A Must-Read about Health Inequity and Harm Reduction

Anyone who has needed the healthcare system in the past decade (me included) knows that our system in the U.S. is seriously broken. But for all that it’s bad enough for people in general, the issues of dismissal and dehumanization at the doctor’s office are much, much worse for Black women, and this book lays out those gaps in care with devastating, clear language.

One of the concepts in this book that blew my mind was of “weathering.” Villarosa posits the idea that racism itself—the burden of day-to-day anxiety ignited by microaggressions and outright racism, the myth that health is your personal responsibility and no one else’s, and the intersection between police brutality and the criminalization of mental illness and health inequity—all take a real and exacting toll on women of color, impacting their health and making them more susceptible to poor health outcomes.

Villarosa also exposes all the ways that institutions are keeping us in this bad place—communities are creating their own harm reduction techniques, from needle exchanges to local health programs—but they’re sidelined because of deep prejudice and because they aren’t part of the mainstream medical system. This book is accessible and searingly awful, but it’s not all doom-and-gloom: there are concrete ways that the system can start changing, and fast, and Villarosa gives feminists, people who care for their communities, and people who want to make a change in the healthcare world a roadmap for how to make change.