How Systemic Racism Continues To Determine Black Health And Wealth In Chicago

May 6, 2021
Originally published on May 6, 2021 4:50 pm

There is a 30-year gap in the life expectancies of Black and white Chicagoans depending on their ZIP code. On average, residents of the Streeterville neighborhood, which is 73% white, live to be 90 years old. Nine miles south, the residents of Englewood, which is nearly 95% Black, have a life expectancy of 60.

Journalist Linda Villarosa says the disparity in life expectancies has its roots in government-sanctioned policies that systematically extracted wealth from Black neighborhoods — and eroded the health of generations of people. She writes about her family's own story in The New York Times Magazine article "Black Lives Are Shorter in Chicago. My Family's History Shows Why."

Villarosa says her grandparents, who moved to Chicago from Mississippi during the Great Migration, faced restrictions on where they could live and how they could buy a home. Unable to get a traditional mortgage, her grandfather bought the family home with a contract sale that stipulated he could lose the home if he missed a single payment.

"It wasn't until you made all payments that you owned your home outright. So you really had to be in it for the long haul, and nothing could go wrong or else you could lose your home," she says. "Many of the people at the time bought them at inflated prices. So it was hard to keep up the payments. And you didn't have any equity in your home."

Villarosa says contract sales and other racists policies sucked away wealth and prevented extensive development in Black communities. Soon, Black families began leaving the city; in 1969, when she was 10, Villarosa's family moved to a white suburb in Colorado. Their old neighborhood began to deteriorate.

"That left the community with fewer people," she says. "Health care facilities started to just disappear and schools started to close and jobs dried up, so you saw a neighborhood in decline."

Now, more than 50 years later, the Chicago neighborhood where Villarosa's grandparents once lived is peppered with vacant lots and boarded-up buildings.

"These neighborhoods lack resources. They lack grocery stores. They lack healthy outdoor space. They often lack clean air and clean water and clean land," she says. "If you live in a place like that — that has few resources but also worse conditions — your health suffers."


Interview Highlights

On how banks justified redlining and not giving mortgages to Black families

[Banks] gave ratings of "hazardous" to communities where Black people lived [and] also [to communities] that were subject to pollution. And it wasn't only Black people; it was also some European immigrants — some of [their] neighborhoods also were redlined. But I think because it was a different time and there was the assumption that places where Black people lived, places where immigrants lived, places that ... were near polluting facilities were worth less. ... If the idea is that places where Black people live are worth less, then banks codify that and the government went along with that and didn't try to change it.

On what happens to a community when the middle-class people leave

The community before had been one of mixed income. So you might have someone like my father who was a bacteriologist living next to someone who worked on the railroad, living next to someone who was a clerk at a grocery store, living next to someone who was a nurse. But if the people who were the nurses or the people who were like the bacteriologists and the people who are more educated had more money, had more savings, had more wealth left, then it left the neighborhood with fewer resources and the tax base is worse.

On how being Black in America takes a toll on health

So it kind of works on a whole bunch of levels, and it intersects not just with class and race, but with race itself, separate from class. I look at it in three ways: The first way is if you're Black, even if you are middle class, there is something about the lived experience of being Black in America that weathers the body. And this is the theory of Dr. Arline Geronimus from the University of Michigan. And she believes that the high-effort coping of dealing with racism in America makes the body prematurely aged. And so if your body is older, then you're more susceptible to every kind of health problem. And certainly ... [if you are] struggling economically, it makes everything worse.

Then the communities where we live ... were subject to redlining, were subject to housing covenants, [and] the wealth was sapped away. ... And then finally, there's discrimination in health care that has gone on for centuries. We've known about it. It causes problems when you enter the health care system, and it also causes people to avoid the health care system. And that includes avoiding a COVID-19 vaccine. It includes avoiding doctor visits and avoiding even checkups and tests that you need to be healthy.

