>>> TONIGHT A NEW RAIL TUNNEL UNDER THE HUDSON IS CONSIDERED THE MOST IMPORTANT INFRASTRUCTURE PROJECT IN THE NATION.

AND IT JUST RECEIVED A NEARLY $300 MILLION BOOST FROM PRESIDENT BIDEN.

SO IS THE FUTURE OF THIS LONG DELAYED TUNNEL CONNECTING NEW YORK AND NEW JERSEY FULL STEAM AHEAD?

"METROFOCUS" STARTS RIGHT NOW.

♪♪ ♪♪ >> THIS IS "METROFOCUS" WITH RAFAEL PI ROMAN, JACK FORD AND JENNA FLANAGAN.

"METROFOCUS" IS MADE POSSIBLE BY SUE AND EDGAR WACHENHEIM III, THE PETER G. PETERSON AND JOAN GANZ COONEY FUND BERNARD AND DENISE SCHWARTZ, BARBARA HOPE ZUCKERBERG AND BY -- >> GOOD EVENING.

WELCOME TO "METROFOCUS."

ON JANUARY 31, PRESIDENT BIDEN CAME TO NEW YORK CITY TO ANNOUNCE A $292 MILLION FEDERAL GRANT TO KICK OFF CONSTRUCTION OF THE LONG DELAYED HUDSON TUNNEL PROJECT.

THE PROJECT, WHICH IS PART OF THE LARGER GATEWAY RAIL INVESTMENT PROGRAM, IS CONSIDERED BY JUST ABOUT EVERY INFRASTRUCTURE EXPERT AS CRITICAL NOT ONLY TO NEW YORK AND NEW JERSEY BUT ALSO TO THE ENTIRE NORTHEAST CORRIDOR REGION.

THAT AMONG OTHER THINGS IS HOME TO 17% OF THE U.S. POPULATION AND CONTRIBUTES 20% OF THE NATION'S GDP.

SO WHAT EXACTLY IS THE HUDSON TUNNEL PROJECT?

WHY HAS THIS CONSTRUCTION BEEN DELAYED FOR OVER A DECADE IF IT IS SO CRITICAL?

IS SENATOR CHUCK SCHUMER RIGHT WHEN HE SAYS THAT THE TUNNEL'S FUTURE IS, QUOTE, FINALLY ASSURED?

JOINING US NOW TO ANSWER THESE AND OTHER QUESTIONS IS THE NEW YORK COMMISSIONER AND CO-CHAIR OF THE BI-STATE GATEWAY DEVELOPMENT COMMISSION, ALICIA GLEN.

WELCOME TO THE PROGRAM.

THANK YOU SO MUCH FOR JOINING US TODAY.

>> THANK YOU FOR HAVING ME.

>> BY THE WAY, I DIDN'T HAVE TIME TO MENTION ALL YOUR RESPONSIBILITIES.

I DO WANT TO SAY THAT YOU ARE THE FOUNDER AND MANAGING PRINCIPAL OF THE REAL ESTATE DEVELOPMENT COMPANY M SQUARED AND SERVE WITH GREAT DISTINCTION AS DEPUTY MAYOR FOR HOUSING AND ECONOMIC DEVELOPMENT IN THE de BLASIO ADMINISTRATION, YOU WERE WITH US BEFORE IN THAT CAPACITY.

WELCOME TO "METROFOCUS."

>> NICE TO SEE YOU AGAIN.

>> COMMISSIONER, FIRST OF ALL, WHAT EXACTLY IS THE HUDSON TUNNEL PROJECT?

WHAT DOES IT ENTAIL?

WHY DO YOU BELIEVE THAT IT'S SO CRITICAL?

TO NEW JERSEY AND NEW YORK AND THE NORTHEAST CORRIDOR REGION.

>> IT REALLY IS.

IT'S INCREDIBLY IMPORTANT TO THE NEW YORK AND NEW JERSEY AND NORTHEAST CORRIDOR.

