Book Review

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

by Linda Villarosa. Doubleday: 2022. 288 pages. $30.00, hardcover.

From an award-winning writer at the New York Times Magazine and a contributor to the newspaper's 1619 Project*, this book discusses the extent of racial health disparities in the U.S., showing the toll racism takes on individuals and the nation's health. It is a New York Times Top 10 Book of the Year. Oprah Daily calls it: "A stunning exposé of why Black people in our society 'live sicker and die quicker'—an eye-opening game changer."

Linda Villarosa's 2018 New York Times Magazine article on the poor maternal and infant mortality of black mothers and babies was important because it showed 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. Many studies had previously linked racial discrimination and  Black Americans' health, but this one revealed the extent of the problem. 

This book examines the forces in the American health-care system and in society that cause Black people to “live sicker and die quicker” compared to whites. For example, many of today's medical texts and instruments still assume that Black bodies are basically different from white bodies. 

This book personalizes and adds to the many studies that have documented that there is worse medical treatment and outcomes for Black patients. Because of housing discrimination and income, Blacks live in dirtier, more polluted communities - and contribute to the problems that need solution. 

* The 1619 Project is "an ongoing initiative from the New York Times Magazine that began in August 2019, the 400th anniversary of the beginning of American slavery. It aims to reframe the country’s history by placing the consequences of slavery and the contributions of black Americans at the very center of our national narrative."