On racist beliefs that medical professionals have held about differences in Black and white bodies

There was a myth — and I say "myth," but it was not exactly a myth because it was widely believed by physicians and scientists, especially in the South during the years of slavery — that Black people had extremely high pain tolerance. You could whip Black people, you could work Black people from sunup to sundown, you could torture [them], and there was just a lack of feeling there. It wasn't the same kind of feeling. But also that Black people had less emotional pain, that you could take children away, that you could break up families, and it just didn't mean much. ...

Those beliefs ... helped scaffold slavery to say, "What we're doing here is fine because there's a physiological issue that is keeping Black people from really experiencing the pain the way white people do." So then the throughline to today was that many of these myths are still believed. And so I focused on a study that was from 2016, which really isn't that long ago. It was in the Proceedings of the National Academy of Sciences, and it asked white medical students about different myths. So the idea that Black people have nerve endings that are less sensitive, that Black people's blood coagulates more quickly, that Black people's skin is thicker and that Black people feel less pain. And most of the white medical students and residents believed at least one of the myths. So that's really bad. And that wasn't the only one. There were many other studies.

Amy Salit and Kayla Lattimore produced and edited the audio of this interview. Bridget Bentz, Molly Seavy-Nesper and Acacia Squires adapted it for the web.

Copyright 2021 Fresh Air. To see more, visit Fresh Air.

TERRY GROSS, HOST:

This is FRESH AIR. I'm Terry Gross. For Black families during the Great Migration north who were fleeing Jim Crow and lynchings, Chicago held the possibility of freedom and opportunity. But as my guest Linda Villarosa writes, as more Black people move to the city, a pattern of intentional, government-sanctioned policies systematically extracted the wealth from Black neighborhoods, bringing an erosion of health for generations of people, leaving them to live sick and die young. This is the subject of her latest New York Times Magazine article titled "Black Lives Are Shorter In Chicago. My Family's History Shows Why."

She's a contributing writer to the magazine and covers the intersection of health and medicine and social justice. Subjects she's written about include racial disparities in infections and deaths from COVID-19, how Black people are more likely than white people to live near facilities that produce hazardous waste and get sick as a result, why Black mothers are more likely to die in childbirth and Black babies have a high rate of infant mortality and how physicians propagated myths about the differences between white and Black bodies. She's also written about being a lesbian and about what LGBTQ people are up against in some African countries. Villarosa teaches journalism and Black studies at the City College of New York in Harlem. She's written three books and was the executive editor of Essence magazine.

Linda Villarosa, welcome to FRESH AIR.

LINDA VILLAROSA: Thank you so much, and I'm excited to talk to you.

GROSS: Your article starts with a trip you took with your mother to visit her old neighborhood, Englewood, in Chicago. Did you grow up in that neighborhood, too?

VILLAROSA: So I was born in Chicago, and I lived there until I was 10 years old. And so when my mother came to me - with me to Chicago, I was really excited to kind of go back over the territory and to also hear more about her history there.

GROSS: So what were some of the landmarks that you and your mother remembered from the neighborhood that you looked for and what had become of them?

VILLAROSA: So we started at her college, which was downtown - Roosevelt University - and then we rented a car and drove south. She wanted me to see the church she was married in. Then she said, oh, this is the first home that we were able to afford to buy. And then, this is the apartment I lived in when I was a little girl, and this was the elementary school I went to, and let's go to my high school. And then let's go to the elementary school you went to. And then finally she said, let's go to the house where you grew up. And so we had a little list, and we just started driving south. But what we saw was not what we expected.

GROSS: What did you see?

VILLAROSA: So we saw - first of all, we saw these patches of land that were vacant lots. And so I was surprised to see that much vacant land in the middle of a big city. And so then she said, oh, let's go to this apartment where it was right by the train tracks, the L train. And I remember looking out the window and watching the trains go by. And so we went to the address, and I said, Mom, where is it? And so she pointed and said it used to be there.

