Books,  Reviews

Under the Skin

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

by Linda Villarosa
Published by: Doubleday Books
Publish Date: June 14, 2022
Genre(s): Non-Fiction, Racism, Medical History
HB&W Rating: 4
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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.

Synopsis source: Goodreads


I have long understood that something about being Black has led to the documented poor health of Black Americans….The something is racism.

I received an eARC of this title in exchange for my honest review. Thank you to NetGalley and Doubleday Books for this opportunity.

One of the first books I reviewed here on the blog was The Immortal Life of Henrietta Lacks, a book that went on to be made into a movie by Oprah and that opened the eyes to some of the injustices of the medical world against Black people. While that book did a lot to acknowledge past sins, I fear it was all too easy for white people reading it contemporarily to dismiss it as an unfortunate bit of history and think that it’s all different now and these things are no longer a problem.

Even today the centuries-old fallacies of Black immunity to pain and weakened lung function still show up. At the same time, scientists and doctors ignore or downplay the social and environmental conditions that mar Black lives and communities, and overlook the dark history of racial prejudice based on the assumption of inherent Black inferiority.

Thankfully, Linda Villarosa wrote this book, which links present day beliefs that are carried over from the days of slavery and belief of Black inferiority which allowed whites to justify the enslavement and the cruel treatment thereunder. With eye-opening clarity, Villarosa takes us on a journey of racism and its influence in modern day medicine with heartbreaking stories of people this country has long-mistreated simply because of the color of their skin.

Villarosa cites study after study and uses her own experience as a journalist to investigate why one of the world’s richest countries has the world’s highest maternal and infant mortality rates. While she focuses mostly on this particular area of research, she also touches on other areas, including AIDs and Covid-19. Rich or poor, educated or not, young or old across the board, “African Americans ‘live sicker and die quicker'” when compared to their white counterparts in those same categories. The question in my mind is whether institutions as well as individuals will look at this proof and dismiss it out of hand, or whether they might take a step back and examine things again from a different perspective. After all, “denial of racial bias can be so extreme that no one believes you even when you have the evidence.”

With case studies that break your heart and put a fire in your belly, this book addresses not just the implicit racism in the medical field with its outdated beliefs and blatant disrespect, but how the constant stress of battling racism medically and measurably affects the health of Black people in America. Evocative, eye-opening, and stirring, this is a must-read.

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