Podcast Summary: New Books Network

Episode: Joseph L. Graves Jr., "Why Black People Die Sooner: What Medicine Gets Wrong about Race and How to Fix It"
Date: December 14, 2025
Host: Stephen Pimpair
Guest: Joseph L. Graves Jr.

Overview

In this episode of the New Books Network's Public Policy Channel, host Stephen Pimpair interviews Joseph L. Graves Jr., author of Why Black People Die Sooner: What Medicine Gets Wrong About Race and How to Fix It. The discussion dives into the persistent disparities in life expectancy between Black and white Americans, debunks genetic explanations for these differences, and explores how medicine, public health, and society erroneously racialize disease. Graves also addresses the intertwined histories and futures of race, medical science, structural racism, capitalism, and policy—ultimately calling for systemic transformation to combat these injustices.

About the Author and Motivation for the Book

• Background:

  • Graves is the Mackenzie Scott Endowed Professor of Biology at North Carolina A&T State University.
  • He has spent decades studying racial thinking and health disparities ([02:36]).

• Purpose:

  • The book aims to confront damaging misconceptions about race, genetics, and health:

    “Genetic differences between persons of European and African descent are actually minuscule and certainly not large enough to account for the massive disparities we see in patterns of morbidity and mortality... Genetics doesn't explain it.”
    —Joseph L. Graves Jr. [03:35]

Key Discussion Points & Insights

Life Expectancy Disparities

• Life expectancy gaps have narrowed over the past century but remain at 4-5 years between Black and white Americans ([03:35]).
• These disparities are not due to inherent genetic differences.

Historical Context: Race, Science, and Disease

• Origins of Racial Explanations:
  • Early European Christian thought linked skin color and inferiority to divine origins.
  • 18th and 19th-century “science” viewed people of African descent as an inferior species, created to serve Europeans ([05:16]).
• Shift to Modern Science:
  • Darwin’s work and later research established that human genetic diversity is real but cannot justify racial categories or explain health disparities.

    “By the late 20th century, we had established that there’s geographically based genetic variation, but not enough to apportion people into biological races.”
    —Joseph L. Graves Jr. [07:20]

  • Modern evolutionary theory refutes genetic bases for existing differences in death and disease rates.

Debunking Racialization of Diseases

• Sickle Cell Anemia:
  • Misconception: Sickle cell is a “Black” or “African” disease
  • Reality: The sickle cell trait provides malaria resistance and is distributed widely in globally malaria-endemic zones, not just Africa ([08:58]).

    “If, for example, slavery had brought people from Yemen to the United States to be slaves, then we would have thought of it as a Yemeni disease, not an African disease.”
    —Joseph L. Graves Jr. [08:58]

• Hypertension:
  • Misconception: Higher hypertension in Black Americans has genetic roots
  • Reality: This belief, formed in the 1930s, fails under scrutiny.
  • There is more hypertension-risk genetics in European Americans—not African Americans.
  • The conviction tied to transatlantic slavery and “salt retention” is also unfounded ([12:00]).

    "The idea that the sickle cell trait is a black or African disease is fundamentally wrong."
    —Joseph L. Graves Jr. [09:54] "When we look at the genomic underpinnings of hypertension, there’s actually a greater frequency of the hypertension risk alleles in Europeans in Euro Americans than there are African Americans."
    —Joseph L. Graves Jr. [13:30]

Social and Environmental Causes

• Stress and Diet:
  • Chronic stress from racism and dietary factors drive hypertension rates, not genetics ([14:38]).

    “In a society that is racialized, people who are victims of that racial oppression are going to have more day to day bombardment of things that will elevate their blood pressure.”
    —Joseph L. Graves Jr. [14:38]

• Beyond Poverty:
  • Poverty explains some differences, but racism independently raises morbidity even among middle-class and professional Black Americans ([15:30]).

COVID-19 and Modern Racial Disparities

• Early COVID-19 impact:
  • Grave’s early predictions: Black and brown communities would be hardest hit due to living and working conditions ([16:34]).
  • Factors included essential work, crowded housing, public transit reliance, and effects of redlining in cities like New York ([19:34]).