And then the other place that was really shocking was Mr. Brice's liquor store, where we used to go on Saturdays. My sister and I and my father would go over while she was visiting other relatives. And it was a place of comfort. My dad would hang out and talk to Mr. Brice about fishing. We'd get candy and ice cream sandwiches. And it was gone.

And also, the house where she and my father lived right after they got married. And so she said, maybe I'm misremembering. And I said, well, here's the address. And then I pointed to this really rundown home. The windows were boarded. The stairs were broken. And I said, Mom, I think that's it. And we were really shocked. We did not expect that. But I was surprised and so was she by the condition.

GROSS: Why do you think that instead of becoming gentrified, this neighborhood took the opposite route and it was just vacant lots, boarded-up homes?

VILLAROSA: Well, part of the reason is because so many people left. So, you know, in the 1970s, when we left, a lot of other Black middle-class people left and Black working-class people left. So that just left homes to go empty. And without a lot of people, that meant the population of the schools dropped, and that meant businesses didn't have patrons. And so that was - you know, it looked like the main thing that happened. And there were also other parts of the city that were changing and gentrifying, but not this part.

GROSS: So this was a neighborhood that was largely created during the Great Migration North. You had seven great aunts and uncles who left Mississippi for the North. Four of them moved to Chicago. And then your grandmother moved to Chicago afterwards and met your grandfather there, who was also from Mississippi. They had read articles about Chicago in the Chicago Defender, a Black newspaper that was circulated in the South, too. Do you know what the Chicago Defender had to say about Chicago that made it seem so appealing to people like your family in Mississippi?

VILLAROSA: Well, the Chicago Defender was distributed widely in the South, and it just talked about Chicago and other cities in the North as places of opportunity and mostly about jobs, but also about stories of success, about people who - Black people who were living there. It was really sort of a Bible of sorts for people to say, oh, this looks like a place where we could thrive. And because it was a Black newspaper, it had stories that were positive. It had stories that made Chicago and other cities look really inviting.

So I think my grandparents and my great aunts and uncles were really attracted to that. And they wanted to get out of that area. And I don't know 100% the story, but from what I know, it was a place of terror. It was a place of a lack of opportunity. And my great grandparents had a farm that, by all accounts, was fairly successful. But still, it wasn't enough to support this huge family and also a family of people who could do better elsewhere.

GROSS: So what is the year that your great aunts and uncles moved to Chicago? And what were some of the restrictions they faced that they were surprised to find?

VILLAROSA: They moved sometime in the mid to late 1920s. And we know my grandmother was the last to go because she was the youngest, and she went in 1929. And I think the restrictions were probably when they got there, they weren't exactly the kinds of jobs that they expected. And most of the people - you know, it's mostly great aunts, and they worked as maids. And my grandmother was not the type to work as a maid. She wanted a maid. And so I'm sure - and my mother has told me - that my grandmother was not at all happy to be working as a maid in Chicago. But eventually, she managed to get her beauty license and was a beautician. And when she met my grandfather, he was a bellhop in a hotel downtown until he lost his job during the Great Depression.

GROSS: And what about housing? They all moved to the same neighborhood, and it was, you know, a Black neighborhood with a lot of other people who had migrated from the South. What was housing like for them when they first moved there? Did they face restrictive covenants or other codes that made it hard for them to get the housing that they wanted?

VILLAROSA: They did not share that. They were of a generation where they didn't talk a lot about their problems. They didn't talk a lot about, you know, the restrictions and things like that. But doing the history and looking it up, it's clear that they had to have faced restrictions. There is a reason that everyone settled in, you know, this one patch of neighborhood on the south side and most of it in Bronzeville because it was restricted to where they could go. And my family was fortunate that they were able to buy a house. And it was big enough to house many of them. And it was interesting that my great-aunt, who had the least education, was able to buy the house where they all settled. And they lived together in this house on South Vernon Avenue. And I was really proud of that, to know that, you know, given that they faced restrictions, given that it was hard for Black people to buy homes, that they managed to scratch together the money, partially on their salary as maids, to buy this home.

