Linda Vilarosa explores racism in healthcare in ‘Under the Skin’: Shot

A black woman receives a COVID-19 vaccine at a clinic in Tampere, Fla. Black Americans are twice as likely to die from the disease as whites.

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A black woman receives a COVID-19 vaccine at a clinic in Tampere, Fla. Black Americans are twice as likely to die from the disease as whites.

Octavio Jones / Getty Images

The Covid-19 epidemic, which raises racial inequalities in American health care, is killing more than twice as many black people as whites.

Author Linda Vilarosa has been writing about racial discrimination in health outcomes for decades and recently covered the issue. New York Times’ 1619 projects. He says that while he blamed poverty for the health problems of black Americans, he is now convinced that bias in the health care system and the “climate” effects of living in a racist society are having a devastating effect on African Americans.

Vilarosa indicates “weather” – An idea created by public health professor Dr. Arlene Gernimas – as wear in the body that comes in contact with chronic stress: “As your heart rate increases, your cortisol stress levels in your body increase. Your blood pressure rises,” he says. “It’s not good for the body. But when people are treated badly, that’s what happens.”

In his book, Under the skin, Vilarosa argues that any attempt to close the gap in health outcomes must address the structural racism that underpins the U.S. healthcare system. He points to historical myths about blacks – blacks are more tolerant of pain than whites – with the illusion that it affects the way we care.

In 2019, for example, researchers at UNCP-Chapel Hill published a study showing that black women did not receive as much pain management after C-section as white women, even when everything else was the same – probably, Vilarosa said, because the underlying Bias.

“It’s worrying because they’re the future doctors of America. And that means we have to work differently here,” he says.

Vilarosa said that when he spoke on the panel, he would tickle the word “racism”, and he no longer felt the need to avoid the word.

“We are not accusing individuals of being racist, but we are saying that there is something wrong with what is happening in America,” he said. “When you identify the problem, when you discuss the problem, it’s easier to solve the problem and come up with a solution when you’re pretending it doesn’t exist.”

The following interview has been edited for length and clarity.

Interview highlight

To write about the health crisis in Black America Summary In the 80’s, and the problems that were caught were “our own fault”

Under the Skin, by Linda Vilarosa

It was clear that there was racial health inequality. Black Americans had a higher rate of the so-called “lifestyle disease” that we told them then, and it was heart disease, diabetes, stroke, asthma. We knew it, but we just didn’t understand the reason. And so the explanation was our own fault. So either it was something about our genetic makeup that was making us more sick and also [causing] Low life expectancy and high infant mortality rate, or it was something we were doing wrong. So this SummaryThe idea was that we could fix racial health inequalities by getting all the people [who read] Our magazines, because they are the people we had access to, just to do better. And what we have said is that if you know better, you will do better.

How Dr. Harold Friedman’s research has changed the way we understand racial discrimination in healthcare

He looked at the health of men in Harlem and compared them to men in poor countries in Bangladesh. And it was found that the black men of Harlem lived less years than the men of Bangladesh. It was shocking. It was New England Journal of Medicine. So he came to talk to my class at the Harvard School of Public Health, my fellowship class, and I was very interested in what he had to say. I told him emphatically that it was a problem of poverty. And one thing he said to me, “Wait a minute, look at Harlem’s population. Harlem’s population isn’t all that poor. It’s going to happen. ” What I have learned from him is that if you look at the problem through the wrong lens, you are coming up with the wrong and ineffective solution.

In mythology that black bodies feel less pain than white bodies

This myth began in the years of slavery, and was pushed by doctors and scientists at the time who also had a hand in keeping slavery intact. So the idea is that if blacks have an extreme tolerance for pain, you can hit our bodies, you can hit us, you can whip us, you can take our kids and make us work from sunset to sunset and it doesn’t matter.

What I learned was that myths were pushed using medical evidence in medical journals. So then fast forward, for me, in 2016 and this is a study from the University of Virginia that looked at myths and legends [white] Medical students still believed … with the idea that black people have different abilities to endure pain.

There were other myths that black skin is thicker than white skin. Of course this is a myth. Skin comes in all types of thickness. But if you believe that, it speaks of a kind of false invulnerability that black people have that does not allow us to treat our pain in the same way.

Legend has it that the lungs of blacks were weakened – and how a nation has been corrected to this day.

There was a myth that, again, the years of slavery began with the inferiority of the lungs of black people. So it was the opposite of pain tolerance, where we had a superpower and it was an inferiority. The idea was that because of this weak lung, it was better for us to work in the field because it was like exercise, free labor like exercise. And this is a myth that was believed by doctors and again, in medical journals, at medical conferences.

Today there is a machine called the Speedometer that measures lung function, and often in these same machines that are used today, there is a race correction that assumes that the function of the lungs of black people is inferior. And I was thinking about this a long time ago. A few years ago, my lung function was tested because I was over bronchitis. And then I start to think, I wonder if I got the race correction, which would be really unfair because I grew up in Denver, which is Mile High City, so I have really good lungs. So it’s wrong to assume racial inferiority without looking at other ways I can be different, including growing up in Mile High City.

Maternal mortality rates are higher among black women in the United States

I heard this when I was playing football over the weekend from a woman who was an international lawyer. She was telling me, “Did you know that the United States is the only country where the number of women dying during childbirth or near death is increasing?” So I said, “Oh, no, I didn’t know that.” Then he said, “It’s driven by black women because black women are 3 to 4 times more likely to die or be killed.” I was still thinking, even in 2017, it was a problem of poverty. So I was arguing with him and then he stopped me cold because he said, “Education is not protective.” If you are a black woman with a master’s degree or higher, you are still more likely to die or almost die than a white woman in eighth grade. So that hit me.

It struck me that I was underweight at birth, which was really unusual for me to be so healthy. I was working as its health editor Summary Magazine I was trying to fix everything as a healthy person. And then I had this underweight baby. I have heard many more stories from other black women, including Serena Williams, who were born difficult. … this is just so extensive. And I think my article strikes a chord with people who have had this experience but have never heard of it being discussed.

How “weather” affects other groups of people

I decided to move to West Virginia, an area where HIV was prevalent. It was an HIV outbreak due to opioids. So West Virginia, as we know, was flooded with opioid pills. And then they are dragged off the road. So people became addicted to heroin, so they started using heroin and sharing needles. So that an HIV outbreak is created. So I was just curious to see what was happening [when] You treat people badly, you flood them with pills, and then you take them away and then they become addicted to heroin. Then what actually happened, with less questioning of what the pharmaceutical companies did, was blamed for their condition.

What I found was that, immediately, the first thing I noticed was that people were looking much older than I thought. I always misjudged everyone’s age. I have seen homeless people. There was such an extreme shame from the people. There was so much pain. And I just thought, this is the weather. When people misbehave, they blame themselves. They do not receive medical treatment and care. They get ridiculed and lack support. It happens to you, your body age. So it really is that anyone is abusive and marginalized.

A study on the health of black people can help other people

Since our experience has lasted so long in America, our abuse began in 1619, and it continues to this day, so we are the ones who have studied the best. We were the ones whose bodies were stuffed, which meant a deep focus on our health and our well-being, but we also had pain and loss. And so it is interesting to look at the black body and it is important, but the discrimination and the harm that hurts anyone.

This interview was created and edited by Sam Brigger and Joel Wolfram for broadcast. Bridget Bentz, Molly Seavy-Nesper and Laurel Dalrymple adapted it for the web.

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