Under the Skin
The Hidden Toll of Racism on American Lives and on the Health of Our Nation
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Narrated by:
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Karen Chilton
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By:
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Linda Villarosa
About this listen
PULITZER PRIZE FINALIST • "A stunning exposé of why Black people in our society 'live sicker and die quicker'—an eye-opening game changer."—Oprah Daily
From an award-winning writer at the New York Times Magazine and a contributor to the 1619 Project comes a landmark book that tells the full story of racial health disparities in America, revealing the toll racism takes on individuals and the health of our nation.
In 2018, Linda Villarosa's New York Times Magazine article on maternal and infant mortality among Black mothers and babies in America caused an awakening. Hundreds of studies had previously established a link between racial discrimination and the health of Black Americans, with little progress toward solutions. But Villarosa's article exposing that a Black woman with a college education is as likely to die or nearly die in childbirth as a White woman with an eighth grade education made racial disparities in health care impossible to ignore.
Now, in Under the Skin, Linda Villarosa lays bare the forces in the American health-care system and in American society that cause Black people to “live sicker and die quicker” compared to their White counterparts. Today's medical texts and instruments still carry fallacious slavery-era assumptions that Black bodies are fundamentally different from White bodies. Study after study of medical settings show worse treatment and outcomes for Black patients. Black people live in dirtier, more polluted communities due to environmental racism and neglect from all levels of government. And, most powerfully, Villarosa describes the new understanding that coping with the daily scourge of racism ages Black people prematurely. Anchored by unforgettable human stories and offering incontrovertible proof, Under the Skin is dramatic, tragic, and necessary listening.
©2022 Linda Villarosa (P)2022 Random House AudioListeners also enjoyed...
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Critic reviews
PULITZER PRIZE FINALIST
ONE OF THE BEST BOOKS OF THE YEAR: The New York Times, The Atlantic, NPR, The Washington Post, TIME, Harvard Public Health, Publishers Weekly, BookPage • J. Anthony Lukas Book Prize Winner • NYPL Bernstein Award for Excellence in Journalism Finalist
“Brilliant, illuminating. . . Meticulously researched, sweeping in its historical breadth, damning in its clear-eyed assessment of facts and yet hopeful in its outlook, Under the Skin is a must-read for all who affirm that Black lives matter.”—The Washington Post
“Singular and expansive. . . In this eminently admirable book, there are no easy answers or platitudes.”—The New York Times Book Review
“Perhaps one of the most important and thought-provoking publications of the year is Linda Villarosa’s groundbreaking Under the Skin. . . It’s a stunning exposé of why Black people in our society 'live sicker and die quicker'—an eye-opening game changer.”—Oprah Daily
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Ugh, so boring
- By Maranto on 05-13-19
By: Ann Neumann
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Epic Measures
- One Doctor. Seven Billion Patients.
- By: Jeremy N. Smith
- Narrated by: Patrick Lawlor
- Length: 10 hrs and 12 mins
- Unabridged
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Moneyball meets medicine in this remarkable chronicle of one of the greatest scientific quests of our time - the groundbreaking program to answer the most essential question for humanity: How do we live and die? - and the visionary mastermind behind it.
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Fabulously insightful read!
- By Dr. Jack E. Fincham on 10-08-15
By: Jeremy N. Smith
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Changing the Way We Die
- Compassionate End-of-Life Care and the Hospice Movement
- By: Sheila Himmel, Fran Smith
- Narrated by: Coleen Marlo
- Length: 6 hrs and 49 mins
- Unabridged
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There’s a quiet revolution happening in the way we die. More than 1.5 million Americans a year die in hospice care - nearly 44 percent of all deaths - and a vast industry has sprung up to meet the growing demand. Once viewed as a New Age indulgence, hospice is now a $14 billion business and one of the most successful segments in health care. Changing the Way We Die, by award-winning journalists Fran Smith and Sheila Himmel, is the first book to take a broad, penetrating look at the hospice landscape.
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Sadly, not very engaging.