GROSS: So what were the housing covenants at the time like? And how official were they?

VILLAROSA: Well, they were very official because they were the law of the city. And it just meant that Blacks were restricted to certain neighborhoods, that there were no restrictions for whites. And so that was sort of the first thing that happened. And that was definitely - in the time when my family arrived, those restrictive covenants were in place.

GROSS: You know, I didn't know until I read your piece that it was Lorraine Hansberry's father, Carl Hansberry, who challenged housing covenants in Chicago. The case ended up in the Supreme Court. And he won. And what makes that story even more interesting is that your mother was a classmate of Lorraine Hansberry's.

VILLAROSA: She - they started in elementary school together. And then they went all the way through high school. And my mom often talked - she used to talk about, oh, I had this friend, Lorraine. Her parents were a little bit better off than our family. And I really liked her. Lorraine was so smart. So she would always talk about Lorraine. Finally, I was like, who is this Lorraine? She's like, oh, Lorraine Hansberry. And I said, wait. The Lorraine Hansberry...

GROSS: (Laughter).

VILLAROSA: ...You went to elementary school and high school with her? And I didn't know about the lawsuit. And I didn't understand that the basis of the lawsuit was - laid the groundwork for her famous play, "A Raisin In The Sun," until I started researching this story. And I went back to my mother. And I said, Mom, did you know this? And she said, no. But I knew that Mr. Hansberry was a strong, smart, educated man. And Lorraine, you know, was a wonderful friend to her. And, you know, she just kind of took it for granted. But in researching this piece, I asked to see my mother's yearbook, so from Englewood High School. I think she - they were the class of 1948, I think. And I looked up, there's Lorraine Hansberry in the yearbook. There's my mother, Clara Alexander, in the yearbook. It was really heartwarming to see that.

GROSS: And it was 1949 that the case went to the Supreme Court. And the court declared these housing covenants unconstitutional.

VILLAROSA: It also must have been terrible for the Hansberrys because the Hansberrys moved into a home that was - I don't understand exactly how they moved into it. But they moved into a home that was subject to these racial covenants. And so the neighbors, you know, came and attacked them and tried to drive them out. And I think that was a very difficult situation that Carl Hansberry faced by taking them to court.

GROSS: Let's take a short break here, and then we'll talk some more. If you're just joining us, my guest is Linda Villarosa. Her latest New York Times magazine article is titled "Black Lives Are Shorter In Chicago. My Family's History Shows Why." We'll be right back. This is FRESH AIR.

(SOUNDBITE OF THE ROOTS SONG, "SACRIFICE")

GROSS: This is FRESH AIR. Let's get back to my interview with Linda Villarosa. She's a contributing writer to The New York Times Magazine and covers the intersection of health and medicine and social justice. Her latest article in the magazine is titled "Black Lives Are Shorter In Chicago. My Family's History Shows Why."

So another thing a lot of Black families faced in Chicago and in other cities around the country is redlining, where banks wouldn't lend money to Black families seeking mortgages. How did the banks try to justify that?

VILLAROSA: Terry, to be honest, I don't know. I think that it was a different time. And it was just a given that you could do that. But they gave ratings of hazardous to communities where Black people lived, also that were subject to pollution. And it wasn't only Black people. It was also some European immigrants. Some of those neighborhoods also were redlined. But, I think, because it was a different time, there was the assumption that places where Black people lived, places where immigrants lived, places that were near polluting facilities, were worth less. But to have that happen - we look at it now and even then, it seems so unfair and so limiting. But if the idea is that places where Black people live are worth less, then banks codify that. And the government went along with that and didn't try to change it.

GROSS: So after the Depression, your grandfather got a job as a Pullman porter, which was considered one of the best jobs available to Black men at the time, even though it was a - could be a lot of grueling work and a lot of time away from family, too. So your grandparents saved enough money to buy a home. But they couldn't get a mortgage through the bank. So they got it through a housing contract. Would you explain what these housing contracts were like?

