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Under the Skin

A Conversation with Linda Villarosa

Linda Villarosa is a New York Times contributor, professor, and author of “Under the Skin: The Hidden Toll of Racism on American Lives and on the Health of Our Nation.” In this episode, Chanda and Linda discuss the structural changes needed in our healthcare system, how the pandemic affected mental health, and the toll of micro and macro aggressions.

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Souphak Kienitz  00:01

You’re listening to Conversations with Chanda, a Minneapolis Foundation podcast that unpacks the community’s grittiest, most vexing problems hosted by Chanda Smith Baker. Today’s conversation will be with Linda Villarosa. She’s a contributing writer at The New York Times Magazine, where she covers the intersection of race inequality and public health. Her new book Under the Skin: The Hidden Toll of Racism on American Lives and on the Health of our Nation was named one of the New York Times 10 best books of 2022. She’s a former executive editor of Essence magazine, teaches journalism, English and Black Studies at the City University of New York. Enjoy the show.

Chanda Smith Baker  00:47

Welcome to Conversations with Chanda, it’s a podcast that we have to really describe and have conversations about issues that we’re facing in our communities today and certainly held and the topics you touch on mental health, the stressors that we’ve been living through are things that have been top of mind, for so many I know, I cannot probably count the number of conversations I have been in, particularly with black women. But before we jump in for the audience, if you could just maybe give an introduction of who you are, and talk about this latest book.

Linda Villarosa  01:21

I’m Linda Villarosa. I’m a contributing writer at The New York Times Magazine, and I also teach journalism at the City University of New York, my book is called Under the Skin: The Hidden Toll of Racism on American Lives and on the Health of our Nation. And it really looks at sort of what’s going on health-wise, in the United States. And it the first thing that struck me about, you know, sort of the statistics here was that we spend more on health and health care than any other country in the world. And we’re the richest country in the world by far, yet our money doesn’t buy good health. And even as a country, our health outcomes are worse than every other peer country in every other country that is rich like us. So, we have the shortest life expectancy, the worst COVID outcomes and the worst statistics around both infant and maternal mortality. And that is important to say that it’s not just black people, black people are my jam, that’s what I care about. But just as a country, we’re not that good, even though we spend so much money on health. And then as far as racial health inequality, black people are live six fewer years than white people in our country, we have more than twice the rate of infant mortality. And if we didn’t have that rate, something like four to 5000 more babies with survive, we also have a three to four times more likely rate of maternal mortality, which is really scary, because the you know, pregnancy and childbirth should be the best time of your life, people shouldn’t be dying or almost dying, related to pregnancy, childbirth. And that rate as a country is also one of the, you know, the only wealthy country where that number is on the rise.

Chanda Smith Baker  03:06

At the beginning of the book, you were talking about this issue. And for many of us, and I will just go to black community on the maternal health and infant mortality. You one could believe that that rate is simply related to poverty, or some of the health disparities are simply related to poverty, the lack of maybe understanding where to go maybe you didn’t grow up in a family were going to the doctor was a regular practice. But the book actually describes it quite differently.

Linda Villarosa  03:42

Well, I think there’s a misconception that all racial health disparities are related to poverty, or lack of access to health care. And I think as far as lack of access to health care, even if everyone had universal health care, which should happen in this country, and certainly, we would be better we would be at least approaching the other industrialized countries. But even if we have that, it still wouldn’t erase racial health disparities. And when you look at maternal mortality, you see that a black woman with an advanced degree, so that means a master’s degree Ph.D. an MD, or a JD, is more likely to die or almost die related to pregnancy and childbirth than a white woman with an eighth-grade education. And certainly, that doesn’t make sense, because education, especially at advanced degree is a proxy for knowing what to do during your pregnancy, having access to health care, having access to a good doctor and a good health care facility, and to healthy food and clean air and water. So, it doesn’t make sense that the disparity is greater at the more educated end. So, when the only difference is race. So, I think that’s what really struck me in looking at these issues to say wait, a lot of what we think about some of them is wrong, especially maternal mortality where the rate is growing.

Chanda Smith Baker  05:02

Does that stay true across other areas of health disparities?