    “One of the strongest predictors of SARS CoV2 transmission and infection rates were former redline communities.”
    —Joseph L. Graves Jr. [20:53]

• Broader labor market structure:
  • Disparities driven by social stratification and economic necessity, not “race” per se ([18:53]).

Race, Capitalism, and Potential Solutions

• Racial Capitalism:
  • US capitalism is inextricably linked to racial exploitation.
  • While some argue for reforming capitalism to address racial disparities, Graves is skeptical:

    “It’s not necessary that racism is associated with capitalism, but it was rooted at the very beginning of the society. It’s not going anywhere.”
    —Joseph L. Graves Jr. [21:43]

• Systemic Change:
  • Proposes moving toward collective solutions and a more socialist approach, citing the Nordic welfare states’ success ([21:43–24:37]).
  • Warns of Americans’ misconceptions about socialism, equating it only with negative historical examples.

Solidarity, Immigration, and Global Inequality

• Immigration and Welfare States:
  • Rising migration does strain social solidarity, not necessarily because of race but due to visible difference and social pressure ([25:39]).

    “If they were, for example, northern Germans migrating to Sweden and Norway... it would be harder to identify who’s an immigrant and who isn’t... that influx of immigration puts taxes on the social system.”
    —Joseph L. Graves Jr. [25:46]

• Necessity of Global Cooperation:
  • Sustainable progress requires acknowledgment of transnational and global inequalities.
  • Climate change and worldwide economic injustice will disproportionately harm poor and racialized groups ([26:50]).

Notable Quotes & Memorable Moments

• On Genetics vs. Social Reality:

  “Genetics doesn’t explain it.”
  —Joseph L. Graves Jr. [03:35]

• On Sickle Cell Anemia:

  “That idea comes into play because the people who had the highest prevalence of sickle cell anemia in the United States and in the UK were people who came from those regions... The idea that the sickle cell trait is a black or African disease is fundamentally wrong.” —Joseph L. Graves Jr. [08:58]

• On Hypertension:

  “There’s actually a greater frequency of the hypertension risk alleles in Europeans in Euro Americans than... African Americans.”
  —Joseph L. Graves Jr. [13:30]

• On Environmental Stress:

  “In a society that is racialized, people who are the victims of that racial oppression are going to have more day to day bombardment of things that will elevate their blood pressure.” —Joseph L. Graves Jr. [14:38]

• On Racial Capitalism:

  “It’s not necessary that racism is associated with capitalism, but it was rooted at the very beginning of the society. It’s not going anywhere.” —Joseph L. Graves Jr. [21:43]

• On the Need for Global Solutions:

  “Most of our problems in the 21st century are no longer local problems ... they’re global problems. The idea that we’re going to be able to have certain societies that maintain a really high standard of living ... while the rest of the world ... is simply not sustainable.” —Joseph L. Graves Jr. [26:50]

Timestamps for Key Segments

• [02:36] – Graves’ background and motivation for the book
• [03:35] – Present-day life expectancy gaps & their lack of genetic explanation
• [05:16–08:42] – History of racialized medical explanations
• [08:58–13:30] – Debunking sickle cell and hypertension as “racial” diseases
• [14:38–15:43] – Environmental/stress causes for health disparities—beyond poverty
• [16:34–21:17] – COVID-19’s racialized impact and historical redlining
• [21:43–24:37] – Racial capitalism and systemic reform
• [25:39–27:45] – Immigration, social solidarity, and global economic challenges

Conclusion

This episode provides a thorough, accessible critique of how medicine misapplies notions of race, stressing that genetics is not responsible for health disparities. Instead, Graves illustrates how enduring structures of racism—intertwined with capitalism—produce and maintain these injustices. Gravely realistic yet hopeful for change, Graves encourages listeners and policymakers alike to confront uncomfortable truths, consider systemic transformation, and embrace collective well-being as the only sustainable path forward.