VILLAROSA: So the program was called contract leasing. And what - instead of having a mortgage and owning your home outright, the majority of Black people in Chicago, if they were able to buy a home. Like my grandparents, bought it on contract. So that meant they didn't exactly own it. If they missed a payment, then they could lose the home. It wasn't until you made all payments that you had - that you owned your home outright. So you really had to be in it for the long haul. And nothing could go wrong or else you could lose your home. Many of the people at the time bought them at inflated prices. So it was hard to keep up the payments. And you didn't have any equity in your home.

And so I remember when I asked my mom, how did grandfather afford to - a mortgage? Or how was he given a mortgage at the time? And she said, oh, he didn't have a mortgage. He bought it on some kind of contract. And then I thought, oh, my God. This is the contract leasing. That's what happened to my grandparents. And I started researching this story and intersecting with my family's story. I was shocked. I had thought of it more of an academic thing or more sort of distant from me. But asking my mother these questions, I thought, boy, you know, this contract leasing sucked away so much wealth from the Black community and caused fear for people, fear that you'd lose your home, didn't build equity. And that's what happened to my grandparents.

GROSS: So your parents were able to go to college. Your father became a bacteriologist and your mother a psychiatric social worker. Though, later on in her life, she opened up a bookstore. So at some point, your parents wanted to move. And this is when you and your sister were already born. And they were thinking of moving to a suburb in Chicago, but they didn't. Can you explain the story behind that?

VILLAROSA: So they were ready to get out of, you know, the city of Chicago. And they looked at a suburb near where my father was working at a - he was working at a veterans' hospital. And the suburb was called Maywood. And it was mostly white then. So they started looking for homes. And then my mom had a feeling, you know, that not many Black people here. So she found a police officer. And she said, is it safe for a Black family to move here? And the police officer said, well, I can't guarantee that we could protect you. And my mother realized that that was not the place for us, that if anything happened to my sister and me, my father would go ballistic. And she said I did not want to be a single mother, because I knew your father would go to jail. And so they ended up not moving there.

And we looked at - I remember as a little girl traveling to all these interesting places that my - where my father had gotten requests for transfer. And one of them was Utah, a city in - I think it was Salt Lake City, Utah. And so we went there. And so many people stared at us because we were this Black family of four people. My father said, no. We cannot live here. And then they thought of Montana because my father loved the West. And then we realized, Montana, no. This isn't the place for us. So by the time we got to Denver, you know, we looked in Denver, we thought, well, maybe this is the place for us. This is pretty. There's a lot of outdoor space. My father had had an uncle that loved Colorado and had talked it up to him. And my father liked fishing and the outdoors. So that was, you know, a good place. And my mother looked at the schools and thought, this is a good place for my kids. They can grow up and love the outdoors. And they can also get a good education.

GROSS: And how were you greeted as a Black family in this predominantly white suburb?

VILLAROSA: Well, my parents had gone ahead and bought the house in Lakewood, Colo. So we had a road trip. And the moving van was coming later. And we were in the car together. And, you know, it's a couple days to drive there. And when we drove up to the new house - and my sister and I hadn't seen it - on the garage, someone had written N-word, get out. And so when we saw it, we were so shocked. My father said, we're not staying. Just sell the house. I don't care if we lose all of our money. And then some of the neighbors were really horrified. And they were trying to scrub it off. But we had seen it.

We later found out that two boys that lived two doors down had done that, as, I guess - I'm using quote - "a prank." But I ended up having to go to school with those two boys, who I didn't speak to. But, you know, I knew they had done it. Their father made them apologize. And they were paper boys. So they had to deliver the paper for free to us at their expense. But, you know, you can never unsee that. And it was really hard because my father was so freaked out. And I know my mother was, too. But she was just trying to keep everyone calm.

GROSS: And you were 10 at the time?

VILLAROSA: I was 10.

GROSS: So what was your experience in school like?