- By Debra S. Long on 06-16-18
By: Sheila Himmel, and others
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The Organ Thieves
- The Shocking Story of the First Heart Transplant in the Segregated South
- By: Chip Jones
- Narrated by: JD Jackson
- Length: 12 hrs and 41 mins
- Unabridged
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In 1968, Bruce Tucker, a Black man, went into Virginia’s top research hospital with a head injury, only to have his heart taken out of his body and put into the chest of a White businessman. Now, in The Organ Thieves, Pulitzer Prize-nominated journalist Chip Jones exposes the horrifying inequality surrounding Tucker’s death and how he was used as a human guinea pig without his family’s permission or knowledge.
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Not your story to tell
- By Bianca S on 11-22-20
By: Chip Jones
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Crazy Like Us
- The Globalization of the American Psyche
- By: Ethan Watters
- Narrated by: Patrick Lawlor
- Length: 8 hrs and 57 mins
- Unabridged
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Performance
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America has been the world leader in generating new mental health treatments and modern theories of the human psyche. We export our psychopharmaceuticals packaged with the certainty that our biomedical knowledge will relieve the suffering and stigma of mental illness. We categorize disorders, thereby defining mental illness and health, and then parade these seemingly scientific certainties in front of the world.
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He is a reporter...
- By Briana on 05-07-18
By: Ethan Watters
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A Bittersweet Season
- Caring for Our Aging Parents - And Ourselves
- By: Jane Gross
- Narrated by: Kate Reading
- Length: 15 hrs and 35 mins
- Unabridged
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In telling the intimate story of caring for her aged and ailing mother, Jane Gross offers indispensable, and often surprising, advice for the rapidly increasing number of adult children responsible for aging parents. Gross deftly weaves the specifics of her personal experience with a comprehensive resource for effectively managing the lives of one's own parents while keeping sanity and strength intact.
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Exceptional, thought-provoking, liberating!
- By Anne on 08-10-11
By: Jane Gross
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Unwell Women
- Misdiagnosis and Myth in a Man-Made World
- By: Elinor Cleghorn
- Narrated by: Hanako Footman
- Length: 14 hrs and 8 mins
- Unabridged
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Performance
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Elinor Cleghorn became an unwell woman 10 years ago. She was diagnosed with an autoimmune disease after a long period of being told her symptoms were anything from psychosomatic to a possible pregnancy. As Elinor learned to live with her unpredictable disease, she turned to history for answers, and found an enraging legacy of suffering, mystification, and misdiagnosis. In Unwell Women, Elinor Cleghorn traces the almost unbelievable history of how medicine has failed women by treating their bodies as alien and other, often to perilous effect.
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Profound Read; A Sincere Stepping Stone to Understanding My Own Why
- By Nicole on 07-23-21
By: Elinor Cleghorn
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The Book of Gutsy Women
- By: Hillary Rodham Clinton, Chelsea Clinton
- Narrated by: Hillary Rodham Clinton, Chelsea Clinton
- Length: 14 hrs and 34 mins
- Unabridged
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Hillary Rodham Clinton and her daughter, Chelsea, share the stories of the gutsy women who have inspired them - women with the courage to stand up to the status quo, ask hard questions, and get the job done.
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More encyclopedia than book
- By Fountain of Chris on 10-09-19
By: Hillary Rodham Clinton, and others
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To Repair the World
- Paul Farmer Speaks to the Next Generation
- By: Paul Farmer, Bill Clinton - foreword, Jonathan Weigel - editor
- Narrated by: Joe Barrett, David Ledoux, Kevin T. Collins
- Length: 8 hrs and 58 mins
- Unabridged
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Here, for the first time, is a collection of short speeches by the charismatic doctor and social activist Paul Farmer. One of the most passionate and influential voices for global health equity and social justice, Farmer encourages young people to tackle the greatest challenges of our times. Engaging, often humorous, and always inspiring, these speeches bring to light the brilliance and force of Farmer's vision in a single, accessible volume.
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Resist the Impoverishment of Aspiration
- By Susie on 05-14-13
By: Paul Farmer, and others
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Medical Apartheid
- The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present
- By: Harriet A. Washington
- Narrated by: Ron Butler
- Length: 19 hrs and 2 mins
- Unabridged
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Overall
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Performance
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Story
Medical Apartheid is the first and only comprehensive history of medical experimentation on African Americans. Starting with the earliest encounters between black Americans and Western medical researchers and the racist pseudoscience that resulted, it details the ways both slaves and freedmen were used in hospitals for experiments conducted without their knowledge - a tradition that continues today within some black populations.
