Journalist Linda Villarosa explores racism and health at St. Petersburg event
By Stephanie Colombini
December 9, 2024 at 7:13 AM EST
Villarosa will talk about her book "Under The Skin" on Dec. 10 at Foundation for a Healthy St. Petersburg. The event is free to attend.
A public event in St. Petersburg on Dec. 10 explores how racism intersects with health.
Acclaimed journalist and author Linda Villarosa will discuss her book "Under the Skin: The Hidden Toll of Racism on American Lives and on the Health of Our Nation" as part of Foundation for a Healthy St. Petersburg’s “Speakers Who Inspire" series.
The book highlights how racism in society and the health care system causes Black people to “live sicker and die quicker” compared to their white counterparts. It was a Pulitzer Prize finalist in 2023.
Foundation president Kanika Tomalin describes Tuesday's event as an opportunity for residents to "get up close to people who are laying the path for how we can craft sustainable solutions together."
"Hearing Linda’s thoughts, hearing what she thinks about solutions that might aid our work to create a stronger more equitable community is a first step, but then the work really starts once she leaves and we come together to craft these solutions in ways that make us a stronger place to live," said Tomalin, who has a doctorate in law and policy.
The event takes from 5-8 p.m. at 2333 34th St. S in St. Petersburg. It is free to attend. You can learn more about the agenda and register to go on the event page.
WUSF's Stephanie Colombini talked with Linda Villarosa about how to tackle racial disparities in healthcare and what people can expect from her discussion.
This interview has been edited lightly for clarity.
Could you give us a preview of some of the things you will be discussing during your appearance on Tuesday about your book that explores racism in healthcare?
Yes of course. What I start out with is my own confusion around some of these issues, and I think it started with, why are we such a rich country? And we spend more on health care than any other nation, yet we have such poor health outcomes as a country — not just the race part, but as a country. So that seemed confusing to me. Then when I would have conversations about this, there were only two ways to look at it.
Linda Villarosa's book <i>Under the Skin</i> was a Pulitzer Prize finalist. (522x782, AR: 0.6675191815856778)
Way One was we lack access to health care for everyone, which is totally true. However, even if we had universal health care, which we should, we still would have inequities in health care and health.
The other way to look at it, and we still look at it this way sometimes, is that this is a problem only of the most poor people. Certainly it's a problem worse for those living near or under the poverty line, but even people who have money and education still have poor health outcomes, particularly in the case of maternal mortality and morbidity and infant mortality. So why would an educated, wealthy Black birthing person have a worse health outcome, have a worse birth outcome, than a white woman with an eighth grade education? So that's kind of where I start the discussion is, why is that true?
And then also that so much of what we think of it is wrong. I mean, the first chapter of my book is everything I thought was wrong. So I was under the impression that it was only the most poor who had these issues, and also that if you just did better, you would be better, so that if every individual did everything they could, as far as being healthy, then we wouldn't have race health inequity. But that's not right either. So that's sort of the premise of the book.
How do you tackle something that spans socioeconomic status in that way?
Well, there are many solutions, but most of them are really difficult and most of them are expensive; most of them take almost blowing up the system. But there are some things that we can do now.
One of the things, and it's a growing movement, is using community health workers and people like doulas to accompany people when they enter the health care system, and also to help them be healthier as individuals. Even though I said individual behavior change isn't the only solution, I think that it can help some people, and certainly, you know, we have to work with the people who are poorest. But I think everyone who is going to face discrimination in the health care system may need a loving link.
The problem with it in this country is that we have people who are interested in training to be doulas, training to be community health workers, but it's not institutionalized. So it should be part of the system. Some places have it. There are people like patient navigators in most hospitals. But it's not enough.
I think we can look at medical training — and not just physicians, but nurses, midwives, all kinds of medical training, and look at it through an equity lens. This is happening, which is super exciting and interesting to me. And even before my book came out, but especially when it came out, I was invited to a lot of medical schools to speak, and often it wasn't coming from the top down. It was coming from the medical students themselves.
So even though we're in a difficult time right now and there may be erasures of the kind of projects that have to do with DEI [diversity, equity and inclusion], still that energy from medical students is not going away. It's unfortunate that it's not institutionalized. But I see that energy, and they can figure out how to educate themselves and educate each other. And to press their medical schools into teaching them to be better health care providers that include empathy, tackling their own discrimination that is internal, that is just part of their societal upbringing, and making sure it doesn't interfere with the most kind and equitable care. So those are two solutions that I think are doable and are happening now.
You’re talking in Florida, a place that has restrictions on DEI initiatives, among other policies that can pose challenges for health equity. And the incoming Trump administration could take similar steps nationally. Why is it important that we have this conversation right now?
It was interesting. I was reading this article in The New York Times, and it was about how Black women are super tired and need rest. So I just sunk into that, I was like, I am so tired after the election. I'm kind of like, tired in general. I'm a little sad. And I stuck there for about three minutes, and then I realized, we can't be tired and sad. We have to keep pushing.