YOU HIT THE NAIL ON THE HEAD WHICH IS THAT IT'S OF NATIONAL IMPORTANCE.

20% OF THE GDP OF THE COUNTRY COMES FROM THE NEW YORK AND NEW JERSEY METROPOLITAN AREA.

THE IDEA THAT OUR MOST VITAL LINK BETWEEN WASHINGTON, PHILADELPHIA, UP THROUGH NEW YORK INTO BOSTON, COULD BECOME PARALYZED OR REMAIN OUT OF SERVICE FOR ANY PERIOD OF TIME HAS REAL ECONOMIC CONSEQUENCES TO THE NATION, NOT TO MENTION THE CONSEQUENCES THAT IT HAS FOR THE HUNDREDS OF THOUSANDS OF COMMUTERS AND PEOPLE WHO USE INTRA-CITY RAIL EVERY DAY.

THE PROJECT IS A SERIES OF PROJECTS THAT IS KNOWN TO BE AS THE GATEWAY PROJECT.

REALLY, THE CENTERPIECE OF THE PROJECT IS BUILDING A BRAND-NEW STATE-OF-THE-ART TUNNEL UNDER THE HUDSON RIVER.

THE CURRENT TUNNEL -- THOSE OF US WHO ARE NEW YORKERS AND LIKE TO THINK WE KNOW SOMETHING ABOUT HISTORY, THE CURRENT TUNNEL THAT SERVICES AMTRAK AND OVER 800 NEW JERSEY TRANSIT TRAINS A DAY WAS BUILT 113 YEARS AGO.

IF YOU THINK ABOUT THAT, THE HISTORY OF THE UNITED STATES.

THIS TUNNEL IS A VERY AGING PIECE OF INFRASTRUCTURE.

WE NEED TO HAVE A MODERN RAIL SYSTEM.

SO THIS -- THE CENTERPIECE OF GATEWAY IS THE ACTUAL TUNNEL ITSELF.

THERE ARE ANCILLARY PROJECTS ON BOTH SIDES OF THE RIVER THAT WILL IMPROVE CONNECTIVE WITH BRIDGES, ET CETERA.

AT THE END OF THE DAY, BUILDING A NEW TUNNEL AND REHABBING THE OLD TUNNELS BEGINS TO PUT US INTO THE 21st CENTURY.

LET'S BE REAL.

WE NEED TO HAVE MODERN RAIL.

NEW YORKERS AND BUSINESSES IN NEW YORK AND THE REGION DESERVE THAT KIND OF QUALITY OF TRANSPORTATION.

>> BY THE WAY, QUICKLY FOR OUR AUDIENCE, WHAT IS THE ROLE OF THE BI-STATE GATEWAY COMMISSION IN THIS PROCESS?

>> IT IS -- IT'S INTERESTING -- SIMILAR TO THE PORT AUTHORITY.

IT'S THE PORT AUTHORITY OF NEW YORK AND NEW JERSEY WHOSE CHARTER WAS TO BE A BIPARTISAN AND BI-STATE ENTITY THAT COULD REPRESENT BOTH SIDES OF THE RIVER AND TAKE ON LONG AND BIG INFRASTRUCTURE PROJECTS THAT ARE CRITICAL TO THE REGION.

AS YOU KNOW, INFRASTRUCTURE ISN'T ALWAYS SEXY OR WORK ON POLITICAL CYCLES.

I THINK THAT'S ONE OF THE CHALLENGES THAT WE FACE AS A NATION BUT ALSO HERE IN THE REGION, THAT IF YOU HAVE COMPETING INTERESTED WITH DIFFERENT GOVERNORS, DIFFERENT ELECTION CYCLES, AND YOU HAVE ALL THESE FUNDERS, THE FEDERAL GOVERNMENT, STATE GOVERNMENT, CITY, IT GETS VERY HARD TO ACTUALLY MANAGE A PROJECT.