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Sobering... but necessary.
- By Dr. Pepper on 10-27-16
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Clean
- Overcoming Addiction and Ending America’s Greatest Tragedy
- By: David Sheff
- Narrated by: Jeff Cummings
- Length: 13 hrs and 30 mins
- Unabridged
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Overall
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Performance
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Story
Addiction is a preventable, treatable disease, not a moral failing. As with other illnesses, the approaches most likely to work are based on science - not on faith, tradition, contrition, or wishful thinking. These facts are the foundation of Clean, a myth-shattering look at drug abuse by the author of Beautiful Boy. Based on the latest research in psychology, neuroscience, and medicine, Clean is a leap beyond the traditional approaches to prevention and treatment of addiction.
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Unbearable narration
- By John on 09-10-14
By: David Sheff
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Dirty Work
- Essential Jobs and the Hidden Toll of Inequality in America
- By: Eyal Press
- Narrated by: Neil Shah
- Length: 11 hrs and 18 mins
- Unabridged
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Story
Drone pilots who carry out targeted assassinations. Undocumented immigrants who man the "kill floors" of industrial slaughterhouses. Guards who patrol the wards of America's most violent and abusive prisons. In Dirty Work, Eyal Press offers a paradigm-shifting view of the moral landscape of contemporary America through the stories of people who perform society's most ethically troubling jobs. As Press shows, we are increasingly shielded and distanced from an array of morally questionable activities that other, less privileged people perform in our name.
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A Must Read for Conservatives
- By Nice guy on 11-05-21
By: Eyal Press
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Bellevue
- Three Centuries of Medicine and Mayhem at America's Most Storied Hospital
- By: David Oshinsky
- Narrated by: Fred Sanders
- Length: 14 hrs and 41 mins
- Unabridged
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Performance
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Story
David Oshinsky, whose last book, Polio: An American Story, was awarded a Pulitzer Prize, chronicles the history of America's oldest hospital and in so doing also charts the rise of New York to the nation's preeminent city, the path of American medicine from butchery and quackery to a professional and scientific endeavor, and the growth of a civic institution.
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Fascinating
- By Jean on 12-14-16
By: David Oshinsky
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Nobody Knows the Trouble I’ve Seen
- The Emotional Lives of Black Women
- By: Inger Burnett-Zeigler
- Narrated by: Adenrele Ojo
- Length: 7 hrs and 47 mins
- Unabridged
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Overall
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Performance
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Story
Black women are beautiful, intelligent, and capable - but mostly they embrace strong. Esteemed clinical psychologist Dr. Inger Burnett-Zeigler praises the strength of women while exploring how trauma and adversity have led to deep emotional pain and shaped how they walk through the world.
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Amazing!
- By charlene lindsey on 09-08-21
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A “fascinating psychological thriller” (Baltimore Sun), this entrancing novel introduces Isserley, a female driver who scouts the Scottish Highlands for male hitchhikers with big muscles. She herself is tiny - like a kid peering up over the steering wheel. Scarred and awkward, yet strangely erotic and threatening, Isserley listens to her passengers as they open up to her, revealing clues about who might miss them should they disappear - and then she strikes. What happens to her victims next is only part of a terrifying reality.
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Ugghh -- Seriously Awful
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Chapter 3 was excellent
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The New Middle East
- What Everyone Needs to Know®
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Legacy
- A Black Physician Reckons with Racism in Medicine
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Growing up in Brooklyn, New York, it never occurred to Uché Blackstock and her twin sister, Oni, that they would be anything but physicians. In the 1980s, their mother headed an organization of Black women physicians, and for years the girls watched these fiercely intelligent women in white coats tend to their patients and neighbors, host community health fairs, cure ills, and save lives.
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Hit home
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Torn Apart
- How the Child Welfare System Destroys Black Families--and How Abolition Can Build a Safer World
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Many believe the child welfare system protects children from abuse. But as Torn Apart uncovers, this system is designed to punish Black families. Drawing on decades of research, legal scholar and sociologist Dorothy Roberts reveals that the child welfare system is better understood as a “family policing system” that collaborates with law enforcement and prisons to oppress Black communities. Child protection investigations ensnare a majority of Black children, putting their families under intense state surveillance and regulation.