VILLAROSA: Well, at the beginning, it was kind of terrible because I was starting third grade. Before I got there, I later heard that there had been a school-wide assembly to let the kids know that they were getting their first Negro student or colored. I don't know how they said it. And so everyone was - the kids were all terrified because they thought, oh, my God, what if we say the wrong thing? We don't know what to do. So, you know, I didn't have any friends at the beginning. No one really spoke to me. And finally, there was this little girl who was in my class and who lived around the corner. And she invited me to her house. And I felt so relieved to finally have a friend.

And, you know, my upbringing in Colorado, I'm not complaining. I was one - I guess I was - there were three Black kids in my high school class. There were, if few include my sister, four of us in the school. You know, and I had a, what I thought, was a normal childhood. Now I look back and see how hard I had to work. And I think of your interview with Julie Lythcott, talking about how hard it is to be the only Black person in all-white spaces. And I really related to that because I think it was much harder than I understood. But I also was just trying to be the best, trying to achieve, trying to be really good at everything. But it takes a toll.

GROSS: Let's take a break here. If you're just joining us, my guest is journalist Linda Villarosa. Her latest New York Times Magazine article is titled "Black Lives Are Shorter In Chicago. My Family's History Shows Why." We'll be right back after we take a short break. I'm Terry Gross. And this is FRESH AIR.

(SOUNDBITE OF OTIS SPANN AND MUDDY WATERS' "SPANN BLUES - LIVE/1966")

GROSS: This is FRESH AIR. I'm Terry Gross. Let's get back to my interview with Linda Villarosa. She's a contributor to the New York Times Magazine, and her latest article in the magazine is titled "Black Lives Are Shorter In Chicago. My Family's History Shows Why." She covers the intersection of health and medicine and social justice.

So we've been talking about how your family - you know, your grandparents and your great aunts and uncles migrated from the South to the North, four of them settling in Chicago during the Great Migration North. And then they faced housing covenants and redlining and discriminatory housing contracts and then problems in trying to move to the suburbs because there were places they were just not going to be welcome. So just as your family is part of a trend of - in the Great Migration of families moving from the South to the North, your parents were a part of a trend of Black families from cities moving to suburbs. Do you think, like, in your neighborhood, the neighborhood where you grew up, where your parents had lived before moving to Denver, that the people who could afford it at some point moved out, and the people who stayed behind stayed behind because they couldn't afford to move? Is that too broad of a generalization?

VILLAROSA: I think that the people who could afford to move and also had the wherewithal to do it, like my family, moved out. And many stayed. But some stayed by choice, but others stayed because they had no choice. And my - the rest of my family stayed. And I remember driving from Denver back to Chicago and have - and I don't remember thinking, oh, this is such a horrible neighborhood. I just remember driving back and being so happy to see those great aunts and uncles and to see, you know, family and to see my mother reunite with her parents. And it was a time - if you could get out, you did.

GROSS: What did that do to the community, the fact that a lot of middle-class families moved out?

VILLAROSA: Well, that left the community with fewer people to go to school with. And then it also - the community before had been one of mixed income. So you might have someone like my father, who was a bacteriologists, living next to someone who worked on the railroad, living next to someone who was a clerk at a grocery store, living next to someone who was a nurse. But if the people who were the nurses or the people who were, like, the bacteriologists and the people who were more educated, had more money, had more savings, had more wealth left, then it left the neighborhood with fewer resources, and the tax base is worse and just fewer people.

GROSS: And then services started to disappear, too. Stores started to disappear.

VILLAROSA: Yes. And health care facilities started to disappear, and schools started to close. So you saw a neighborhood in decline.

GROSS: You write that Englewood has become an example of the racial disparities in health, and it has the city's highest rates of death from heart disease and diabetes, the highest rates of infant mortality. It had very high rates of infection and death from COVID-19. Make the correlation between class and life expectancy and health.

