On Wednesday, October 14, journalist, author, and educator, Linda Villarosa, shared insights on medical inequality with the Barnard community in the second installment of the “Big Problems: Making Sense of 2020” lecture series.

Linda Villarosa’s lecture marks the second installment of Barnard’s “Big Problems: Making Sense of 2020” series. The event was held over a private Zoom call and was introduced by Barnard Provost and Dean of Faculty, Linda A. Bell. Provost Bell began by remarking on recent protests and the uplifting sense of possibility and hope that they bring. The Big Problems lecture series was designed to reveal truths about our world and to ask engaging questions which Provost Bell brought up, including, “What does this moment reveal about existing power structures and value systems?” and “What might our world ideally look like as we move forward?”

Author and cultural critic Roxane Gay kickstarted the first lecture in the Big Problems series on Wednesday, September 16th. In her lecture, Gay covered a wide array of topics, including the election, protests, and the possibility of rebuilding a better world in the wake of 2020. Linda Villarosa’s talk expanded upon the unrest and inequality in America’s healthcare system.

Linda Villarosa is a journalist, author, editor, novelist, and educator. She writes for the New York Times on topics of race and public health and was formerly the executive editor of Essence Magazine. Villarosa has written three books with another on the way and has also written a number of award-winning articles on the HIV/AIDS crisis, Black maternal and infant mortality, and structural racial inequality in healthcare. Recently, Villarosa examined the toll COVID-19 has taken on Black families in her article “‘A Terrible Price’: The Deadly Racial Disparities of Covid-19 in America”. Villarosa is a graduate of the University of Colorado. After her time there, Villarosa spent a year at the Harvard T.H. Chan School of Public Health as a journalism fellow and then got her master’s degree in urban journalism and digital storytelling from CUNY’s Craig Newmark Graduate School of Journalism. 

Villarosa began by introducing the topic of racial health inequality, which she explained was deeply personal because being Black in America’s healthcare system negatively affects her and her family. America has the most advanced health technology in the world but lags behind other “developed” countries in aspects such as infant mortality, maternal mortality, and life expectancy. According to Villarosa, if there was a “Black America,” their health outcomes would look like that of some of the poorest countries in the world, and the Black-white health gap is worse now than in 1850 when Black mothers were so likely to lose a child that they hesitated to name them. She added that Black people in America “live quicker, die sicker” with a life expectancy 3.5 years lower than white people, but that far too often race is ignored as a contributing factor. Medical professionals will often attribute poor health outcomes to poverty, but Villarosa has found that even when economic conditions are equal or better for Black people, their health outcomes are still worse.

Villarosa offered three explanations as to why COVID-19 hit Black communities harder. Firstly, is the lived experience of being Black in America. She points to the concept of “weathering”, where constant trauma exposure ages Black bodies more quickly and creates less healthy babies, similarly to how a storm might damage the outside of a house. This phenomenon has caused the health outcomes of young Black people and older white people battling COVID-19 to be incredibly similar. Secondly, Villarosa said that Black people are more likely to live in less environmentally healthy communities. She points to factors such as redlining and environmental racism as contributing to the issue. Black people are 75% more likely to live in communities with poor air quality, highlighting the intersection of race and poverty in healthcare. Thirdly, Villarosa said that there is inherent discrimination in our healthcare system where Black people are less likely to be taken seriously by healthcare professionals or receive adequate care. This inequity has historical roots, going back to early studies suggesting that Black people do not feel pain the same way white people do so as to justify slavery. 

Despite the unique challenges faced by Black people in American healthcare, Villarosa states that she is hopeful. Her lecture ended with an anecdote about a group of medical students at UC Berkeley. Villarosa told the story of one medical student who had a professor as passionate about racism in healthcare as Villarosa. To combat inequality in their future field, the student founded the Institute for Healing and Justice in Medicine with a $750 grant and an office based in one of their student lounges. Villarosa urged audience members to visit their website and to read their manifesto. The fact that these students used such a small grant to push back against institutions and to fight things they’re learning because they’re passionate, Villarosa said, is what gives her hope.

After Villarosa’s lecture, Provost Linda Bell asked a few student-generated questions based on a few articles first-year students read as part of the Big Problems curriculum. One student asked what kind of work it would take at a systemic level to solve high Black infant and maternal mortality rates. Villarosa cited a protocol put in place in California where doctors were granted toolkits for labor, containing everything a doctor might need for a variety of situations. The rate of women who died in childbirth dropped by 50% over a few years, but the racial disparity remained the same. New pieces of legislation championed by Black women will require every healthcare provider who works with women or delivers babies to go through implicit bias training to work in that field, which Villarosa said she is excited for. In a later question, Villarosa also stated her belief that we will need a change in administration before any federal legislation can pass because we’re still fighting to keep legislation like the Affordable Care Act.

Another student asked how to find a balance between trusting science and questioning the motives of people behind the science, especially knowing how it has been used in the past to justify things like slavery. To that, Villarosa urged the audience to think of the Tuskegee Syphilis Study which ended as recently as 1970, and to the recent ICE sterilizations. Our job now is to have much more progressive-thinking lawsuits, lawyers, and government workers to combat these issues. Villarosa added that we have to trust science, but also question everything;, and that she is glad that doctors are beginning to question themselves. 

When asked about the intersection of infant mortality rates and COVID-19’s impact on the healthcare system, Villarosa shared an anecdote about an “underground railroad” of healthcare in New Orleans where doulas and midwives are helping poor mothers who are afraid to go to the hospital to give birth. She cited one instance where a woman was having a miscarriage and was turned away due to an influx of COVID-19 patients and a doula had to call a doctor friend to escort that patient into a hospital so she could get the care she urgently needed. Villarosa wishes this “underground railroad of healthcare” was not necessary, but she is glad that it exists, especially now.

In response to a question about what women of color should do when going to see a doctor for care, Villarosa said that they have to always be fierce advocates for themselves and each other. Villarosa shared that she always goes to the doctor with her mother and stays alert for any signs that she might not be getting the best care possible. She also shared a story of how a friend of hers had a “team of people” around her to help her do daily tasks while fighting cancer. 

Another student asked Villarosa who should be fighting to fix medical discrimination, and if Black women should be expected to lead this cause even though they constantly fight for other groups. Villarosa explained that the reproductive justice movement is an under-told story. People often think of reproductive rights in the frame of the Supreme Court, but the movement is Black-led and focuses not only on reproductive freedoms but the right to raise your child in a healthy environment. Villarosa said that we often think of organizations like NARAL or Planned Parenthood, but Sister Song, a reproductive justice organization led by women of color, is rarely ever talked about. She posed the idea that Black women don’t have to solve the world’s problems and save themselves at the same time, but asked, “What if we’re the ones who have this knowledge and experience to save ourselves?”

Linda Villarosa was the second of three speakers in the “Big Problems: Making Sense of 2020” lecture series. She was preceded by Roxane Gay and will be followed by Roberta Schwartz ‘91, Executive Vice President, Chief Innovation Officer, & Chief Executive Officer of Houston Methodist Hospital. The event is open to anyone in the Barnard community with registration.

Linda Villarosa via barnard.edu