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Important to Read. Unfinished Work.
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How the Word Is Passed
- A Reckoning with the History of Slavery Across America
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Beginning in his hometown of New Orleans, Clint Smith leads the listener on an unforgettable tour of monuments and landmarks—those that are honest about the past and those that are not—that offer an intergenerational story of how slavery has been central in shaping our nation's collective history, and ourselves.
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Sincerely grateful read
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By: Clint Smith
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Under the Skin
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A “fascinating psychological thriller” (Baltimore Sun), this entrancing novel introduces Isserley, a female driver who scouts the Scottish Highlands for male hitchhikers with big muscles. She herself is tiny - like a kid peering up over the steering wheel. Scarred and awkward, yet strangely erotic and threatening, Isserley listens to her passengers as they open up to her, revealing clues about who might miss them should they disappear - and then she strikes. What happens to her victims next is only part of a terrifying reality.
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Ugghh -- Seriously Awful
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Weathering
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Dr. Arline T. Geronimus coined the term “weathering” to describe the effects of systemic oppression—including racism and classism—on the body. In Weathering, based on more than 30 years of research, she argues that health and aging have more to do with how society treats us than how well we take care of ourselves. She explains what happens to human bodies as they attempt to withstand and overcome the challenges and insults that society leverages at them, and details how this process ravages their health. And she proposes solutions.
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Chapter 3 was excellent
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By: James L. Gelvin
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Legacy
- A Black Physician Reckons with Racism in Medicine
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Hit home
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Torn Apart
- How the Child Welfare System Destroys Black Families--and How Abolition Can Build a Safer World
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- Narrated by: Dorothy Roberts, Janina Edwards
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Many believe the child welfare system protects children from abuse. But as Torn Apart uncovers, this system is designed to punish Black families. Drawing on decades of research, legal scholar and sociologist Dorothy Roberts reveals that the child welfare system is better understood as a “family policing system” that collaborates with law enforcement and prisons to oppress Black communities. Child protection investigations ensnare a majority of Black children, putting their families under intense state surveillance and regulation.
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Important to Read. Unfinished Work.
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How the Word Is Passed
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Sincerely grateful read
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Speak, Okinawa
- A Memoir
- By: Elizabeth Miki Brina
- Narrated by: Sachi Lovatt
- Length: 8 hrs and 29 mins
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Elizabeth's mother was working as a nightclub hostess on US-occupied Okinawa when she met the American soldier who would become her husband. The language barrier and power imbalance that defined their early relationship followed them to the predominantly white, upstate New York suburb where they moved to raise their only daughter. There, Elizabeth grew up with the trappings of a typical American childhood and adolescence. Yet even though she felt almost no connection to her mother's distant home, she also felt out of place among her peers.
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Excellent!!
- By noriko s. cuaron on 03-03-21
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Before the Streetlights Come On
- Black America's Urgent Call for Climate Solutions
- By: Heather McTeer Toney
- Narrated by: Karan Kendrick
- Length: 6 hrs and 31 mins
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In Before the Streetlights Come On, climate activist Heather McTeer Toney insists that those most affected by climate change are best suited to lead the movement for climate justice. McTeer Toney brings her background in politics, community advocacy, and leadership in environmental justice to this revolutionary exploration of why and how Black Americans are uniquely qualified to lead national and global conversations around systems of racial disparity and solutions to the climate crisis.
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Invisible Child
- Poverty, Survival & Hope in an American City
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Andrea Elliott follows eight dramatic years in the life of Dasani, a girl whose imagination is as soaring as the skyscrapers near her Brooklyn shelter. In this sweeping narrative, Elliott weaves the story of Dasani’s childhood with the history of her ancestors, tracing their passage from slavery to the Great Migration north. As Dasani comes of age, New York City’s homeless crisis has exploded, deepening the chasm between rich and poor. She must guide her siblings through a world riddled by hunger, violence, racism, drug addiction, and the threat of foster care.