SO CREATING A COMMISSION WHO HAS INDEPENDENT AUTHORITY OVER THIS SO THAT IT CAN SURVIVE THE DURATION OF BUILDING A PROJECT OF THIS COMPLEXITY BUT ALSO HOPEFULLY TRY TO NAVIGATE AND DE-POLITICIZE, IF THAT'S EVEN A CONCEPT THAT WE CAN SAY.

BUT I THINK WE HAVE TO SEE THIS AS NOT A POLITICAL ACTIVITY BUT AS ONE THAT IS FUNDAMENTALLY CRITICAL TO OUR ECONOMY.

>> AS I SAID IN THE INTRODUCTION, PRESIDENT BIDEN CAME TO MANHATTAN AND ANNOUNCED THE $292 MILLION GRANT.

HOW SIGNIFICANT IS THAT FOR THE ENTIRE PROJECT?

IF ONLY PSYCHOLOGICALLY OR FOR MOMENTUM SAKE.

>> ABSOLUTELY, THERE'S A SYMBOLIC PIECE OF THIS.

ONE OF THE PROBLEMS THAT'S BEEN PLAGUING THIS PROJECT FOR THE PAST DECADE HAS BEEN A LOT OF TALKING AND NOT A LOT OF WALKING.

OBVIOUSLY, THE TRUMP YEARS REALLY MADE THIS MUCH MORE DIFFICULT WHEN FOR POLITICAL REASONS AND/OR OTHER STRATEGIC REASONS, THE GOVERNMENT REALLY WITHDREW FROM BEING A PLAYER AT THE TABLE.

YOU HAD THIS PERFECT STORM WHERE YOU HAVE A PRESIDENT WHO IS ACTUALLY KNOWN AS AMTRAK JOE, THIS COMES TO HIM LITERALLY IT IS THE WAY HE HAS EXPERIENCED COMMUTING AND EXPERIENCED THE VITAL IMPORTANCE OF HAVING MODERN INFRASTRUCTURE.

SO FINALLY, WE HAVE AN ALIGNMENT WHEREAS A RESULT OF THE PRESIDENT AND THE CONGRESS'S WORK WITH THE INFRASTRUCTURE BILL AND THE BUILD AMERICA BACK FINANCING, THIS IS ACTUALLY A REAL-LIVE DOWN PAYMENT ON THIS PROJECT.

$300 MILLION IS NOT GOING TO REALLY MAKE A DENT IN THE OVERALL SIZE OF THE PROJECT.

BUT AS YOU KNOW, MOMENTUM MATTERS.

IT'S A REALLY IMPORTANT STEP TO STOP TALKING ABOUT WHETHER OR NOT WE'RE GOING TO BREAK GROUND AND ACTUALLY BREAK GROUND.

I THINK PARTICULARLY WHEN WE ARE GOING TO BE GOING INTO ANOTHER ELECTION CYCLE.

THE GOOD NEWS IS, IF WE DO ALL THE WORK WE'RE DOING RIGHT NOW AND GO THROUGH ALL OF THE APPROVALS THAT WE ARE PUSHING SO HARD TO GET THROUGH REGULATORY AGENCIES, THERE BECOMES AN INEVITABILITY TO IT.

THIS WILL GO TO BUILDING THE CONCRETE CASING.

AT THE END OF THE DAY -- THIS IS WHY NEW YORKERS CARE ABOUT THIS -- IS THAT IT'S ALSO REALLY SAYING TO NEW YORKERS AND PEOPLE IN THE REGION THAT WE ARE GOING TO BE DOING SOMETHING ABOUT PENN STATION, WE'RE GOING TO BE IMPROVING THE QUALITY OF COMMUTERS AND BUSINESSES' LIVES.

THIS IS THE VITAL PIECE.

>> THE ENTIRE PROJECT IS NOW ESTIMATED TO COST AT THE END OF IT $16 BILLION.