And I teach journalism, so that is my day job. And after the election, I didn't feel great. And I went to class kind of like shoulders slumped in the I'm-so-tired mode. And the other people in the class, the students, were not tired. They were on fire. And I realized I need to teach them how to be smart media consumers, smart media providers, and to teach everyone how to understand what's true and what's not, how to understand what's happening and how to push back against it. Now is the time.
If the election had turned out differently, there may have been a, “Oh, OK, let's just chill now.” There's no time for “let's chill now.” Now is the time that all of us who believe in the things that we do, believe in what's right, have to push back. Have to make sure that those of us who need it the most are cared for.
Much of the work is on the local level. When I enter your state, I hope to be an energizer. I hope to be a cheerleader. I hope to say, “Do not give up even in the face of the most barriers.” That's the time when you have to be the strongest, and that's the time you have to rise to the occasion. And I really believe that.
And you're speaking at this event that's open to the public, people are encouraged to ask questions. What do you hope that everyday members of the audience who maybe don't have an organization that they're tied to, they're just coming to learn, take away from this? How do you advise them to be more empowered as they go about seeking health care, to be aware of these inequities that you're talking about?
I'm going to answer that in two ways. When my book first came out, my daughter, who's really smart, said to me, “Who's the audience for your book?” And I said, medical students, doctors, nurses, health care providers, public health people. And she said, “Mommy, no, that is not the only audience.” It is people who have been treated unkindly in the medical care system, and maybe worse than unkindly, maybe horribly. It may have damaged their health, it may have even harmed them. Those are the people who are often gaslit and treated as though it's their fault.
So I think one thing my book does that I learned from my child is to lift up the stories of what has happened, and to say to people, this is not your fault. Do not blame yourselves. And I think that's an important thing. And in every single talk I've given, even people who have reviewed my book — in my New York Times book review, a wonderful, brilliant writer wrote the review, really positive, but in the middle, she talked about how harshly she herself was treated by the medical care system. That is not the usual thing in a book review. And I just thought this is such a universal problem that many of us are silent about because we are ashamed and blaming ourselves.
So I think that's one thing that my book really does. The other thing is, I'm not a doctor, so the advice I give is to take matters into your own hands sometimes, and to help each other when you enter that system. Don't enter alone. Be empowered and informed if you have to enter the health care system and be that person for other people. One thing that I was really excited about was the number of people just in my life who have become doulas since I wrote the story about America's Black mothers and babies, and since my book, and that really excites me.
I want to add one more thing. The most important work is local, and in Florida, that work is difficult, but that work is vital, and you can be involved.
Acclaimed journalist and author Linda Villarosa will discuss her book "Under the Skin: The Hidden Toll of Racism on American Lives and on the Health of Our Nation" as part of Foundation for a Healthy St. Petersburg’s “Speakers Who Inspire" series.
The book highlights how racism in society and the health care system causes Black people to “live sicker and die quicker” compared to their white counterparts. It was a Pulitzer Prize finalist in 2023.
Foundation president Kanika Tomalin describes Tuesday's event as an opportunity for residents to "get up close to people who are laying the path for how we can craft sustainable solutions together."
"Hearing Linda’s thoughts, hearing what she thinks about solutions that might aid our work to create a stronger more equitable community is a first step, but then the work really starts once she leaves and we come together to craft these solutions in ways that make us a stronger place to live," said Tomalin, who has a doctorate in law and policy.
The event takes from 5-8 p.m. at 2333 34th St. S in St. Petersburg. It is free to attend. You can learn more about the agenda and register to go on the event page.
WUSF's Stephanie Colombini talked with Linda Villarosa about how to tackle racial disparities in healthcare and what people can expect from her discussion.
This interview has been edited lightly for clarity.
Could you give us a preview of some of the things you will be discussing during your appearance on Tuesday about your book that explores racism in healthcare?
Yes of course. What I start out with is my own confusion around some of these issues, and I think it started with, why are we such a rich country? And we spend more on health care than any other nation, yet we have such poor health outcomes as a country — not just the race part, but as a country. So that seemed confusing to me. Then when I would have conversations about this, there were only two ways to look at it.
Linda Villarosa's book <i>Under the Skin</i> was a Pulitzer Prize finalist. (522x782, AR: 0.6675191815856778)
Way One was we lack access to health care for everyone, which is totally true. However, even if we had universal health care, which we should, we still would have inequities in health care and health.
The other way to look at it, and we still look at it this way sometimes, is that this is a problem only of the most poor people. Certainly it's a problem worse for those living near or under the poverty line, but even people who have money and education still have poor health outcomes, particularly in the case of maternal mortality and morbidity and infant mortality. So why would an educated, wealthy Black birthing person have a worse health outcome, have a worse birth outcome, than a white woman with an eighth grade education? So that's kind of where I start the discussion is, why is that true?