Linda Villarosa  05:07

In life expectancy it does. And I think it hasn’t even been looked at in some areas, because it’s interesting, a lot of the statistics and not everything. But a lot of the statistics, you know, the study aren’t done that great. They use people, black folks who are, you know, less wealthy, and they compare them to white people who have access and but in maternal mortality, that isn’t the case. And in life expectancy, there are some studies where that isn’t the case. And certainly, in discrimination in the health care system itself. There’s a research paper from 20 years ago called “Unequal Treatment,” and it’s considered the gold standard. And what they did was matched access to health care with you know, black and white people in the study had equal access to health care, yet it was very clear that black people and sometimes other people of color got much worse healthcare and much worse treatment within the health care system. It’s the 20th anniversary of the publication of that document this year, and there is going to be a look back at it. So, I’m really excited to see alarmed that I doubt much has changed in the 20 years but I’m also interested to see if anything has changed.

Chanda Smith Baker  06:18

As I was listening through that part of the book on Audible, I was reminded, I think I’ve shared this story once before on the podcast, but I went in for an annual mammogram and I thought I had popped a lung. And I wanted to get a screening done. And they wouldn’t give it to me because of my age. And so they start going through all of the data and saying that I was too young. And it was very unlikely. And I didn’t have family history. And it was this whole thing. So, when I when they finished, I said, you know that those statistics are not true for black women. Correct? And the partitioner said, Yeah, I know, the new brochures, come out next week. We don’t have them yet. Right. And so, you know, and I would just remember thinking, why did you tell me like so let’s talk about me. Let’s talk about my health. Let’s talk about why I’m here, put everything you just set aside. And then today, I’m going to get a screening. Right, like I’m not leaving without the screening. But how easily probably a few years before, I probably would have left.

Linda Villarosa  07:31

What happened with the screening?

Chanda Smith Baker  07:33

There was something that was abnormal, and then I went through some advanced ultrasounds, you know, it was pretty scary for a couple of weeks. And coincidentally, I came out of the office and ran into one of my cousins, who had advanced stage four breast cancer. And so I was telling her my experience, and she said Chanda, you must insist on staying. That happened to me. When I insisted, I probably would have had stage four cancer to be treated, I would have caught it early.

Linda Villarosa  08:09

Well, I’m really glad you insisted and got the treatment that you needed, and the care. And I think you know, with black women and breast cancer, we’re more likely to have it younger, and a more advanced, like inflammatory breast cancer, which spreads quickly and is more aggressive. But I think exactly what you said medicine should be personalized. It shouldn’t be related to our demographics. I point out demographics not to suggest what kind of care people should get. But suggest wait, this is going on. Something has been missing for many of us in this country. If you walk in, in your black body, saying that something’s wrong and you’re afraid and that you know, these tests have shown this thing, then obviously, you should be listened to. And so that is what bothers me is the fact that you knew you had done research you understood and then you weren’t listened to. And that happens so often to especially black women in this country, including Serena Williams, that’s what happened to her when she was in 2017 when she got pregnant, was delivering her baby. She had her baby but then she knew something was wrong. She ended up having a pulmonary embolism. And she knew what was going on. She wasn’t listened to. She had had a C section and the C section, stitches bursts because she couldn’t breathe. And she ended up instead of having a wonderful experience which her wealth and her knowledge about her own body should have provided she ended up being on bedrest for weeks and weeks and it nearly turning into a tragedy for her. So that kind of thing not being listened to is you know what I write about and what makes me angry.

Chanda Smith Baker  09:48

I went in and I was very afraid of what was being presented in my body. And then there’s other folks that are afraid to go to the doctor. And I think that They are afraid of the outcome and you share some of those stories too. Can you share perhaps either advice for folks on how to either overcome that fear or explaining where that fear is coming from, that might support people in how they’re thinking through their own.