HOW MUCH BEYOND THE $292 MILLION THAT HAS BEEN ANNOUNCED HAS THE FEDERAL GOVERNMENT PLEDGED FOR THE PROJECT, OR YOU THINK WILL BE COMMITTING TO THE PROJECT?

>> RIGHT NOW, WE'RE IN THE PROCESS OF GOING THROUGH THE PRELIMINARY RISK ASSESSMENT.

WE SUBMITTED A FINANCIAL PLAN TO THE U.S. GOVERNMENT.

WE ARE ASSUMING AND EXPECTING THE FEDERAL GOVERNMENT WILL PLAY BETWEEN 50% TO 60% OF THE TOTAL PROJECT COST.

IT'S A MOVING NUMBER RIGHT NOW.

I THINK AS NEW YORKERS WE SHOULD BE VERY EXCITED AND HAPPY THAT WE HAVE SENATOR SCHUMER, WHO IS OBVIOUSLY A MASSIVE PROPONENT OF THE PROJECT.

AT THE END OF THE DAY, THIS WILL BE A REAL PARTNERSHIP BETWEEN AGENCIES, THE FEDERAL GOVERNMENT AND THE STATE GOVERNMENT.

THE NUMBER IS MOVING.

IT'S A LARGE NUMBER.

THE COST OF NOT DOING THE PROJECT IS -- >> WE WILL TALK ABOUT THE COST OF NOT DOING IT IN A SECOND.

IT'S MOVING TO THE POINT WHERE NOT THAT LONG AGO I THINK LESS THAN A YEAR AGO IT WAS ESTIMATED IT WAS PROJECTED TO COST $14 BILLION.

NOW IT'S $16 BILLION.

WHY THAT CHANGE?

IS IT A FUNCTION OF THE GROWING INFLATION?

WHETHER IT IS OR IS NOT, HOW CONCERNED ARE YOU OF BUILDING THIS THING IN A MOMENT WHERE WE HAVE HIGH INFLATION AND WHERE PEOPLE ARE PREDICTING A RECESSION?

>> I THINK -- LOOK, THE NUMBER DID MOVE SUBSTANTIALLY.

THAT'S A RESULT OF TWO THINGS.

ONE, INFLATION IS REAL IN TERMS OF PARTICULARLY THE COST OF RAW MATERIALS AND LABOR.

THE FEDERAL GOVERNMENT ACTUALLY REQUIRES YOU TO BUILD IN A FAIRLY SUBSTANTIAL CUSHION TO TAKE INTO ACCOUNT WHAT LABOR AND COMMODITY MARKET WILLS BE.

THE INTEREST RATE ENVIRONMENT MATTERS.

AT THE END OF THE DAY, WHEN THE FEDERAL GOVERNMENT IS ACTUALLY SUPPORTING THE PROJECT, IT'S BECAUSE THE STATES ARE BORROWING MONEY FROM THE FEDERAL GOVERNMENT.

AS YOU KNOW, INTEREST RATES HAVE RISEN APPROXIMATELY 200 TO 250 BIPS IN AN UNPRECEDENTED SPIKE.

AT THE END OF THE DAY, THAT NUMBER HOPEFULLY WILL COME DOWN AS THINGS SETTLE DOWN IN TERMS OF CONSTRUCTION COSTS, LABOR AND INTEREST RATES START TO DROP.

BUT I THINK THAT WE WOULD ALL RATHER BE HONEST ABOUT WHAT OUR OUTSIDE EXPOSURE IS AND GET COMFORTABLE WITH IT AND THEN IT'S OUR JOB AS PEOPLE WHO ARE PROTECTING TAXPAYERS TO REALLY MAKE SURE THAT WE ARE SPENDING OUR MONEY WISELY.

WE ARE IN A VERY DIFFICULT ENVIRONMENT RIGHT NOW.

THAT DOESN'T MEAN WE STOP.

IT MEANS WE JUST WORK HARDER.

