Unequal Health: Anti-Black Racism and the Threat to America's Health

Unequal Health is a gift to the institutions and practitioners of public health and health care. It is a comprehensive and thoroughly documented compendium of the biases, false science, and ignorance that inform the care of African Americans nationwide. The authors also tackle the grossly unequal upstream conditions such as housing, education, food as well as the constant small and large threats that our African American citizens experience daily. All these impacts are woven into the book’s well documented, unconscionably disparate health outcomes. The totality of the challenge and solutions is laid out plainly for academics and non-academics alike. It is a clear call to action which would “raise all boats” for our society if we have the collective will to face the facts and implement the necessary solutions.

These authors have produced a definitive research-based book I read cover to cover as soon as I could get my hands on it. You should read this book if you work in healthcare, teach healthcare providers, advise healthcare administrators, research and deliver pharmaceuticals, build healthcare facilities, or are in any other way associated with healthcare. This book defines the criticality of solving the healthcare disparities challenge and offers solutions that can produce sustainable change and long-term impact.

To successfully solve a serious problem, one must first fully understand the roots of the problem. The authors of Unequal Health took a deep dive into the available research data to gain such an understanding and to identify the root causes that contribute to the problem of inequities and disparities in the health care available between Blacks and Whites. Some of the factors identified are obvious (e.g., socioeconomic differences, overt racial discrimination), while others are more subtle (e.g., diagnostic errors due to misunderstandings of the role of race in illnesses), but all result in Black Americans receiving deficient health care throughout their lives. Based on the authors’ understanding of these multiple factors, they propose a series of systemic changes to the health care establishment to address and mitigate the identified problem areas. The authors acknowledge that the changes that they suggest would not be easily implemented, but they propose a valuable roadmap for policy makers for how the problems of health care disparities could be reduced. As a side benefit of this important work, many of the problems and potential solutions identified by their investigation of how racial issues result in health care disparities for Black Americans can be generalized to health disparities for members of other minority and marginalized groups (e.g., Latinx, Native Americans, LGBT+, the economically disadvantaged). The book is well-researched and documented, is readable and accessible to all, and represents something of a call to arms for society to provide the same quality of effective medical care to all. In sum, the authors have provided a comprehensive guide for health care providers, health care administrators, and political actors who can provide the necessary resources of the steps to be taken to achieve these goals. I recommend it most highly.

I have read Unequal Health and was struck not only by its depth of knowledge but also its readability. It is clear from the very beginning of the book that the authors took great pains not only the research of the material (e.g. historical analysis of systematic racism in America, disparities in health care stemming from this racism, and impact on the American health care system) but also to structure the material in a way that is cogent and approachable. This book is not only for the social researcher but was also written for a layperson interested in the material. I highly recommend this book to anyone interested in the American health system, inequality in the provision of healthcare services to people of color, and what steps should be taken to address and fix this injustice.

This book provides a comprehensive review of a major public health dilemma – the persistent gaps in health between Black and White Americans, using a social justice lens. I highly recommend this valuable contribution to the study of racial inequities in health. It takes you from the historical roots of health inequities, the evolution of the science including our understandings of the mechanisms through which racism impacts health, and importantly what we and society can do about it.