And then also that so much of what we think of it is wrong. I mean, the first chapter of my book is everything I thought was wrong. So I was under the impression that it was only the most poor who had these issues, and also that if you just did better, you would be better, so that if every individual did everything they could, as far as being healthy, then we wouldn't have race health inequity. But that's not right either. So that's sort of the premise of the book.
How do you tackle something that spans socioeconomic status in that way?
Well, there are many solutions, but most of them are really difficult and most of them are expensive; most of them take almost blowing up the system. But there are some things that we can do now.
One of the things, and it's a growing movement, is using community health workers and people like doulas to accompany people when they enter the health care system, and also to help them be healthier as individuals. Even though I said individual behavior change isn't the only solution, I think that it can help some people, and certainly, you know, we have to work with the people who are poorest. But I think everyone who is going to face discrimination in the health care system may need a loving link.
The problem with it in this country is that we have people who are interested in training to be doulas, training to be community health workers, but it's not institutionalized. So it should be part of the system. Some places have it. There are people like patient navigators in most hospitals. But it's not enough.
I think we can look at medical training — and not just physicians, but nurses, midwives, all kinds of medical training, and look at it through an equity lens. This is happening, which is super exciting and interesting to me. And even before my book came out, but especially when it came out, I was invited to a lot of medical schools to speak, and often it wasn't coming from the top down. It was coming from the medical students themselves.
So even though we're in a difficult time right now and there may be erasures of the kind of projects that have to do with DEI [diversity, equity and inclusion], still that energy from medical students is not going away. It's unfortunate that it's not institutionalized. But I see that energy, and they can figure out how to educate themselves and educate each other. And to press their medical schools into teaching them to be better health care providers that include empathy, tackling their own discrimination that is internal, that is just part of their societal upbringing, and making sure it doesn't interfere with the most kind and equitable care. So those are two solutions that I think are doable and are happening now.
You’re talking in Florida, a place that has restrictions on DEI initiatives, among other policies that can pose challenges for health equity. And the incoming Trump administration could take similar steps nationally. Why is it important that we have this conversation right now?
It was interesting. I was reading this article in The New York Times, and it was about how Black women are super tired and need rest. So I just sunk into that, I was like, I am so tired after the election. I'm kind of like, tired in general. I'm a little sad. And I stuck there for about three minutes, and then I realized, we can't be tired and sad. We have to keep pushing.
And I teach journalism, so that is my day job. And after the election, I didn't feel great. And I went to class kind of like shoulders slumped in the I'm-so-tired mode. And the other people in the class, the students, were not tired. They were on fire. And I realized I need to teach them how to be smart media consumers, smart media providers, and to teach everyone how to understand what's true and what's not, how to understand what's happening and how to push back against it. Now is the time.
If the election had turned out differently, there may have been a, “Oh, OK, let's just chill now.” There's no time for “let's chill now.” Now is the time that all of us who believe in the things that we do, believe in what's right, have to push back. Have to make sure that those of us who need it the most are cared for.
Much of the work is on the local level. When I enter your state, I hope to be an energizer. I hope to be a cheerleader. I hope to say, “Do not give up even in the face of the most barriers.” That's the time when you have to be the strongest, and that's the time you have to rise to the occasion. And I really believe that.
And you're speaking at this event that's open to the public, people are encouraged to ask questions. What do you hope that everyday members of the audience who maybe don't have an organization that they're tied to, they're just coming to learn, take away from this? How do you advise them to be more empowered as they go about seeking health care, to be aware of these inequities that you're talking about?
I'm going to answer that in two ways. When my book first came out, my daughter, who's really smart, said to me, “Who's the audience for your book?” And I said, medical students, doctors, nurses, health care providers, public health people. And she said, “Mommy, no, that is not the only audience.” It is people who have been treated unkindly in the medical care system, and maybe worse than unkindly, maybe horribly. It may have damaged their health, it may have even harmed them. Those are the people who are often gaslit and treated as though it's their fault.
So I think one thing my book does that I learned from my child is to lift up the stories of what has happened, and to say to people, this is not your fault. Do not blame yourselves. And I think that's an important thing. And in every single talk I've given, even people who have reviewed my book — in my New York Times book review, a wonderful, brilliant writer wrote the review, really positive, but in the middle, she talked about how harshly she herself was treated by the medical care system. That is not the usual thing in a book review. And I just thought this is such a universal problem that many of us are silent about because we are ashamed and blaming ourselves.
So I think that's one thing that my book really does. The other thing is, I'm not a doctor, so the advice I give is to take matters into your own hands sometimes, and to help each other when you enter that system. Don't enter alone. Be empowered and informed if you have to enter the health care system and be that person for other people. One thing that I was really excited about was the number of people just in my life who have become doulas since I wrote the story about America's Black mothers and babies, and since my book, and that really excites me.
I want to add one more thing. The most important work is local, and in Florida, that work is difficult, but that work is vital, and you can be involved.