Linda Villarosa  10:15

I think what’s interesting is when we talk about like, I mean, sometimes it’s called healthcare hesitancy, it’s like a fear of going into the system. And, you know, I was talking about it with some other academic types. And they were like, well, because of the Tuskegee experiment, I was like, this isn’t about the Tuskegee experiment. That was terrible. But that happened, you know, the last century, this is about what happened to you previously, what happened to your family members, which you know, about, there is a justified fear of our healthcare system. If you’re walking in as an oppressed or marginalized person, especially in black skin, there are not enough providers that look like us, there is a clear evidence based history of us being treated differently and discriminated against. So, it makes sense, what I suggest for people is go in with someone else, go and don’t go by yourself. If especially if it’s something like what you were dealing with possible breast cancer, it’s something that is scary, and it matters. Listen, listening matters. I go in a lot with my other family members. And I think it you walk a fine line, like a lot of us have shared stories, it’s like always get dressed up. So people look at you with respect, come in knowledgeable about whatever you’re talking about. So that you can have a conversation one on one, and you’re not talked down to. And I certainly have had a lot of those conversations and seen, you know, a lot of people who you know, my loved ones who go into the hospital system, and you see not treated well, including my own father, and my father in law. And so you know, I get it, I get the fear, but avoiding the healthcare system itself isn’t good. My advice really is to, you know, keep away from the healthcare system as long as you can, by taking great care of yourself, and paying attention to your health. So, you’re having less contact with the healthcare system, but when you need to go, you have to go. But you also have to say to yourself, I have to figure out how to get the treatment and care I need, even if it means bringing in someone with me to help me here and to help me speak and to state my needs.

Chanda Smith Baker  12:20

You mentioned your father, and in the book, you talked about your mother telling you to get to the hospital and dress up, that also reminded me of not just issues and health, but things that my mother used to say to me, in terms of, you know, be presentable, so people will respect you in the way that we often have to arm ourselves to be seen as credible, or to be taken seriously as we navigate. My assumption is that that is not true in broader communities, do you think that there’s going to be a day where that will not be the case?

Linda Villarosa  12:53

I’m a half-glass very full person. So my instinct is to say yes, but I do worry about this system, if most of the people who are the healthcare providers don’t look like us. And there’s, you know, it’s very hard to get through medical school, it’s very hard to get through if you don’t have family who were also physicians, or you don’t have a, you know, a school system that encourages you to do that. And then, you know, it’s interesting is, when I interview a lot of physicians, and 100% of the time, when I interview a black physician, woman, especially, you know, she tells me a story of how she’s, you know, worked with the patient, she’s wearing a white coat, and then they’ll turn to her and say, When is the doctor gonna come in? So I think that there’s two ways to think of it. One is to work with the healthcare system that we have now. And it’s to say, what are the things I need to do to get good treatment and care. And then the second part is to say, this health care system in this country is broken. And we have to abolish it and start from scratch, and really, you know, try to make it better. So I think it’s hard at this stage to imagine that the healthcare system is going to change one that’s based on capitalism, and it’s based on money making, and it’s based on having, you know, just doing an appointment as quickly and as efficiently as possible. And that means doing less listening, because you just don’t have time. And I have great empathy for healthcare providers. But still, they’re working within a system that doesn’t work very well for many of us.

Chanda Smith Baker  14:24

For the social determinants of health and some of the environmental factors. I was thinking about a lot of the activism that’s happened even in Minnesota around an incinerator that was placed right outside of North Minneapolis, which is seen as the black neighborhood, or other toxins that maybe are elevated over what the compliance levels out to be where community actually has to activate to get it within compliance, where you see elevated illnesses and impacts on our young people. And then you talked about the life difference. When I was working to open up a grocery store on the north side, statistically, we found out that you could go in any direction, I think two miles in any direction, and the life expectancy was seven years difference, you know, thinking about the social determinants. And as I understand it, about 90% of what we can do happens in community. What else can you share that would be important for us to understand about what we should be doing in community as it relates to our health outcomes?