VILLAROSA: So it kind of works on a whole bunch of levels. And it intersects not just with class and race, but with race itself separate from class. I look at it in three ways. The first way is if you're Black, even if you are middle class, there is something about the lived experience of being Black in America that weathers the body. And this is the theory of Dr. Arline Geronimus from the University of Michigan. And she believes that the high-effort coping of dealing with racism in America makes the body prematurely aged. And so if you - your body is older, then you're more susceptible to every kind of health problem. And certainly if you are - have the lens of poverty over it or struggling to - economically, it makes everything worse.

Then, the communities where we live and we've talked about were subject to redlining, were subject to housing covenants. The wealth was sapped away. And so these neighborhoods lack resources. They lack healthy - they lack grocery stores. They lack healthy outdoor space. They often lack clean air and clean water and clean land. So if you live in a place like that, that has few resources but also worse conditions, your health suffers.

And then finally, there's discrimination in health care that has gone on for centuries. We've known about it. And, you know, it causes problems when you enter the health care system, and it also causes people to avoid the health care system. And that includes avoiding a COVID-19 vaccine. It includes avoiding, you know, doctor visits and avoiding even checkups and tests that you need to be healthy.

GROSS: If you're just joining us, my guest is Linda Villarosa. Her latest New York Times Magazine article is titled "Black Lives Are Shorter in Chicago. My Family's History Shows Why." We'll be right back after a short break. This is FRESH AIR.

(SOUNDBITE OF PRINCE'S "BALLAD OF DOROTHY PARKER")

GROSS: This is FRESH AIR. Let's get back to my interview with Linda Villarosa. She's a contributing writer to the New York Times Magazine. Her latest article in the magazine is titled "Black Lives Are Shorter In Chicago. My Family's History Shows Why."

You are now in the process of writing a book that's an expansion of an article you wrote about why babies in the U.S. - why Black babies in the U.S. have higher mortality rates and why Black pregnant women are more likely to die in childbirth. What are some of the disparities that you found?

VILLAROSA: What happened was I was using the Black mothers and babies story as a jumping off point to talk about racial health disparities in the United States. And then, I started working on the 1619 Project essay. And then I realized, wait a minute, this story goes back further. I had thought I would start at 1850 because that was the time when you really - the census showed that Black babies were much more likely to die than white babies. And that was, you know, a time where you really saw this huge disparity. But then when I started working on the 1619 Project essay and looked back at the ways that enslaved people were used as - for experiments by white Southern doctors, the ways Black bodies were used and tortured, I thought, oh, I need to go back further because this throughline and myths and false ideas that started during that time about Black people and about Black people's bodies, there's a throughline to current day.

And then COVID happened. And I thought, well, I can't turn in this book and - without talking about COVID and talked about how COVID sort of validated and also unearthed the problems so everyone could see the problems in society that cause poor health of Black people, the problems and the discrimination in the health care system itself. So the book just got much, much bigger.

GROSS: A related subject that you've written about and I imagine you expand on this in the book, too, is some of the really crazy and wrongheaded medical beliefs about the difference between Black and white bodies, like Black people have literally thicker skin, that they have a higher tolerance for pain. What are some of the things that you learned that medical professionals used to believe about the differences between Black and white bodies?

VILLAROSA: Well, the way the 1619 Project started was a bunch of writers got called into a meeting with Nikole Hannah-Jones. And I was really excited to be part of it. And what we were told is to look back at the consequences of slavery - of the years of slavery and also the contributions of African Americans.

So the first round, I was assigned a medical essay. They said, don't make it a horror show. Take one thing that happened, and bring the throughline to current day. So what I did was do pain tolerance. So there was a myth. And I say myth, but it was not exactly a myth because it was widely believed by physicians and scientists, especially in the South during the years of slavery, that Black people had extremely high pain tolerance. And this is - you know, you could whip Black people; you could work Black people from sunup to sundown; you could torture. And there was just a lack of feeling. There - you know, it wasn't the same kind of feeling, but also that Black people had less emotional pain, that you could take children away, that you could break up families, and it just didn't mean much.