>> AS YOU KNOW, AS MANY OF OUR VIEWERS, ESPECIALLY VIEWERS FROM NEW JERSEY KNOW, THERE WAS A PREDECESSOR PROJECT WHICH ALREADY HAD BILLIONS OF DOLLARS COMMITTED TO IT IN 2010.

THEN GOVERNOR CHRISTIE PULLED THE PLUG BECAUSE HE SAID HE WAS TOLD IT WOULD GO OVER BUDGET AND THE STATE, ONLY NEW JERSEY, WOULD HAVE TO COVER THE COSTS BEYOND THE PROJECTED COSTS.

IF THERE ARE COSTS OVERRUN, WHICH THERE WILL BE SOME, NO DOUBT, THIS TIME DOES NEW YORK AND NEW JERSEY HAVE TO FOOT THE BILL?

IS THAT A PROBLEM?

>> LOOK, THERE'S ALWAYS POTENTIAL RISK IN ANY LARGE-SCALE PROJECT.

YOUR VIEWERS ARE INTELLIGENT ENOUGH TO KNOW THAT.

THE TRUTH OF THE MATTER IS ONE OF THE REASONS WHY THE NUMBER IS COMING OUT AS BIG AS IT IS IS BECAUSE WE ARE DOING A MUCH MORE THOROUGH RISK ANALYSIS AND ADDING CONTINGENCIES.

IT'S A MORE NUANCED PROCESS.

HE DIDN'T WANT TO PLEDGE NEW JERSEY'S REVENUE TOWARDS WHAT IS SERVICING MOSTLY NEW JERSEY CONSTITUENTS.

ABOUT 20% OF THE TRAINS THAT GO THROUGH THE TUNNEL ARE AMTRAK.

80% ARE NEW JERSEY TRANSIT.

AT THE END OF THE DAY, THE STATES ARE GOING TO HAVE TO BEAR SOME COST.

THE FEDERAL GOVERNMENT IS COMMITTED.

THE FACT THAT THE FIRST MONEY IN THE PROJECT RIGHT NOW IS $300 MILLION THAT PRESIDENT BIDEN HIMSELF CAME UP DURING A WEEK HE WAS GETTING READY TO DO THE STATE OF THE UNION, SHOULD SUGGEST AND SIGNAL TO EVERYBODY THAT THIS IS A HUGE PRIORITY AND THAT, AGAIN, THERE ARE VERY SMART, COMMITTED PEOPLE HERE WHO ARE GOING TO WORK AS HARD AS THEY CAN TO MAKE SURE WE DO NOT HAVE HUGE BUDGET OVERRUNS.

>> SENATOR SCHUMER SAID THE PROJECT IS FINALLY ASSURED.

ARE YOU THAT OPTIMISTIC?

IS IT ASSURED?

>> THAT'S THE DIFFERENCE BETWEEN A SENATOR AND A COMMISSIONER.

I THINK THE ANSWER IS, YES.

THE WORK TO REALLY LOCK DOWN THE AGREEMENTS AND THE FEDERAL FUNDING AGREEMENT, WHICH IS ULTIMATELY THE DOCUMENT THAT DRIVES ALL OF THE OTHER FINANCIAL COMMITMENTS, THAT WILL BE DONE OVER THE COURSE OF THE NEXT 18 MONTHS.

I'M NOT A POLITICAL PROGNOSTICATOR.

I'M ASSUMING FOR THE NEXT 18 MONTHS, WE'RE GOING TO BE ABLE TO WORK PRODUCTIVELY WITH WASHINGTON, WITH SENATOR SCHUMER AND WE HAVE TWO GOVERNORS -- LET'S BE HONEST, FOR THE FIRST TIME IN A LONG TIME, WHO HAVE BOTH BEEN PUBLICALLY COMMITTED TO THIS PROJECT AND ARE MORE INTERESTED IN GETTING SOMETHING DONE THAN JUST PLAYING GAMES WITH EACH OTHER.

RIGHT?

