“UNDER THE SKIN: THE HIDDEN TOLL OF RACISM ON AMERICAN LIVES AND ON THE HEALTH OF OUR NATION”

When the Supreme Court overturned it’s 1973 landmark decision Roe v. Wade, thus removing a federally protected right to an abortion and returning the issue to state legislatures, many Americans felt it was an assault on health care.  While any person of childbearing age will likely feel the impact of this decision, some heath care experts are warning that it will also further the disparities and negative outcomes that already exist in America along racial lines.  One such expert, Linda Villarosa, a contributing writer for The New York Times Magazine and former public health editor at Essence Magazine, lays out the case how and why racism is in fact a public health risk in her book “Under the Skin: The Hidden Toll of Racism on American Lives and on The Health of Our Nation.

Aired on August 4, 2022

 

TRANSCRIPT

> WHEN THE SUPREME COURT OVERTURNED IT 1973 LANDMARK DECISION ROE VS. WADE, THUS REMOVING A FEDERALLY PROTECTED RIGHT TO AN ABORTION AND RETURNING THE ISSUE TO STATE LEGISLATURES, MANY AMERICANS FELT IT WAS AN ASSAULT ON HEALTH CARE.

WHILE ANY PERSON OF CHILD BEARING AGE WILL FEEL THIS DECISION, SOME HEALTH-CARE EXPERTS ARE WARNING IT WILL FURTHER THE DISPARITIES THAT ALREADY EXIST IN AMERICA ALONG RACE LINES.

FORMER ESSENCE MAGAZINE EDITOR LAYS OUT THE CASE FOR HOW AND WHY RACISM IS A PUBLIC HEALTH RISK IN HER NEW BOOK 'UNDER THE SKIN, THE HIDDEN TOLL OF RACISM ON AMERICAN LIVES AND ON THE HEALTH OF OUR NATION', AND SHE JOINS US NOW.

LINDA, WELCOME TO 'METROFOCUS.'

THANK YOU.

GOOD TO BE HERE.

I JUST WANT TO STARLET OFF SAYING YOU HAVE BEEN SOUNDING THIS ALARM FOR QUITE SOME TIME.

IN 2018 YOU WROTE AN ARTICLE FOR THE 'TIMES,' WHY AMERICA'S BLACK MOTHERS AND BABIES ARE IN A LIFE OR DEATH CRISIS.

SO, CAN YOU JUST EXPLAIN FOR THE VIEWERS, WHAT IS THE UNIQUE CRISIS THAT'S FACING BLACK MATERNAL HEALTH?

FIRST, IT'S A CRISIS FACING AMERICA SOME WE ARE THE ONLY WEALTHY COUNTRY WHERE THE NUMBER OF WOMEN WHO DIE OR ALMOST DIE RELATED TO PREGNANCY AND CHILDBIRTH CONTINUES TO RISE.

THE ONLY WEALTHY NATION.

BLACK WOMEN ARE THREE TO FOUR TIMES MORE LIKELY TO FACE THE CRISIS OF DEATH OR NEAR DEATH ON WHAT SHOULD BE THE BEST TIME OF THEIR LYES, AND EDUCATION DOESN'T PROTECT US.

IN OTHER WORDS, EVEN IF YOU'RE AN ELK KATED BLACK WOMAN WITH A MASTERS DEGREE OR MORE, YOU'RE STILL MORE LIKELY TO DIE OR ALMOST DIE THAN A WHITE WOMAN WITH AN EIGHTH GRADE EDUCATION.

SO CLEARLY THIS IS A CRISIS.

AND WHAT I TRY TO LAY OUT IS AMERICA'S BLACK MOTHERS AND BABIES WITH A FOCUS ON AMERICA, BECAUSE THIS IS A CRISIS THAT AFFECTS ALL OF US.

WELL, WHAT IS AT THE ROOT OF THIS CRISIS, THEN?

I FEEL SO MANY PEOPLE MIGHT WONDER, HOW IS IT THAT WE GOT TO THIS PLACE?

I THINK THAT THE KNEE JERK REACTION IS IS IT'S SOMETHING WRONG WITH WOMEN'S BODIES OR WE'RE DOING SOMETHING WRONG CULTURALLY OR EDUCATIONALLY.

I THINK WE PRETTY MUCH -- THAT'S BEEN DISPROVEN.

AND WHAT I LAY OUT IN MY BOOK AND IN THAT ARTICLE IS THREEFOLD.

ONE IS THAT THERE'S THE EXPERIENCE OF RACISM AND DISCRIMINATION AND BIAS IN THE HEALTH-CARE SYSTEM ITSELF, WHICH HAS BEEN WELL DOCUMENTED FOR DECADES.

