Just Health: Treating Structural Racism to Heal America

by Dayna Bowen Matthew

The author of the bestselling Just Medicine reveals how racial inequality undermines public health and how we can change it

With the rise of the Movement for Black Lives and the feverish calls for Medicare for All, the public spotlight on racial inequality and access to healthcare has never been brighter. The rise of COVID-19 and its disproportionate effects on people of color has especially made clear how the color of one’s skin is directly related to the quality of care (or lack thereof) a person receives, and the disastrous health outcomes Americans suffer as a result of racism and an unjust healthcare system.

Timely and accessible, Just Health examines how deep structural racism embedded in the fabric of American society leads to worse health outcomes and lower life expectancy for people of color. By presenting evidence of discrimination in housing, education, employment, and the criminal justice system, Dayna Bowen Matthew shows how racial inequality pervades American society and the multitude of ways that this undermines the health of minority populations. The author provides a clear path forward for overcoming these massive barriers to health and ensuring that everyone has an equal opportunity to be healthy. She encourages health providers to take a leading role in the fight to dismantle the structural inequities their patients face.

A compelling and essential read, Just Health helps us to understand how racial inequality damages the health of our minority communities and explains what we can do to fight back.

Genres: Nonfiction, Medicine

336 pages, Hardcover

Published February 22, 2022

About the author

Dayna Bowen Matthew, JD, PhD is the Dean and Harold H. Greene Professor of Law at the George Washington University Law School. Dr. Matthew is a leader in public health and civil rights law who has also held many public policy roles. These include serving as senior adviser to the Office of Civil Rights for the U.S. Environmental Protection Agency, and as a member of the health policy team for U.S. Sen. Debbie Stabenow of Michigan.

Reviews

[Steve · Rating 5 out of 5]

Powerful stuff. A fresh (and, at times, necessarily raw) and compelling opportunity to think more broadly about (and, hopefully, become energized to take action with regard to) structural racism.

Reviewer's tip for mainstream readers: My gut says that most readers would be moved (OK, I was blown away) by, and get most of what they need out of this book - and feel that the purchase price was fully justified - by reading the book's (not just moving, but) emotive, eulogistic, stirring 25-page Introduction. The author lays her cards on the table, outlines her (persuasive) argument, and sketches her roadmap for the rest of the book, which systematically dives deeper into (and offers more support and opens doors to alternative reading and research relating to) the various elements of the larger whole. (In other words, to be clear, this is not light reading.)

As for the book itself, well it makes a cogent and compelling case that we (as a nation? a society? a community?) need to embrace and invest in and commit to a broad, far-reaching, holistic, long-term approach to addressing (and slowly, systematically, but relentlessly undoing the innumerable aspects of) structural racism.

If you're looking for serious stuff (walking that tightrope of mainstream non-fiction heavily laced with hard core research that academics tend to call "scholarship,") ... or if you've worked your way through that stack of books you bought (or the reading lists that you collected) during the Black Lives Matters book buying frenzy (which, as I understand it, peaked in 2020), consider this one as a worthy addition to the literature.

Reviewer's disclosure: The author is a professional colleague, but, in that vein, it is the exception (rather than the rule) that I would read (the entirety of) a colleague's book that falls well outside my area(s) of expertise (and, yes, generally, interests). But, without diminishing the importance of my other colleagues' work (or, for that matter, my work), this is really important stuff, and I can't recommend reading (particularly the first chapter) and thinking about ... and, hopefully, changing behavior as a result of .... the book's clarion call for broad based action to address structural racism.

[Andy]

DNF. Neither fish nor fowl: mix of memoir and legal history and public health. I can see how some people would like the anecdotes about her parents, but that's not my cup of tea. I'm wary of anecdotes for explaining big social issues: someone else could write about their 90-year-old grandma and say "See, there's no problem" to argue the exact opposite of the point the author is trying to make. I think some of that personal story is okay at the beginning to frame where the author is coming from, but I don't like how it's woven throughout the book as part of the argument.

The author is an expert on her family and presumably on law since she's a law professor, but the topic of this book is health and that aspect seems a little weak. For example, on p.140, she writes: "The third National Health and Nutrition Examination Survey estimated that 40 percent of childhood asthma is related to a child's home environment." If you know what NHANES is, that sentence doesn't even make sense. So I looked up the reference the author gives, and that reference cites another paper that should have been cited to make the relevant point here. This isn't a huge deal for the overall argument, but it's concerning from a rigorous nerd standpoint. Also, on p.122: "the infant mortality rate, a key indicator of African American health, has grown worse over time." No! As demonstrated by the graph in the book, it has gotten dramatically better.
All this is a shame because we do need good books to explain social determinants of health and how to improve health at the population level, and the author's general concern about structural racism's impact on illness and death is valid.

Alternative titles:
The Broken Ladder: How Inequality Affects the Way We Think, Live, and Die
The Color of Law: A Forgotten History of How Our Government Segregated America
The New Jim Crow: Mass Incarceration in the Age of Colorblindness
The Origins of Human Disease
The Spirit Level: Why More Equal Societies Almost Always Do Better
The Status Syndrome: How Social Standing Affects Our Health and Longevity
How to Be an Antiracist

[Magalys]

This book is full of information. Like JAM-PACKED. A lot of important historical and extensive epidemiological research went into this and it shows. It’s not the smoothest reading experience as this reads a bit like a textbook but it’s a very valuable resource for people who do the work of creating safe and healthy communities to get into. I was able to read this through #Netgalley.

I think people who teach public health at universities or are interested in working in health policy should read this especially.

[Natalie Nicole · Rating 5 out of 5]

Excited to read this book by @lawdeanmatthew. So timely and an honest look at how the passing of her father and many in his generation was not merely due to individual health flaws, but generation systemic racial burdens that chip away at lifespans and carry forward domino effects for their offspring. #DaynaBowenMatthew #JustHealth #NetGalley

[Susie Knights · Rating 5 out of 5]

oh boy. I picked up this book as part of a writing assignment and jumped for joy because I knew I had found the perfect source. Mint condition, new, and the exact topic of my paper. This book was rich with personal accounts, statistics, and insurmountable evidence. It should be clarified that the person writing this review is white. I consider myself to be relatively educated on racism in the United States, I knew all these statements to be true but the statistics and evidence used is all new to me. I learned about Supreme Court cases I had never heard of. This book was a great read for any person that is trying to educate themselves about racism in the United States particularly within the healthcare industry. Definitely not an introductory book, this book requires some prior knowledge, but it is dense and phenomenal.

[Jalayne J · Rating 5 out of 5]

Amazing 🤩

[Michaela Puryear · Rating 4 out of 5]

Informational but a bit repetitive and it definitely reads like a research paper which is not necessarily bad just not my preference.