Systemic

How Racism Is Making Us Sick

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Pub Date Jun 18 2024 | Archive Date Jun 04 2024

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Description

In the spirit of Medical Apartheid and Killing the Black Body; A science-based, data-driven, and global exploration of racial disparities in health care access by virologist, immunologist, and science journalist Layal Liverpool.

Layal Liverpool spent years as a teen bouncing from doctor to doctor, each one failing to diagnose her dermatological complaint. Just when she’d grown used to the idea that she had an extremely rare and untreatable skin condition, one dermatologist, after a quick exam, told her that she had a classic (and common) case of eczema and explained that it often appears differently on darker skin. Her experience stuck with her, making her wonder whether other medical conditions might be going undiagnosed in darker-skinned people and whether racism could, in fact, make people sick.

The pandemic taught us that diseases like Covid disproportionately affect people of color. Here, Liverpool goes a step further to show that this disparity exists for all types of illness and that it is caused by racism. In Systemic, Liverpool shares her journey to show how racism, woven into our societies, as well as into the structures of medicine and science, is harmful to our health. Refuting the false belief that there are biological differences between races, Liverpool goes on to show that racism-related stress and trauma can however, lead to biological changes that make people of color more vulnerable to illness, debunking the myth of illness as the great equalizer.

From the problem of racial bias in medicine where the default human subject is white, to the dangerous health consequences of systemic racism, from the physical and psychological effects of daily microaggressions to intergenerational trauma and data gaps, Liverpool reveals the fatal stereotypes that keep people of color undiagnosed, untreated, and unsafe, and tells us what we can do about it.
In the spirit of Medical Apartheid and Killing the Black Body; A science-based, data-driven, and global exploration of racial disparities in health care access by virologist, immunologist, and...

Advance Praise

"Layal Liverpool has produced a work of towering importance that will undoubtedly change science and save lives, but it will also change the way you see yourself and the people around you. Systemic is beautifully written and scholarly but perhaps almost uniquely for such a book it is deeply personal and accessible, packed with compelling stories and fascinating details which are harnessed to make an impassioned argument for a better world." —Chris Van Tulleken, NYT bestselling author of Ultra-Processed People

"Layal Liverpool has produced a work of towering importance that will undoubtedly change science and save lives, but it will also change the way you see yourself and the people around you. Systemic...


Marketing Plan

MARKETING AND PUBLICITY PLANS • Cover reveal on Astra House’s social media channels • Major national and regional media campaign including print, online, radio, TV, and podcasts • Pitch first serial to national general-interest publication as well as by-lined Op Eds in major newspapers in advance of publication, feature stories, and profiles • Extensive book club and library outreach • Target outreach to Black-interest, science, women’s interest, and health reporters and publications, as well as high profile influencers who have been vocal about health inequity • Academic and nonprofit outreach • ARC giveaways

MARKETING AND PUBLICITY PLANS • Cover reveal on Astra House’s social media channels • Major national and regional media campaign including print, online, radio, TV, and podcasts • Pitch first...


Available Editions

EDITION Other Format
ISBN 9781662601675
PRICE $30.00 (USD)
PAGES 320

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Featured Reviews

I am currently writing a review for Rain Taxi....this should be coming out later in the year.. The work is quite good, going in directions that I did not think of. I am impressed by the critical thinking of the the writer...Liverpool thinks outside of the box, and I appreciate that as a reader. More to come.

DOUG

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This book is so good

Everyone should read this book


At first, I was a bit scared because of the medical aspect that it might be too technical or difficult to understand, but that was absolutely not the case.
Everything in this book is well explained, with concrete examples that make even the most precise biological concepts easy to grasp.

I learned so much. I was already aware of many of the racist ideas that still exist in medicine (especially in gynecology and about pregnancy and births), but there are so many other things I didn't know (probably some naivety on my part that made it feel so shocking how many criteria for diagnosis are still based on assumptions and racist ideas that have zero basis in science or reality).