THE SECOND IS SOMETHING ABOUT THE LIVED EXPERIENCE OF BEING BLACK AND A WOMAN, A BIRTHING PERSON IN AMERICA, IS BAD FOR THE BODY AND THE BABY.

I DID NOT COME UP WITH THAT.

I'M A JOURNALIST, BUT THERE ARE SCIENTISTS WHO HAVE SAID THOSE WORDS VERBATIM.

FINALLY THERE'S SOMETHING ABOUT OUR COMMUNITIES THAT ARE LESS HEALTHFUL.

BLACK COMMUNITIES AND OTHER COMMUNITIES OF COLOR ARE SUBJECT TO MORE POLLUTION.

AIR AND WATER POLLUTION.

LESS GOOD HEALTH-CARE FACILITIES.

IT'S HARDER TO ACCESS HEALTHY FOOD.

IT'S SOMETIMES UNSAFE.

THE HOUSING ISN'T SAFE, THE EDUCATIONAL SYSTEM.

SO THOSE THREE THINGS ARE REALLY WHAT IS AT THE HEART OF THIS, NOT SOMETHING THAT WE ARE DOING WRONG OR SOMETHING WRONG WITH US.

I WAS WONDERING IF YOU COULD UNPACK FURTHER THE HEALTH DISPARITIES AND THE EXPERIENCE OF BLOCK MOTHERS AND BABIES.

AND I ASK THAT QUESTION BECAUSE, AS PEOPLE WERE REVIEWING YOUR BOOK, A LOT OF PEOPLE DIRECTLY TIED OUR CURRENT MATERNAL -- THE WAY THAT AMERICA VIEWS MATERNAL HEALTH THE OUR PAST AND SLAVERY.

I THINK THAT IS FAIR, AND I WAS PART OF THE 1619 PROJECT, WHICH WENT BACK IN TIME TO LOOK AT -- BECAUSE THERE'S NEVER BEEN A TIME IN AMERICA WHERE BLACK PEOPLE AND WHITE PEOPLE HAVE HAD EQUAL HEALTH OUTCOMES.

SO IT'S ALWAYS BEEN A PROBLEM.

AND IF YOU LOOK BACK AT WHAT WAS HAPPENING FOR US DURING ENSLAVEMENT, ESPECIALLY WITH REPRODUCTION DID, AND SOMEONE SAID IT TO ME RECENTLY.

IT WAS LIKE WORK DEALT WITH FORCED LABOR S, AND A DOUBLE MEANING.

ONE IS WE WERE FORCED TO WORK, RAISE THE ECONOMY, RAISE THE FORTUNES OF THE SOUTH AND CEMENT THEM BY PROVIDING FREE LABOR, BUT WE ALSO CREATED MORE FREE LABOR BY BEING FORCED TO REPRODUCE.

SO, IF WE HAVE HAD INJUSTICE IN REPRODUCTION FOR 400 YEARS, IT'S NOT SURPRISING THAT NOW THAT ROE VS. WADE HAS FALLEN THAT WE WOULD BE HIT HARDEST AND LONGEST.

AND SO WHEN YOU ALSO TALK ABOUT BLACK -- BIRTHING PEOPLE OF BEING HIT HARD INTEREST LONGEST, I WAS ALSO WONDERING IF YOU COULD EXPAND ON A CONCEPT I CALLED WEATHERING, WHICH I FOUND TO BE VERY INTERESTING AND SOMETHING THAT I DON'T THINK GETS ADDRESSED ENOUGH WHEN TALK ABOUT HOW RACISM AFFECTS THE BODY.

WEATHERING IS A VERY INTERESTING CONCEPT, COINED BY ARLENE JERONIMUS.

IT'S THE IDEA THAT SOMETHING ABOUT HAVING TO, SORT OF, HARD COPING AGAINST DAILY DISCRIMINATION AND HARD CORE DISCRIMINATION WEATHERS THE BODY.

IN OTHER WORDS, EVERY TIME YOU HAVE TO DEAL WITH SOME KIND OF STRESS, BUT EXTREME STRESS ESPECIALLY, THE SYSTEMS OF THE BODY KICK INTO GEAR.

SO YOUR HEART RATE GOES UP, YOUR BLOOD PRESSURE, YOUR STRESS HORMONE LEVELS.

AND CERTAINLY THIS IS A SURVIVAL MECHANISM, BUT IT ONLY TURNS DANGEROUS WHEN IT HAPPENS OVER AND OVER AGAIN, AND WHAT SHE FOUND IS IT RAISES SOMETHING CALLED THE ALISTATIC LOAD, AND THAT MEANS YOUR BODY IS WORKING OVERTIME.

IF THAT HAPPENS OVER AND OVER AGAIN, WHICH IS WHAT HAPPENS TO PEOPLE WHO ARE DISCRIMINATED AGAINST, WHICH HAS HAPPENED LONGEST AND WORSE FOR BLACK PEOPLE, IT CAUSES THE BODY TO PREMATURELY AGE, AND THAT IS CALLED WEATHERING, THE SAME WAY A HOUSE WOULD WEATHER A STORM.

