Author Highlights Racial Health Disparities in Presidential Lecture

Stony Brook University President Maurie McInnis (left) hosted author and activist Linda Villarosa at the April 25 Presidential Lecture at the Charles B. Wang Center. Photos by Isabel Epstein.

Author and activist Linda Villarosa spoke about the environment and environmental justice at Stony Brook University's Presidential Lecture, held April 25 at the Charles B. Wang Center.

Villarosa, the former executive editor of Essence magazine, is currently a contributing writer at The New York Times Magazineon topics of race, inequality, and public health. She discussed her most recent book, Under the Skin: The Hidden Toll of Racism on American Lives and on the Health of Our Nation, which details the deeply disturbing story of racial health disparities in America, revealing the toll racism takes on individuals and public health.

The event, hosted by President Maurie McInnis, was the latest Presidential Lecture in "Answering the Call: A Special Series on Climate Change."

"Persistence, intelligence, a fierce devotion to the facts - and an easy capacity for outrage," McInnis began in her introductory remarks. "These are what The Guardian recently said are the key characteristics of a great journalist and, even more specifically, the defining traits of Linda Villarosa in her expansive, incisive, and courageous career."

Villarosa quoted Dr. Martin Luther King Jr.: "Of all forms of inequality, injustice in health, is the most shocking and inhuman," citing its influence on her work.

"We are the richest country in the world," she said. "We spend more on health care than any other country. But money does not buy good health in this country. Of all the wealthy countries, we have the highest maternal and infant mortality rates, the lowest life expectancy, and when COVID came, especially at the beginning, our outcomes were much worse than other wealthy countries. How can we be spending so much on health care, but have such poor outcomes?"

The mystery, said Villarosa, is hiding in plain sight.

"Our health care system is based on capitalism, and you have to pay for it," she said. "That in itself makes it unfair."

Even if the U.S. did have universal access to health care, Villarosa said we would still see the same forms of inequality.

"Black Americans have the worst health outcomes of everyone starting at birth and carrying all the way through to the end of life," she said. "We have the highest rates of maternal mortality and infant mortality."

Villarosa noted that Black women are three to four times more likely to die or almost die in childbirth than white women, and that Black babies are two-and-a-half times more likely to die before they reach age one.

"Additionally, the life expectancy of Black people is six fewer years," Villarosa said. "It used to be 3 1/2 and was getting better, but Black folks had such bad health outcomes during COVID that the life expectancy gap increased to six years. Things would be so much better for Black people if we had better access to health care and if we solved the poverty problem."

However, Villarosa said that it's more than poverty causing the disparity, offering that in 1959, 60 percent of Black people were living under the poverty line compared to about 18 percent today. Although the poverty levels have dropped, there hasn't been a corresponding narrowing in health care outcomes, and sometimes there's even been a worsening of health outcomes.

"If this were a question of poverty, we'd see health outcomes improving," she said. "But health outcomes are not matching the improvements in wealth. There's something else going on."

Villarosa's book focuses on three factors: 1) the lived experience of being Black in America and how treatment in society is related to our poor health outcomes in Black communities; 2) segregation sanctioned by the government, banks and other entities that causes Black communities to be less healthful, and: 3) discrimination in the healthcare system itself.

She offered the idea that the lived experience of being Black itself harms the body.

"Arline Geronimus, a scholar and a professor at the University of Michigan, coined the term 'weathering,'" said Villarosa. "That refers to what happens to your body every time you're treated badly. But it happens more when you're the target of continued and repeated toxic stress. It creates a premature aging called weathering."

Villarosa described her family's experience moving from Chicago to Denver in 1968 in an effort to find a better life.

"My parents had lived in Chicago their whole lives and had had enough," she said. "They bought a house in Denver and packed up our car and moved us. My sister and I were so happy we'd be getting our own rooms."

Unfortunately, that hopeful ride came to an end when the Villarosas pulled up to her their new home only to find someone had scrawled "N-word Go Home" on the garage door.

"We found out it was the twins who lived two doors down who I ended up having to go through my whole school career with," she said. "I think of how terrible it was to live for years in a community where we felt we weren't wanted. Years later when I got pregnant, I was doing everything right. I was the health editor of Essenceat the time. And I still gave birth to a tiny baby. Thankfully she's fine now, but I often think about whether my early experiences had an effect on my own pregnancy."

Villarosa also described the experience of visiting her mother's childhood home in rural Mississippi and the effects of redlining.

"The town my mom grew up in was redlined, which meant Black people couldn't get a mortgage," she said. "If people can't own homes in this community, you can understand how without wealth there is no health."

Despite these challenges, Villarosa looks forward to meaningful change.

"I feel hopeful when people listen to talks like these and want to learn more, and I feel hopeful when I talk to today's medical students," she said. "There are many people who are trying to put the 'care' back in 'healthcare.' Let's figure out how to take care of ourselves and each other. And let's figure out how to challenge a system that has not been that good to us."

- Robert Emproto

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