people:

·       Bias in the health care system leading to different treatment of Black and White patients

·       Environmental injustice which disproportionately exposes Black communities to pollution from highways, toxic waste dumps, and lead pipes and so on

·       “Weathering”—the chronic stress resulting from constantly coping with racism that can result in premature aging and poor health outcomes. 

She also asks the important question: “What if Black people are simply the canaries in the coal mine?” Does sustained discrimination cause harm to anyone, no matter their race? To help answer this question, she visits West Virginia, one of the whitest (93% white) and poorest states, with the lowest life expectancy in the nation.  She found that West Virginia is plagued by some of the same diseases that shorten the lives of Black Americans with poor physical and mental health.

Villarosa documents unending examples of social racism, inbred bias, and general neglect, but somehow remains hopeful for change, introducing individuals and programs that are making positive differences. Her compelling account clearly reveals that the American medical system must be reformed. A convincing must-read.