IT KNOCKS THE PAINT OFF, PUTS THE SHINGLES -- MAKES THE SHINGLES FLY OFF, THE WINDOWS BREAK, BUT SHE ALSO -- SHE'S A VERY POETIC SCIENTIST, AND SHE ALSO NOTED THAT BLACK PEOPLE AND OTHER PEOPLE OF COLOR ALSO WE THINKER THE STORM.

WE HAVE COMMUNITY, KINSHIP, NEIGHBORHOOD COHESION, WE HAVE LOVE.

AND I REALLY LIKE THAT CONCEPT, WHICH IS -- YOU KNOW, I'M SAYING CONCEPT, BUT IT'S VERY WELL PROVEN, AND SHE AND OTHERS HAVE BEEN TALKING ABOUT IT FOR DECADES.

BUT IT CAUGHT ON MORE RECENTLY BECAUSE OF COVID.

AND YOU SAW RIGHT AWAY THAT PEOPLE WHO WERE OLDER HAD WORSE HEALTH OUTCOMES.

BUT THEN ALSO PEOPLE -- BLACK PEOPLE HAD WORSE HEALTH OUTCOMES AT YOUNGER AGES, AND YOU KNOW, IT WAS DIFFERENT.

IT WAS LIKE A TEN-YEAR AGE DIFFERENCE IN WORST HEALTH OUTCOME, AND EVERYONE INSTANTLY WENT TO THE DOCTOR AND SAID, OH, YOUR WEATHERING HYPOTHESIS EXPLAINS THE DISPARITY.

NOW TO BACK UP TO A SORT OF HIGHER VIEW, HOW DOES THIS CONSTANT EFFECT OF WEATHERING, BROUGHT ON MY CHRONIC AND PERSISTENT RACISM IN THE COUNTRY, HOW IS THIS AFFECTING ALL OF AMERICA?

HOW IS IT COSTING EVERYONE?

WELL, AMERICA HAS THE WEALTHIEST -- WE'RE VERY WEALTHY, AMONG THE WEALTHIEST NATIONS.

WE ALSO HAVE THE BEST HEALTH CARE.

IT'S HIGH TECH.

WE SPEND THE MOST OF ANY COUNTRY IN THE WORLD ON HEALTH CARE.

YET OUR HEALTH-CARE STATUS COUNTRY ISN'T GREAT.

SO IN OTHER WORDS WE HAVE EXTREMELY HIGH LEVEL OF INFANT MORTALITY COMPARED TO OTHER COUNTRIES, THOUGH WE SPEND MORE.

THEN AT THE OTHER END OF THE SPECTRUM, WE HAVE A LOW LIFE EXPECT EXPECTANCY COMPARE ODD OTHER COUNTRIES AND OTHER DISPARITIES IN BETWEEN.

WHY WOULD THE RICH COUNTRY WITH THE BEST HEALTH CARE -- WE SPEND SO MUCH ON HEALTH CARE, HAVE WORSE HEALTH OUTCOMES?

YOU LOOK AT THE INEQUALITY IN THE SYSTEM, THE EXPERIENCE OF BLACK PEOPLE ACROSS CLASS LINES, AND THEN IT KIND OF MAKES SENSE.

IT'S A TERRIBLE MAKING SENSE.

BUT IT DOES AFFECT ALL OF US, BECAUSE IT'S NOT JUST THE BLACK HEALTH STATUS.

IT'S THE HEALTH STATUS FOR THE COUNTRY AS A WHOLE.

YOU MENTIONED EARLIER THAT THE HEALTH OUTCOMES OF A WELL EDUCATED, PERHAPS, HIGH EARNING BLACK PERSON COULD ACTUALLY OR AT LEAST EXPECT A PARENT COULD BE WORSE THAN A WHITE PERSON WHO IS LESS EDUCATED AND EARNING LESS MONEY.

I WONDER, WHAT ROLE DOES THE MEDICAL COMMUNITY PLAY IN THIS, AND HOW CAN IT BEGIN TO ADDRESS?

BECAUSE IF WE SPEND SO MUCH MONEY ON HEALTH CARE, IS NOT ACKNOWLEDGING OR ADDRESS TEACHING OUR HEALTH CARE PROFESSIONALS ABOUT THE PHYSICAL EFFECT OF RACISM PART OF THAT?

I HAVE BEEN THINKING A LOT ABOUT THIS BECAUSE I TALKED TO A LOT OF MEDICAL STUDENT GROUPS AND PHYSICIANS, AND I WANT TO MAKE CLEAR I DON'T THINK THIS IS A PROBLEM OF INDIVIDUAL DOCTORS WHO GO INTO MEDICINE BECAUSE THEY'RE TRYING TO DO HARM TO PEOPLE.