Linda Villarosa  15:36

Well, I think, unfortunately, the phrase social determinants of health is just jargon. And it’s a poor way to describe really something that is very important. It’s like, what is the environment that you work in, that you live in, that you go to school in, that you sleep in, that you go to church in, that you have recreation in, and if that environment, like you said, you know, many of the black communities in this country have been redlined, which means that in the past, people weren’t able to get mortgages, because they were rated as hazardous. But then, you know, who came in was polluting industries, because, you know, they don’t care about that, and are doing that kind of thing. But it was to people in communities that were the least able to push back against this kind of pollution. And I think, what’s very interesting is sometimes, like you were saying, most of the ways that, you know, what affects our health has to do with the environment, it’s less about healthcare itself. And, but health but there is that there are, you know, in communities that were traditionally redlined, or, you know, black communities and communities of color, you often have poor health care resources, when I’m giving talks, I’m sometimes to medical colleges and things like that. And they’re like, What can we do? And I said, Well, you have to do something outside of just your clinic or your hospital or whatever. Because, one, if people are hesitant to go there, then you’re not really helping them. If they’re not being treated, once they get there, you’re not really helping them. So, what can you do in the community to make it more helpful? I love some of the things you were talking about to say, you know, what, if there’s no grocery store, is there a some kind of market that you could set up is there another way outside of the mainstream system to get healthy food to the community, because that’s one of the problems in, you know, a community that has poor so called social determinants of health, it’s hard to access food, healthy and affordable food, what I don’t like is when you go into these communities, and you look at the statistics, and then you sort of say, oh, it’s the people’s fault. When if you look at the history, it’s not our fault, and it may be the fault of the polluting, you know, company, or it may be the fault of the supermarket that refuses to come to the so-called hood. So, you know, what I think is I love when communities get together. And there are alternate ways. I don’t think this is the solution, the solution is investing replaces, you know, institutional and structural way. But in the meantime, I like community, you know, organizations that try to, you know, make lives better for people.

Chanda Smith Baker  18:11

Yeah, we’re seeing more of that too, having community gardens, creating green space and placemaking. And ways for people connect, because isolation seems to also be a real challenge that was there and predated Of course, 2020. But then following the pandemic, where folks were in their homes, it feels like the issues related to stress and mental health seem to be more present. We’re also talking about the more as we also came out of 2020, with the murder of George Floyd.

Linda Villarosa  18:44

I think it’s been particularly hard for younger people, you know, if you think about it, school is often a safe place, of course, young for young people of color, it’s a place where you can have community, it’s a place where you have structure you have learning and often you have food, and, and recreation exercise. So, when that got taken away, you saw the mental health of people, especially young people of color really drop, you also saw, you know, we’re more likely as a demographic to have a child who lost a caregiver give because of COVID. And because black people and other people of color had worse health outcomes during COVID and more deaths. It made sense that, you know, a lot of people died and left behind children. So, I think that that is a group I’m paying attention to, and you know, I am worried about their mental health. There’s also fewer mental health facilities, and practitioners that look like us, and whoever they look like it’s definitely fewer in schools, like the social work school social worker, a school counselor is often absent, or just there’s like one for a whole bunch of kids in the you know, in the more marginalized schools, and I think that’s something that we really have to pay attention to because you know, Young people are the future, we don’t want them to grow up, being, you know, not feeling good emotionally.

Chanda Smith Baker  20:05

My youngest is a senior this year, and I was trying to calculate in my head, you know, how much of his school experience since eighth grade has been what would consider to be a normal high school experience. So maybe a year and a half or so of that time. And I could see sort of the impact of that on his classmates. And it does feel like we’ve skipped past sort of the impact of what that means for them. The budgets of schools are also being very squeezed. I mean, I guess I’m asking this question more as a mom, trying to think through what might be the long term effects. Because I’m also very worried of, you know, what that could look like even how to talk about that grief or, or loss that they might have experienced.

Linda Villarosa  20:59

I think the point is to talk about that grief and loss. And to not hold it in, I was looking at statistics around teachers, and black women teachers are the most likely to be quitting now. And I think it’s because you know, a teacher has dual stress, she has her own stress, she has the stress of her own children. And then she has the stress of the children that she’s teaching and often caring for. But I think it’s really important to you know, I love what you said, and it’s very true that we’ve skipped over this part. It’s like, oh, no, this is the new normal. Well, the new normal comes in, in a way where people aren’t feeling great at all levels. And we have to pay attention to this. And I think in this country pays short shrift to mental health. Because there’s national sort of character that says, Oh, if you just work hard, and you know, you’re a rugged individual, and you, you know, take good care of yourself, you’ll be fine. And that isn’t always true. When we do need support, we do need each other. We do need services, to address mental health at all levels.

Chanda Smith Baker  22:00

I was just talking about that with a group of girlfriends and some of the languaging that we often hear, you know, when people say you need, you know, I’ve grown, I’m tired, I can’t I can’t go. And someone will say, Well, you can rest when you’re dead. Or, you know, you got to keep grinding or, you know, why are you in bed so early, like the things that we say that actually discourage the rest that one might need when you’re feeling tired, or you need to replenish. And so there seems to be some unlearning that we need around some of the pressures that we have placed upon ourselves to perform and be available. In chapter six of the book, strong, loud and angry, the invisibility of black emotional pain. I listened to that chapter twice, because so much was resonant for me. But also because often when we think of mental health issues, I think that there are images that come forward, that may not be how you see yourself.