I recommend this book to everyone but specifically to anyone working in the broad field of healthcare and medicine, because it is SO important to check your bias and to be well informed, to know how to challenge racist ideas (even and especially if they're what you were thought in school / by other doctors).


Thank you NetGalley and Astra Publishing House for the opportunity to read this ARC.

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Systemic is a must-read for anyone working on the front lines in healthcare or medical education. The references to current events as well as the COVID pandemic made the content that much more impactful and relevant. As a medical educator who has extensively studied and teaches in the social determinants of health, I am so impressed with this book. It reads like a scientific paper— which is so appropriate! I plan to share this with my students as soon as it is published!

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Illuminating and academic delve into systemic racism in an accessible way. This book challenges readers to think critically and evaluate the world around them, to see and identify racism in science, research, and treatment in the medical field. Racism is so pervasive, that the manifestation in medical care is a result of living in a white supremacist society that refuses to change. This book is a must-read for everyone, even if you are uninvolved in the medical field. There is so much for everyone to learn, from understanding the existing stereotypes and barriers that Black people, and other people of color, face when they need healthcare, to understanding where these originate and continue to perpetuate in research and scientific spaces. Anyone working, or with an understanding of, science and research in any field will benefit from this book and should also look at their own institutions/fields to reflect.

I received a free ARC via NetGalley for this book. Thank you to the publisher and author!

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I'm going to make a rather odd suggestion up front: start with the conclusion. What an excellent wrap-up that effectively delivers all one needs to know about the goals and contributions of this text.

Let me also suggest a term that summarizes a lot of what Liverpool aims to highlight here, but with greater specificity than the unfortunately vague "systemic": medlining. Sadly, I can't say I've coined the term, as a Google Search points me to a 1998 article (https://www.washingtonpost.com/wp-srv/business/longterm/ethics/medlining.htm). The basic idea comes from redlining, or the practice of discrimination by way of caging in our out certain people based on perceived belonging to certain social groups, especially race. Redlining is about space, especially living spaces like neighbourhoods. Medlining is about medical practice: not physical offices or hospitals or care facilities, but structures embedded in the system, including tools used to make decisions about health, based on discriminatory notions about social identities, notably, again, race.

Liverpool is a wonderful science writer for the lay reader. She backs up her claims with academic research and other quality sources, while at the same time writing with clarity for those less in the know. My only wish was more images. The hardest part for me to wrap my head around was about genes and population sampling. I feel like a series of images illustrating how slicing and dicing the population based on (or without) different classifications, such as race, would have made it much easier to grasp.

Liverpool's focus is also narrow, focused largely on Black and White (her choice of capitalization) folks within the Western sphere, and there mostly the US and the UK. This is not so much her fault, given the state of medical research globally. It's kind of a case in point, really. She does try to draw in perspectives and research from other areas in nuanced ways. For example, how colourism is embodied in Filipinix communities with respect to both anti-Black racism and anti-Indigeneity.

I'd also be remiss to overlook some of Liverpool's more tenuous claims, like the association between perceived lifetime discrimination and dementia. This is a classic case of confusing correlation with causation. As an Oxford Ph.D., she should know better than to conclude to her lay audience that "racism clearly afects* our biology."

* Finally, there was some oddities in the text, like all cases of doubling being singular, e.g., f instead of ff. Perhaps this was an issue in the galley version.

Overall, a wonderful read, evidence-based, humane, and mightily convincing.

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Very well-written and clear - exactly what I was looking for at the perfect meeting of an academic exploration that does not require one to be an expert in the topic to understand. I applaud Liverpool for making this such an accessible piece. I don't very often read non-fiction because I tire of the way some authors almost make it a competition to make the information difficult to process. Not this book.

