Under the Skin

Under the Skin: The Hidden Toll of Racism on Health in America
By Linda Villarosa

“under the skin: the hidden toll of racism on health in america” by linda villarosa

There is too much to say about the state of healthcare in the U.S. The killing of a healthcare CEO catalyzed a spontaneous and near universal expression of outrage, not at the killer nor the crime, but at the ongoing crimes committed by the healthcare system itself, symbolized by one CEO. Under the Skin explores the specific way that healthcare commits crimes against Black people and Black women specifically. Villarosa has a journalist's ear for putting the stark facts into specific narratives. This makes the overall point of the book more challenging to digest, not less so. Statistics are one thing but when we are talking about healthcare statistics are nefarious and are used to obfuscate harm as much as they are used to insure quality of care. Most education for allied healthcare providers is severely lacking in any content related to racial disparities in health outcomes let alone the actual care we are supposed to be providing. Villarossa does a deft job at highlighting the interconnectedness of the biopsychosocial factors at play in poor health outcomes for Black Americans. 

When I was entering graduate school for Chinese medicine we were asked to read The Spirit Catches You and You Fall Down in the interest of establishing some shared conversation about the cultural parameters of healthcare and healthcare education. The authors came and spoke to us. It was all very interesting (and it’s a fantastic book) but nothing else was done with the subject over the course of my 5 years in school and my subsequent 9 years teaching at the same school. I found the faculty and administration to be largely discurious about these issues and often skirted any substantive conversation about including this topic in the curriculum or providing faculty the necessary training to understand and teach to these issues. 

I know most of my colleagues to be quite the opposite and decidedly curious and wanting to learn more and do better. This book provides an excellent background perspective on the critical conversation of healthcare disparities.

-Michael McMahon