Linda Villarosa  22:58

That’s right. I went kind of hard in that chapter and use big examples. The two examples were a woman I who actually went to my college grew up in the same place, I grew up in Denver, and she had been struggling with emotional health issues, you know, since she was a child, but it was overlooked, including a really obvious eating disorder, because under the assumption that black women don’t have eating disorders, and what very yo-yo with her weight, but no one was really paying attention to her. She struggled all through high school, even in college and predominately white spaces. She ended up being successful as a Hollywood stylist. What she felt was she had like a loose grasp on success. Because she was one of the only black people doing that, that she was really stressed out. It was exacerbating her earlier struggles with mental health, and she was drinking too much. Finally, she was at a turning point where she was going to kill herself. And she managed to call a suicide hotline, she had a belt around her neck. And then she got help from her parents when she admitted that she wasn’t just a strong black woman who could handle everything and be successful in this white space. And that’s when she got the help. And that’s when she started speaking out about it. The male person in the chapter is someone who was struggling with mental illness early on too and his family really tried to get support, but there weren’t many resources. It was hard to sort of, you know, the family was putting a lot of money to try to help him. Eventually, he had a run in with the police and got murdered by police who covered it up. And this is someone I, you know; this is a family. My family is connected to their family. And I was really struck by that. Wow, how that that could happen to this family where you know, his dream was to start a restaurant in Martha’s Vineyard. And then he had a child who had written a letter to the child to try to get the child the letter but he died first. And I found that so tragic, but it was because he had untreated mental illness or not adequately treated, and also, you know, was using drugs. And when we are in pain, we’re often not treated with kindness and treatment we are treated with incarceration, or policing.

Chanda Smith Baker  25:15

And with the lack of inpatient facilities, there are more people that are in public spaces, you share this awesome in the book, we’re seeing this being very centered in the police reform movement, right, the activities that are around that, what our neighbors that are struggling with mental health, and they are showing up in public spaces, and we sort of stuff around them, and we see them but they’re really invisible. They are being policed. Oftentimes, we’re calling and there’s nowhere for the police to take them they’re sending them to emergency rooms, where they’re, you know, maybe placed on hold and then put back in community without adequate support. Is it making us more empathetic? Do you think? Or? Or are we just ignoring it more, because it becomes so publicly, I guess, stereotyped in many ways that maybe we don’t want to be seen in those ways.

Linda Villarosa  26:15

I think the stereotype is that people who are mentally ill and in public spaces are violent and dangerous, when actually they are more likely to be the subject, the victims of violence, including by the police. And I think it’s a hard issue. It’s a structural issue. And I think a lot of what I talk about in my book is taking away the individual, like taking away the almost the individualism of this and saying what is the structural issue that we, that needs to be solved by the government or by, you know, the authorities, and by our structures and institutions, rather than to look at individuals and say, they’re, they’re violent, they’re dangerous, and then to have that mixed in with stereotypes of black people, makes it so that it’s makes the problems hard to solve, and it makes people I mean, as we saw with Tyree Nichols, even other black people unsympathetic who are also, you know, affected by the stereotypes that have been baked into the institutions and structures of our country since the 1600s.

Chanda Smith Baker  27:17

And I appreciate hearing that. And I think this is also true, actually, for our young people where there doesn’t seem to be adequate structural support for those that are struggling. And you mentioned the first story of the young woman who would have been struggling through her childhood into adulthood. If there are people that are listening that have folks in their lives that, particularly young folks that are struggling, do you have any sites or resources that you could cite that might that they should go to?