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Narration is completely over the top
- By Heather on 10-14-21
By: Andrea Elliott
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Time
- The Untold Story of the Love That Held Us Together When Incarceration Kept Us Apart
- By: Fox Richardson, Rob Richardson, Sister Helen Prejean - foreword
- Narrated by: Fox Richardson, Rob Richardson
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The twenty-one years that kept Rob separated from his wife, Fox, and their six sons was long enough. As Rob survived two decades at America's bloodiest penitentiary and Fox raised their sons solo, they never stopped fighting for Rob's freedom and for their futures against the statistical odds. All the while, it was love that carried them through.
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A wonderful portrayal of authentic love
- By Anonymous User on 02-28-23
By: Fox Richardson, and others
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A Bigger Picture
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Leading climate justice activist Vanessa Nakate brings her fierce, fearless spirit, new perspective, and superstar bona fides to the biggest issue of our time. In A Bigger Picture, her first book, she shares her story as a young Ugandan woman who sees that her community bears disproportionate consequences to the climate crisis. At the same time, she sees that activists from African nations and the global south are not being heard in the same way as activists from white nations are heard.
By: Vanessa Nakate
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We Cry Justice
- Reading the Bible with the Poor People's Campaign
- By: William J. Barber II - foreword, Liz Theoharis - editor
- Narrated by: Kim Niemi
- Length: 6 hrs and 4 mins
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Overall
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Performance
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From Genesis to Revelation, the Bible proclaims justice and abundance for the poor. Yet these powerful passages about poverty are frequently overlooked and misinterpreted. Enter the Poor People's Campaign, a movement against racism, poverty, ecological devastation, militarism, and religious nationalism. In We Cry Justice, Liz Theoharis, co-chair of the campaign, is joined by pastors, community organizers, scholars, low-wage workers, lay leaders, and people in poverty to interpret sacred stories about the poor seeking healing, equity, and freedom.
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We Cry Justice
- By Anonymous User on 06-03-24
By: William J. Barber II - foreword, and others
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Black Fatigue
- How Racism Erodes the Mind, Body, and Spirit
- By: Mary-Frances Winters
- Narrated by: Robin Miles
- Length: 6 hrs and 34 mins
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Overall
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Performance
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This is the first book to define and explore Black fatigue, the intergenerational impact of systemic racism on the physical and psychological health of Black people - and explain why and how society needs to collectively do more to combat its pernicious effects.
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Great Book— For Certain Audience
- By Taylor on 05-06-21
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America's Bitter Pill
- Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Healthcare System
- By: Steven Brill
- Narrated by: Dan Woren
- Length: 17 hrs and 10 mins
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Overall
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Performance
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Story
America’s Bitter Pill is Steven Brill’s acclaimed book on how the Affordable Care Act, or Obamacare, was written, how it is being implemented, and, most important, how it is changing—and failing to change—the rampant abuses in the healthcare industry. It’s a fly-on-the-wall account of the titanic fight to pass a 961-page law aimed at fixing America’s largest, most dysfunctional industry. It’s a penetrating chronicle of how the profiteering that Brill first identified in his trailblazing Time magazine cover story continues, despite Obamacare.
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Great history, questionable solutions
- By Andrew S. Breza on 01-14-15
By: Steven Brill
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Mediocre
- The Dangerous Legacy of White Male America
- By: Ijeoma Oluo
- Narrated by: Ijeoma Oluo
- Length: 10 hrs and 1 min
- Unabridged
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Overall
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Performance
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Story
Through the last 150 years of American history—from the post-reconstruction South and the mythic stories of cowboys in the West, to the present-day controversy over NFL protests and the backlash against the rise of women in politics—Ijeoma Oluo exposes the devastating consequences of white male supremacy on women, people of color, and white men themselves. Mediocre investigates the real costs of this phenomenon in order to imagine a new white male identity, one free from racism and sexism.
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This was so enlightening.
- By Firewhiskey Reader on 01-07-21
By: Ijeoma Oluo
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Last Days
- By: Brian Evenson
- Narrated by: Chris Patton
- Length: 6 hrs and 17 mins
- Unabridged
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Overall
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Performance
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Story
Still reeling from a brutal dismemberment, detective Kline is forcibly recruited to solve a murder inside a religious cult that takes literally the New Testament idea that you should cut off your hand if it offends you. Armed only with his gun, his wits, and a gift for self-preservation, Kline must navigate a gauntlet of lies, threats, and misinformation. All too soon he discovers that the stakes are higher than he thought and that his survival depends on an act of sheer will.