And so the throughline from those beliefs, which obviously helped scaffold slavery to say, oh, yeah, what we're doing here is fine because there's a physiological issue that is keeping Black people from really experiencing the pain the way white people do. So then the throughline to today was that many of these myths are still believed. And so I focused on a study that was from 2016, which really isn't that long ago. It was in the Proceedings of the National Academy of Science, and it asked white medical students about different myths - so the idea that Black people have nerve endings that are less sensitive, that Black people's blood coagulates more quickly, that Black people's skin is thicker and that Black people feel less pain. And most of the white medical students and residents believed at least one of the myths. So that's really bad. And that wasn't the only one. There were many other studies. That was just the one that just struck me the most because it was medical students. And so these are the doctors of the future still believing these myths.

The second myth I looked at was the idea that Black people have worse lung function. So that was used to justify enforced free labor to say, oh, actually working harder will build the lungs. So they called it vitality - lacked vitality of the lungs. So then one of the doctors - that was Dr. Samuel Cartwright - he believed these myths. He pushed these myths. He pushed them at medical society meetings. He pushed them in journals.

He used an instrument called a spirometer to measure lung function. And so he believed that the spirometer, when measuring Black lung function, needed to be corrected because Black people's lungs were 20% worse. So now the throughline to the present is the current spirometer - not every single one - but, you know, there's a race correction in even the current-day spirometer. So if I go to the doctor because I have bronchitis and I need to have my lungs tested, if the doctor is using one of these race corrections, then it makes an assumption that my lungs are 10 to 15% less strong or less functional, less capable than a white person, which is wrong. It's incorrect. It doesn't account for the fact that I grew up in the Mile High City. I'm in pretty good shape. So that doesn't matter. Only my race as a Black person matters. And that's incorrect medicine and an incorrect calculation.

GROSS: And it could lead to an incorrect diagnosis or treatment.

VILLAROSA: Exactly.

GROSS: Since you write so much about the intersection of health and social justice, when you go to a doctor or to an emergency room, to anyone in the medical profession who you haven't dealt with before and who you don't know and if you think they are making any kind of racial assumption, do you say anything?

VILLAROSA: Oh, yeah. Well, first of all, my mother taught me how to deal with the medical profession. And my mother, for a minute - she's had a lot of different lives - but she was a hospital administrator. So whenever - we don't still do this, but if we have to go visit someone in the hospital, she said, you need to get really dressed up. You need to show them that we're professional people. And I'm thinking, why? We're just visiting someone in the hospital. And she said it's really important that people understand two things. One, that you are not naive and you have some kind of background and knowledge in medicine. And two, you need to show up for people in the hospital, so - because - to show that they're not alone, that people in the hospital or in the medical system are vulnerable, are often afraid. You know, they're dealing with a provider undressed, and so that makes you feel vulnerable. So it's always better when you have someone with you.

So I'm often the person in our family and friend group who goes with someone else. I often have people come with me. But I'm pretty - at some points, people - doctors will say to me, are you a doctor?

(LAUGHTER)

VILLAROSA: I say, no, I just care a lot. And I, you know, am really interested in this. And I'm just asking a lot of questions. And I'm questioning you not because I think you're - don't know what you're talking about, but just so I understand everything that's going on with my loved one or myself.

GROSS: Linda Villarosa, it's been a pleasure to talk with you. Thank you so much for coming to our show.

VILLAROSA: Thank you. I've really enjoyed this conversation.

GROSS: Linda Villarosa's latest article in the New York Times Magazine is titled "Black Lives Are Shorter In Chicago. My Family's History Shows Why." After we take a short break, we'll remember music writer Ed Ward. Among his many credentials, for 30 years, he was a regular contributor to FRESH AIR, doing great pieces on the history of rock 'n' roll. His death was reported earlier this week. He was 72. This is FRESH AIR.

(SOUNDBITE OF RANKY TANKY'S "FREEDOM") Transcript provided by NPR, Copyright NPR.