Linda Villarosa  27:47

You know, what’s interesting, it’s like in this book, I tried not to do that. So, my first book, body and soul is a resource guide. And it’s a self help book. I mean, it’s not exactly new. But you know, it had resources, resources, resources. And in this book, what I tried to do was say, you know, it’s, I tried to make it have a dual purpose. One is to get the eye of medical schools and sort of medical administrators to get the eye of public policy people to say these are structural issues that need structural and institutional solutions. And what my daughter who’s very smart said to me, mommy, the other thing that your book does, is it lifts up the stories of individuals so that we don’t think it’s our fault. We’re not blamed. So, it’s sort of a less of a resource guide and more of a please pay attention to this issue because if you don’t, things are going to be worse and you’re not paying attention to people suffering in pain even within the healthcare institution that should be caring and treating us.

Chanda Smith Baker  28:51

The other statement I’ve been hearing, the thing that you lifted was this term called weathering and the impact on the body and I have heard that language before. Can you share more about what weathering is?

Linda Villarosa  29:04

Yes. And I learned about weathering maybe in 2017 or 2018, when I was working on my piece about maternal and infant mortality, and once I heard it, I was very intrigued, but the researcher, Dr. Arline Geronimus had not gotten a lot of attention for this because people just didn’t believe that it was a thing, despite she’s done like, it’s been her most of her life since she was an undergraduate at Princeton, trying to, you know, sort of prove this theory. So, the theory goes like this, that if you’re a person, any oppressed or marginalized person who has to fight against the systems, then you know, creates a kind of premature aging, and it works like this. Let’s say that you are subjected to either a micro aggression in the day to day or worse, a macro aggression by the police and how discrimination in housing or at your job. Every time that happens, your body goes into fight or flight. So that means your heart rate speeds up, your pulse quickens. And then your body is flooded with so called stress hormones, cortisol, and other stress hormones, which in the knot, you know, like once in a while, that’s amazing because it helps you run, it makes your body tense, it helps you escape danger. But if it happens over and over again, and it happens over and over again, to black people in this country, sometimes other people of color, and people who are fighting to just survive, it throws your body into, you know, flooded with kind of a toxic stress that over time creates a premature aging, and Dr. Geronimus and she used the term weathering because it’s sort of like how a storm weathers a house, it breaks might crack or break the windows, it knocks the shingles off, it chips, the paint, but it also speaks to resilience and love and community because we do weather this storm here in this country. And Dr. Geronimus is now has a book coming out next month, called “Weathering,” because once COVID happened, and you saw these worse health outcomes of black people at younger ages, so as a demographic, let’s say that for white folks, the the worst health outcomes for COVID were between age 70 and 80. For us, it was 10. And sometimes 20 years earlier as a group. So, then it sort of made sense that if we if our bodies were prematurely age, because of fighting against just trying to survive in America made sense that our COVID outcomes were worse. So now people are really paying attention to this idea of weathering and to her theories. I’m really happy for her book. So please, you know, look out for it’s called “Weathering” and it comes out in March.

Chanda Smith Baker  31:41

Do people know that they’re being weathered? I don’t know if that’s the right language as they’re going through it? Or is it something that you believe you just have to live through? Like, I mean, I know that there’s tact, right, like there’s a structural element to it. But there’s a piece even I think some of the languaging in the book is that, you know, you sort of got to like deal with what is America in the in these bodies?

Linda Villarosa  32:04

Right. But I like the dual, the dual. So, it’s like, yes, you’re being weathered, but yes, we can weather the storm. Yeah. And I think what she points to is kinship. And she points to one of the things she’s very interesting for her is that she talks about people living in communities of color, that are protective, as opposed to people who are the only in the in the predominantly white institutions and communities. It’s harder for those folks. And she says, you know, you have to find ways to get support and to get love and to get community so that you’re not just weathering the storm by yourself. And that’s what I like about that is to say, and I thought of the student I had, Trey, a few years ago, he was from the South Bronx, and he come to City College to college. And you know, it took everything he had to get to college. So we were in a black studies class, and he says, the assignment is to think of a time when you experience racism or discrimination. So, he’s the only one in the class and on and that never happened to me that never I don’t have that. So, I’m like, sure this guy said he’s a young black guy living in the South Bronx, certainly. And then he just keeps insisting that nothing’s ever happened. Finally, we drag it out of him. He said, okay, they’re this one time in high school. I mean, he’s only 19. Now, so high school is recent. He said I was he and his friend, were going to get pizza with these two young women that they were trying to impress. So, they’re walking down the street to the pizza, place, the four of them, and then a police car comes up, has guns out throws, the guy’s against the police car facedown, handcuffs them, the women are screaming and they’re taking videos of it. Then time passes. And then it turns out that it was a mistaken identity, and they let them go. So, then I said, Why didn’t you say that right away? And he said, oh, I didn’t think that was discrimination or racism. That’s just my life. That’s how that’s just the every day and I just thought, what did that guy’s body go through and the to all four of them when that happened? Of course, their pulse rate went up, their you know, heart rate goes up their you know, blood pressure, the stress hormones, flooding their bodies. And I’m thinking, if that is there every day that’s unhealthy. And it bothered, you know, it’s like, ah, that’s what weathering really means. But then I thought, you know, his was very cute. I taught him something. We had a really good session. I think we watched 13th, we watched the Ava DuVernay movie. He was so excited that he called his mother. And right after class, I’m in the hall talking to his mother and he put mom on the phone. This is my professor. And I just thought that was that mother probably got him to college and is protecting him and he relies on her. And that is the kind of love that helps us survive in this country.