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Red Harvest for the 21st Century
- By Joe Kraus on 10-04-17
By: Brian Evenson
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Medical Apartheid
- The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present
- By: Harriet A. Washington
- Narrated by: Ron Butler
- Length: 19 hrs and 2 mins
- Unabridged
-
Overall
-
Performance
-
Story
Medical Apartheid is the first and only comprehensive history of medical experimentation on African Americans. Starting with the earliest encounters between black Americans and Western medical researchers and the racist pseudoscience that resulted, it details the ways both slaves and freedmen were used in hospitals for experiments conducted without their knowledge - a tradition that continues today within some black populations.
-
-
Sobering... but necessary.
- By Dr. Pepper on 10-27-16
-
Killing the Black Body
- Race, Reproduction, and the Meaning of Liberty
- By: Dorothy Roberts
- Narrated by: Shayna Small
- Length: 14 hrs and 38 mins
- Unabridged
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Overall
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Performance
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Story
This is a no-holds-barred response to the liberal and conservative retreat from an assertive, activist, and socially transformative civil rights agenda of recent years - using a Black feminist lens and the issue of the impact of recent legislation, social policy, and welfare "reform" on Black women's - especially poor Black women's - control over their bodies' autonomy and their freedom to bear and raise children with respect and dignity in a society whose white mainstream is determined to demonize, even criminalize their lives.
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Terribly sad but very informative. Highly recommend.
- By Jaecey Adams on 01-17-21
By: Dorothy Roberts
What listeners say about Under the Skin
Average customer ratingsReviews - Please select the tabs below to change the source of reviews.
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- Otis Anderson III
- 07-27-22
Greatness exemplified
Excellent research with a true interaction of human experience. She tells the TRUTH!!! It is a pleasure to hear a full narrative
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- shopper
- 07-21-22
A Must Read
Loved this book. So much has been explained. Really tore off the band aid
and exposed all the disparities
I have always been a fan of Ms Villarosa.
The narration is perfection
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- Kaleemah B.
- 12-31-22
Eye Opening and Validation of what I feel about access to healthcare.
The book was eye opening & a validation for me that as a black person in America if you’re not educated and have access to 4-5 star health insurance you will be tossed to the wolves. Health is Wealth isn’t just a saying in my Community. It can be a matter of life or death.
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- Robert S. Becker
- 07-23-22
Astonishing
Like Elizabeth Rosenthal, Linda Villarosa makes an irrefutable argument that American healthcare is broken. Her theme is racial health disparities but the problems she describes affect individuals of all types. The text is sometimes repetitive and the performance is sometimes monotonous, but the story is always vital and engrossing.
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- Anonymous 1958
- 01-26-23
This should be required reading for all healthcare professionals
This should be required reading for all healthcare professionals and there needs to be similar reading for all teachers no matter their race, because bias can be against your own race as well.
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- Aiman Tulaimat
- 12-15-23
Personal stories
The book is a good survey of the effect of racism on the health of black Americans. It does not provide solutions to me. That means that the solution for this problem is a large societal endeavor and part of civil resistance and action against racism at large.
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- Victor Manuel Frausto
- 12-08-22
Narration was the best
I would recommend this to everyone specially public health students to learn more about racism in public health.
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- D. Fyler
- 02-01-23
An important book
I read the author’s original sentinel article on blk maternal mortality in the NYT magazine. That article really raised awareness of the issues of implicit bias in health care and how it effects patients ( in a very bad way for blk folk). This book is that article fleshed out to book length with more information on how health outcomes are effected on blk folk as a whole. Definitely not pleasant reading but if you are looking for lighthearted entertainment you wouldn’t be reading this book anyway.
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- Adam Avakian
- 01-13-23
Amazing writing. Ridiculous cast.
Signed up for Audible plus just for this and I'm so glad I did. Hoping for a lot more stories like this! Going to go listen again now.
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- Barbara Kuhn
- 11-15-22
Excellent
Heartbreaking Honest Painful However we need to admit to our past and get to real work on a better future We need to stop kidding ourselves about how great America is because we’re behind dozens of better performing countries and it’s not because we’re being taken advantage of It’s because we want to hold on to Jim Crow if not actual 1700s slavery
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