Why Black Americans ‘Live Sicker and Die Quicker’
New column in The American Journal of Nursing
Hi All,
The “Healing Newsletter” this week features my quarterly “What I’m Reading” column for The American Journal of Nursing. In recognition of Black History Month, I wrote about Linda Villarosa's book Under the Skin: The Hidden Toll of Racism on American Lives and on the Health of Our Nation. It’s an eye-opening book and sobering. White clinicians—and I include myself in that category—may like to think that our drugs and high-tech treatments are inherently color-blind and therefore health care is, too. Villarosa’s book shows the incorrectness of such an assumption. Racism permeates American institutions. It’s naive to think that health care would somehow be different, especially since health care is, after all, implemented by people, and prejudice against Black Americans has a long and difficult history in the U.S.
I quote the start of the article below and link to The American Journal of Nursing for the full article. You can comment here if you want, or read the article and return to comment. That’s awkward, I know, but I need to respect copyright.
Hugs to all,
Theresa
After reading the first chapter of Linda Villarosa's Under the Skin: The Hidden Toll of Racism on American Lives and on the Health of Our Nation (Doubleday, 2022), I felt sick to my stomach. I kept reading, of course, but it's hard to learn about systemic racism in health care. We clinicians want to think we are better than that, that we treat all patients the same regardless of the color of their skin, but Villarosa's book shows that this ideal is often not lived up to. Under the Skin implicitly asks how we can best protect and care for Black Americans going forward.
The book begins with an oft-cited fact that frequently fails to get the national attention it deserves: the money spent on health care in the United States is not buying health. Villarosa writes, “Although the United States has the most advanced medical technology in the world—and spends more on health care than anywhere else—we lag behind all other wealthy nations in key measures of health that serve as a proxy for our overall well-being.” The picture is worse for people of color. Black Americans, specifically, “live sicker and die quicker” than their White counterparts, with “elevated death rates” largely caused by diabetes, stroke, and heart disease.
Wishing everyone a late Happy Valentine’s Day! I used to dislike Valentine’s Day because it can feel so couple-focused, but this year I looked at it as an honoring of love in its many permutations.
In that spirit, sending love and hugs to all of you,
Theresa
Pretty cookies!
For me the most horrifying detail from studies of racism in medicine is that medical professionals routinely undertreat Black patients’ pain. How cruel that is, to make so many people suffer needlessly, and how counterproductive too, since the stress from pain can impede healing. Let us hope that articles like yours help to bring about change.
I read your latest newsletter and the piece you wrote in AJN, Theresa. Both reinforced for me the conviction that we will never be a truly united country until we address the legacy of racism so intimately woven into American history and society. I had always thought of healthcare as more egalitarian than other parts of our culture, based on personal experiences I'd had as a medical student, resident, and attending. However, it is hard to ignore the many initiatives being created just in the last several years to address deep-seated problems within our industry. It is sad to acknowledge the need to address such a failure of core ethical principles in a field which has always prided itself on its professionalism in the care of patients.