Under the Skin
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From an award-winning writer at the New York Times Magazine and a contributor to the 1619 Project comes a landmark book that tells the full story of racial health disparities in America, revealing the toll racism takes on individuals and the health of our nation. In 2018, Linda Villarosa's New York Times Magazine article on maternal and infant mortality among black mothers and babies in America caused an awakening. Hundreds of studies had previously established a link between racial discrimination and the health of Black Americans, with little progress toward solutions. But Villarosa's article exposing that a Black woman with a college education is as likely to die or nearly die in childbirth as a white woman with an eighth grade education made racial disparities in health care impossible to ignore. Now, in Under the Skin, Linda Villarosa lays bare the forces in the American health-care system and in American society that cause Black people to “live sicker and die quicker” compared to their white counterparts. Today's medical texts and instruments still carry fallacious slavery-era assumptions that Black bodies are fundamentally different from white bodies. Study after study of medical settings show worse treatment and outcomes for Black patients. Black people live in dirtier, more polluted communities due to environmental racism and neglect from all levels of government. And, most powerfully, Villarosa describes the new understanding that coping with the daily scourge of racism ages Black people prematurely. Anchored by unforgettable human stories and offering incontrovertible proof, Under the Skin is dramatic, tragic, and necessary reading.
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A fascinating read supporting claims that I have heard from TikTokers and others. Linda Villarosa provides both statistical and anecdotal evidence to support the claim that the underlying racism (and the surrounding cultural and psychological impacts) are to blame for the medical disparity between those of different races in the United States. The book is well researched and well written. This is an interesting read for anyone looking to go into any medical field and for those looking for ways to combat/recognize racism in today's world.
Quotes:
“1. You are treated with less courtesy than other people are.
2. You are treated with less respect than other people are.
3. You receive poorer service than other people at restaurants or stores.
4. People act if as if they think you are not smart.
5. People act as if they are afraid of you.
6. People act as if they think you are dishonest.
7. People act as if they're better than you are.
8. You are called names or insulted.
9. You are threatened or harassed.”
“The United States has the highest rate of infant mortality and the lowest life expectancy in comparison with other wealthy countries. An American woman is more likely to die as a result of pregnancy and childbirth than women in other countries of comparable wealth. That rate is higher now than it was in the 1990s, even though most of these deaths of mothers are avoidable.”
“in recent years I have come to understand that much of what I believed about health disparities and inequality in the United States was wrong. The something that is making Black Americans sicker is not race per se, or the lack of money, education, information, and access to health services that can be tied to being Black in America. It is also not genes or something inherently wrong or inferior about the Black body. The something is racism.”
“To put it in the plainest terms, from birth to death the impact on the bodies of Black Americans of living in communities that have been harmed by long-standing racial discrimination, of a deeply rooted and dangerous racial bias in our health-care system, and of the insidious consequences of present-day racism affects who lives and who dies.”
“These factors create physical vulnerability and systemic disadvantages that education, income, and access to health care cannot erase. This inequality, born more than four hundred years ago and embedded in every structure and institution of American society, including the health-care system, is driving our country's poor national health outcomes relative to the rest of the developed world. It has taken me three decades of reporting on the health of African Americans and several disturbing personal medical crises to understand the ways discrimination and bias contribute to poor health outcomes primarily in African Americans, but in reality in all oppressed people.”
“If you really care about these issues and want to make a difference, you must not use race as a proxy for poverty or poverty as a proxy for race. They intersect and overlap, but to really understand the health of this country, you have to be more sophisticated than assuming that only poor Blacks are affected by this crisis. Look deeper, think differently.”
