PULITZER PRIZE FINALIST • "A stunning exposé of why Black people in our society 'live sicker and die quicker'—an eye-opening game changer."—Oprah Daily
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.
APPLE BOOKS REVIEW
Find out how racism weakens the body as well as the soul. Journalist Linda Villarosa’s shocking and enlightening expose presents a powerful study of how race impacts health—and health care—in America. Villarosa has been writing about health issues in the Black community since the 1980s, and she explores why people of color “live sicker and die quicker.” She presents hard evidence on harmful medical misinformation that has circulated for centuries, how bigoted housing practices put Black families in toxic environments, and why the stress of racism can shave years off an individual’s life. Villarosa’s reporting mixes facts with personal stories of real people struggling with the practical consequences of racism. Under the Skin will make you think about institutional racism in a whole new way.
Journalist Villarosa (Body & Soul) takes a stunning look at the racial disparities in health outcomes for Black and white Americans. Contending that these health disparities, which persist across different levels of income and education, demonstrate "the impact of insidious discrimination associated with the lived experience of being Black in America," Villarosa cites evidence that white physicians prescribe lower levels of pain medication to Black patients, that infant and maternal mortality rates are higher among African Americans, that Black communities bear greater costs of environmental pollution and climate change than white communities, and that "toxic stress" associated with racism prematurely age Black Americans' immune systems. According to Villarosa, these ill effects are not only caused by encounters with racist individuals, but also by a social structure that deprioritizes African Americans' needs and ability to access resources that more privileged people take for granted. Skillfully interweaving historical and medical facts with empathetic profiles of people who have been affected by HIV/AIDS, Covid-19, and other health crises enabled by structural racism, Villarosa delivers a passionate call for equality in the American medical system. The result is an urgent and utterly convincing must-read.