Chanda Smith Baker  34:47

The images and videos of police encounters and Black death have taken its toll on America and on us. In Minnesota, we’ve had a number of them, you know, George Floyd certainly took the glow, to really pressure, the type of changes that we’re seeing today. You know, I think we are doing structural changes. But I don’t know if you have any comment about what those images because there’s an advantage of having those images, or those videos be seen, you know, unfortunately, to pressure, the system to change, but also the impact of that, I wonder if that also feeds into this idea that this is every day expectation versus something that really ought to be stopped in the minds, particularly of our young folks.

Linda Villarosa  35:40

I think that there should not have been a so called racial awakening that to everyday racism began, George Floyd had to be murdered, for this country to have this kind of, you know, eye opening, which, you know, most of us who were, you know, live here, know, you know, it’s like the whole the rest of us, the rest of them discovered racism, so, but it shouldn’t happen on the back on the body and on the life of someone. I have noticed that in my feeds, in my social media feeds, and certainly, among my children, you know, everyone’s saying, I’m not watching that anymore. I’m not watching that theater of death. But I am, you know, I’m grateful that we have body cams on cops. I’m grateful that people do take videos. I’m glad that you know, some of the surveillance that seems really alarming in communities actually works out this time. But I think that people should care for themselves. You don’t have to watch that. If you don’t want to we know that that happens. And that does take a toll seeing that. And it’s scary. I think the flip side is it’s forced conversations among parents, to taking care of children and teaching them how to care for themselves, which is unfortunate in this country. That was just a mother came to me and said, do you think I should have the talk with my son? And I was like, how old is he? And she said, Oh, my God, he’s only 10? yes, if he’s 10, because often black children are perceived as older. And that’s why sometimes that’s one reason where, where black girls especially get punished. Black boys get more punished, because they’re perceived as being older, even when they’re like 10. So, I’d say oh, yeah, have the conversation in a, you know, age-appropriate and gentle. You don’t have to be totally scary. But there should be some kind of self-help that you do within your family, to say, this is the reality of our lives here. And this is how you have to think about it.

Chanda Smith Baker  37:32

You shared with us why you wrote the book and who you were hoping to influence through the writing, in your hopes for the outcome and how this might influence what would you hope would happen? What would you hope change?

Linda Villarosa  37:46

Well, I think this is the one time when I’m glad that I wrote really slowly, I was kind of low key procrastinating, I was getting a lot of rest at the beginning because I was so tired. And so it ended up that the book was actually a year and a half late. But it came out at exactly the right time it came out so I could have the last chapter be about COVID. It came out at a time when at the beginning, when I was early in the writing, no one was saying racism is a public health threat. That was just not something that was said, by the time I had gotten into the book, a lot of institutions and organizations were saying that and saying because of the murder of George Floyd, because of COVID, and the racial health disparities that were, you know, on earth because of that. And so, I am feeling like my book came out at a time where people’s minds are more open to change at the medical student level at the medical school level medical training and treatment. I’ve given a lot of grand rounds at hospitals, I was never being invited to speak at a hospital. I’m not a physician. And I’ve done a whole bunch of them, where doctors wanted me to come in and wanted to hear, you know, what’s going on and wanted to know, I mean, yesterday, a major hospital in California, one of the best in the world. I did a grand rounds for them, where they asked the last question was, what can we do to do better? So, I think that kind of opening of minds and hearts is very important. And just to you know, I’m about the structural issues, and institutional issues, if the structures and institutions can change, and there are people that want to change. I think that’s a very, very good sign. And, you know, it makes me happy that I can be part of the solution.