BUT IT'S SYSTEMIC.

AND I GOT A NOTE FROM A FRIEND OF MINE, AND SHE WAS TALKING AT THIS TERRIBLE THING THAT HAPPENED TO HER WHEN SHE WAS PREGNANT.

AND I SAID, DID I HAPPEN BY A DOCTOR?

SHE SAID, NO, IT WAS AN EMS PERSON -- THIS WOMAN IS SO SOPHISTICATED, AND SHE WAS ACCUSED OF DRUG SEEKING.

THE FIRST THING THEY ASK IS, WHAT DRUGS ARE YOU ON?

WHEN SHE WAS HAVING A SEVERE MISCARRIAGE.

THAT KIND OF THING, I HEAR IT EVERY DAY FROM BLACK WOMEN, AND THESE ARE IN MY FRIEND GROUP.

SO PART OF THIS -- IT'S BEEN WELL DOCUMENTED THAT BLACK PEOPLE AND OTHER PEOPLE OF COLOR HAVE A WORSE TIME IN THE MEDICAL SYSTEM, AND IT'S NOT JUST ANECDOTAL.

WHAT I LOOK AT IS A 2002 REPORT OF 480 OTHER STUDIES THAT TALKED ABOUT THIS DISCRIMINATION THAT BLACK PEOPLE EXPERIENCE MORE OFTEN IN THE HEALTH-CARE SYSTEM AND THERE WAS ONE STUDY I REMEMBER THAT REALLY HIT ME, AND IT WAS ABOUT AMPUTATION.

IT LOOKED AT PEOPLE WHO HAD DIABETES, AND EVERYTHING WAS LEVEL AT THE SEVERITY OF THE DIABETES.

IT LOOKED AT THEIR HEALTH INSURANCE.

EVERYTHING WAS LEVEL.

IT LOOKED AT BLACK PATIENTS AND WHITE PATIENTS.

BLACK PATIENT WERE MORE LIKELY, EVEN WHEN OTHER THINGS WERE EQUAL, TO HAVE A LEG AMPUTATED.

SO I DON'T THINK INDIVIDUAL EVIL DOCTORS OR HEALTH-CARE PROVIDERS ARE GOING IN TO DO HARM, BUT SOMEBODY IS MAKING A DECISION BASED ON, PERHAPS AND PROBABLY, IMPLICIT BIAS TO CUT OFF SOMEONE'S LEG MORE OFTEN IF THEY'RE BLACK.

HOW DOES THIS COUNTRY AND ESPECIALLY THE MEDICAL INDUSTRY BEGIN TO ADDRESS THIS?

WELL, I AM A VERY GLASS HALF FULL PERSON, AND I'M SEEING CHANGES.

I AM SEEING MEDICAL STUDENTS WHO ARE POLITICIZED DURING THE HEAT OF THE BLACK LIVES MATTER MOVEMENT.

THEY WERE IN HIGH SCHOOL.

THEY WERE IN UNDERGRADUATE COLLEGE, AND NOW THEY'RE IN MEDICAL SCHOOL.

THEY'RE SAYING, WAIT A MINUTE, WE DON'T WANT TO GO INTO A SYSTEM THAT IS UNFAIR.

I SEE MEDICAL SCHOOLS THEMSELVES, YOU KNOW, THE ADMINISTRATIONS SOMETIMES GRAPPLING WITH THIS.

MEDICAL SOCIETY.

CERTAINLY GROUPS OF NURSES AND MID WIVES GLARAPPLING WITH THISO TRY TO DO BETTER.

I REALLY APPRECIATE THAT.

I APPRECIATE THERE'S AN ENERGY AND WILLINGNESS TO APPRECIATE THIS PROBLEM AND NOT SHY AWAY FROM IT, BECAUSE IT REALLY IS HARMING PEOPLE AND HARMING OUR COUNTRY AS A WHOLE.

ALL RIGHT, WELL, I'D LIKE TO THANK OUR GUEST, AGAIN, A 'THE NEW YORK TIMES' MAGAZINE CONTRIBUTING WRITER AND FORMER ESSENCE MAG SEEN EXECUTIVE EDITOR AUTHOR OF 'UNDER THE SKIN, THE HIDDEN TOLL OF RACISM ON OUR LIVES AND THE HEALTH OF THE NATION'. THANK YOU SO MUCH FOR JOINING US ON 'METROFOCUS.'

THANK YOU, I REALLY APPRECIATE YOU AND ALL THAT YOU DO.

©2022 WNET. All Rights Reserved. 825 Eighth Avenue, New York, NY 10019

WNET is a 501(c)(3) nonprofit organization. Tax ID: 26-2810489