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This book is fantastic.
I have previously read numerous books on racism in healthcare, and other forms of discrimination in healthcare such as sexism - and this is one of the best. Racism in healthcare is a truly fatal problem that we must prioritise. Every year people fall ill and suffer due to society’s racism. This book proves just how systemic and deeply embedded racism is within society. I found the chapter on race-based medicine particularly interesting and shocking, as I had no idea how many areas of medicine adjust results due to race.
Thank you very much for the copy of this book, I highly recommend it

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Wow. People always have needed, and always will need, doctors, healthcare, hospitals, nurses, medicine, carers- The list goes on. And ever since the beginning of human history, we have worked hard to improve how we treat ourselves. We’ve developed medicines, pain killers, disinfectants, new technologies, vaccines, surgical techniques. And more recently we’ve began enhancing the way we provide healthcare with AI, while paying more attention than ever to mental health, neurodivergence, therapies, and more diverse diagnosis. You’d think that with so much improvement, the healthcare system, above all else, would be the least discriminatory when it comes to the race of the human being.

Turns out that’s not really the case. This book has never been more relevant.

In this book, Liverpool presents us with an incredibly important documentation of how racism systematically manifests itself into the healthcare system across the world, delving into stories from people all across the world, and dismantling the ever-living racist science and stereotypes practiced by doctors and medical schools worldwide.

This book is a must read for everyone, however I especially recommend it for those going into healthcare (ANY area in healthcare), as well as social sciences and politics. We all need to be aware of just how common and systemic the racism in our healthcare system really is, in order to dismantle and remove it completely.

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In "Systemic," Layla Liverpool, a science journalist and former biomedical researcher, bridges together her scientific expertise and journalistic acumen to shed light on the intricate ways racism manifests in our health systems and impacts individuals across the globe. Liverpool encourages readers to reflect on the broader implications of systemic racism on individual well-being and societal health. Her book provides a valuable resource for readers who seek to deepen their understanding of the complex interplay between race, health, and the systems that shape our lives. "Systemic" is a must-read for anyone committed to promoting health equity and dismantling the structures that perpetuate racial disparities in our societies. Liverpool's blend of scientific rigor, journalistic insight, and personal stories makes this upcoming release an essential addition to the conversation on racism and health.

Liverpool's background in virology and immunology adds a unique layer of depth to her exploration of the health gaps existing between racial and ethnic groups globally. She traces these disparities from pregnancy through early life and across the lifespan, providing a comprehensive examination of the systemic roots that perpetuate health inequities. The book explores the often-overlooked connection between health care disparities and the lived experiences of marginalized communities globally.

I appreciated Liverpool's meticulous examination of how racism is not only a social issue but a deeply ingrained health concern. She elucidates how systemic racism is internalized in the body, influencing health outcomes and exacerbating existing disparities. Liverpool goes beyond mere observation, dissecting the structural underpinnings of societies that deny equal access to a healthy living environment. Being from The Bronx where environmental injustice is a major issue this aspect of the book spoke powerfully to me. Her exploration of racism in the medical field, and how it reinforces existing inequities, is also particularly insightful.

As a black woman who navigated pregnancy during the tumultuous year of 2020 and faced the challenges of a COVID-positive status during my fourth trimester, I deeply appreciated the personal stories shared in this text. The inclusion of Serena Williams' testimony about her experience with pulmonary embolisms post-childbirth resonates profoundly, highlighting the systemic failures that disproportionately affect Black women's health.

Thank you to the author and publisher for the e-arc copy!

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Thank you, NetGalley and Astra Publishing House for this advanced readers copy. This book needs to be required reading in every health class, public health program, medical School curriculum. I was aware of some of things brought up by this author as I am nurse working in women’s health for many years, but many of the topics written about were new. Racism touches EVERY aspect of life and health of men, women and children. We need to do better in how we care for people, the research studies that are conducted and the resources provided. Do better! We are all human. Thank you Layal Liverpool for showing what changes have been made recently, but just how far we still have to go.

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