Chanda Smith Baker  39:34

You know, one of the questions that I’ve been asking lately is, what is bringing you hope right now?

Linda Villarosa  39:40

I think that when I go to a college, and I see kids hungry for information, last semester, I’m at the City University of New York, I taught, we have a medical school. It’s almost all people of color. I taught a class on help racial health disparities and medical inequality. I had some You know, these are pre-med students, they are going to be tomorrow’s doctors. And they were so happy to be in the class, they were very funny because at first they weren’t sure what it was about. I was like, well, it’s one, it’ll be easier than all your other courses. You’re not going to have to memorize chemistry. And engaging in those conversations, listening to them, say, I want to stay in the community and make it better and practice in the community where I’m from. Many of them were from the Bronx, some from the South Bronx. And you know, I was really others from Harlem. And I was really excited to see that energy and to see that open mindness and they started to tell their friends, hey, take this class next, you know, semester, and I was really feeling hopeful about that future.

Chanda Smith Baker  40:45

And I have to bring up our mutual person that we both love, Miss Fay Price, who was at Pillsbury House theater, she is just a phenomenal leader. In our community, certainly outside of our community. She was at Pillsbury House theater, we met when she got the recognition from the McKnight Foundation, your family must be something because I tell you…

Linda Villarosa  41:13

Well, her mom was my godmother. And we grew up together when we were younger, both in Chicago, we got back in touch as adults. And you know, we spend Thanksgiving together family means a lot to both of us. And we know that family is a way to protect yourself and take care of ourselves and each other. And I think, you know, I have a little tiny family, and she has a little tiny family. So, we really appreciate that we are connected and through love.

Chanda Smith Baker  41:40

Mikal Nabors on our team insisted that I tell you how much your New York Times article meant to him. And as soon as I said, he goes, you know, who are you talking to tomorrow? As soon as I said your name. He said, she wrote this amazing piece in The New York Times and I’m from the south side of Chicago. And please let her know how much it meant to me. And I just wanted to share that because often, I mean, you know, we’re out in these spaces, and you don’t often maybe know how it sits the individual. But he said, it just gave him a deep sense of pride. And he wanted me to tell you that.

Linda Villarosa  42:22

Oh, thank you, I really appreciate that. And I never get tired of hearing that. It just, you know, one of the ways that keeps me going. So, thank you.

Chanda Smith Baker  42:29

And thank you for the conversation. I do encourage everyone to get the book Under the Skin. I have already recommended it to my linked sisters and other women and folks that I know are interested in this issue that are thinking differently about how they care for themselves and others and community and that are working on systems change as it relates to all the things that we’ve talked about. And more. So, thank you so much for being with me today. And on Conversations with Chanda.

Linda Villarosa  42:58

Thank you. It’s nice to see you and hear what you’re about and I love your podcast.

Souphak Kienitz  43:06

And that’s Linda Villarosa and our host Chanda Smith Baker. If you enjoy this show and want to learn more about what we do here at the Minneapolis Foundation, please visit us online at

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About Our Guest

Linda Villarosa

Linda Villarosa is a contributing writer at the New York Times Magazine, where she covers the intersection of race, inequality, and public health. Her new book “Under the Skin: The Hidden Toll of Racism on American Lives and on the Health of Our Nation” was named one of the New York Times’ 10 Best Books of 2022. It lays bare the healthcare disparities between Black and white Americans and calls out the huge toll racism takes on people of color and the costs this has for us as a Nation.

In her pieces for The Times, Linda has focused on the consistent poorer health outcomes for Black Americans, including higher rates of maternal and infant mortality, mortality for COVID and HIV/AIDS, and the shocking difference in life expectancy in predominantly Black vs. white Chicago neighborhoods. As a contributor to The New York Times’ Pulitzer Prize-winning 1619 Project and The 1619 Project: A New Origin Story, she traced the race-based physiological myths that have endured since slavery and continue to plague medicine today. A former executive editor of Essence Magazine, Linda teaches journalism, English, and Black Studies at the City University of New York.