I THINK THIS IS A REALLY UNIQUE TIME.

I FEEL VERY CONFIDENT THAT THIS IS GOING TO HAPPEN.

>> IF IT HAPPENS, QUICKLY, BECAUSE I GOT ANOTHER QUESTION AND WE HAVE LESS THAN A MINUTE, WHAT'S THE TIME LINE?

WHEN IS -- IF ALL GOES WELL, WHEN IS THE WHOLE THING GOING TO BE FINISHED?

>> THIS IS SHOCKING.

IT WILL MAKE EVERYBODY CRAZY.

THE TRUTH IS, THE TUNNEL -- THE NEW TUNNEL WILL PROBABLY NOT BE FINISHED UNTIL 2034.

THE EXPERIENCE OF INCREASED CAPACITY, OF HAVING TWO FULLY IN-SERVICE TUNNELS, PROBABLY 2038 OR '37.

I WILL TRY TO MAKE THAT GO FASTER.

I WOULD LIKE TO GET ON THOSE TRAINS WHILE I CAN WALK AND NOT BE IN A WHEELCHAIR.

>> IF YOU ARE COMMITTED TO IT, I KNOW IT'S GOING TO HAPPEN.

WE WILL HAVE TO END IT THERE.

OUR TIME IS OVER.

COMMISSIONER, THANK YOU FOR JOINING US TODAY.

IT'S BEEN A PLEASURE TO TALK TO YOU.

IT'S GOING TO HAPPEN.

IF IT DOESN'T, WE'RE IN DEEP DOO-DOO.

>> WELL SAID.

>>> WHEN THE SUPREME COURT OVERTURNED ITS 1973 LANDMARK DECISION ROE V. WADE, THUS REMOVING AFEDERALLY PROTECTED RIGHT TO AN ABORTION AND RETURNING THE ISSUE TO STATE LEGISLATURES, MANY AMERICANS FELT IT WAS AN ASSAULT ON HEALTH CARE.

WHILE ANY PERSON OF CHILDBEARING AGE WILL FEEL THE IMPACT OF THIS DECISION, SOME HEALTH CARE EXPERTS ARE WARNING THAT IT WILL ALSO FURTHER THE DISPARITIES AND NEGATIVE OUTCOMES THAT ALREADY EXIST IN AMERICA ALONG RACIAL LINES.

ONE SUCH EXPERT, LINDA VILLAROSA, IS A "NEW YORK TIMES MAGAZINE" CONTRIBUTOR WRITER AND FORMER EXECUTIVE EDITOR.

SHE LAYS OUT THE CASE FOR HOW AND WHY RACISM IS A PUBLIC HEALTH RISK IN HER NEW BOOK "UNDER THE SKIN: THE HIDDEN TOLL OF RACISM ON AMERICAN LIVES AND ON THE HEALTH OF OUR NATION."

SHE JOINS US NOW.

LINDA, WELCOME TO "METROFOCUS."

>> THANK YOU.

GOOD TO BE HERE.

>> LINDA, I WANT TO START OFF BY SAYING THAT YOU HAVE BEEN SOUNDING THIS ALARM FOR SOME TIME.

IN FACT, IN 2018, YOU WROTE AN ARTICLE FOR "THE TIMES," WHY AMERICA'S BLACK MOTHERS AND BABIES ARE IN A LIFE AND DEATH -- LIFE OR DEATH CRISIS.

CAN YOU JUST EXPLAIN FOR THE VIEWERS, WHAT IS THE UNIQUE CRISIS THAT'S FACING BLACK MATERNAL HEALTH?

>> FIRST, IT'S A CRISIS FACING AMERICA.

WE ARE THE ONLY WEALTHY COUNTRY WHERE THE NUMBER OF WOMEN WHO DIE OR ALMOST DIE RELATED TO PREGNANCY AND CHILDBIRTH CONTINUES TO RISE.

THE ONLY WEALTHY NATION.

BLACK WOMEN ARE THREE TO FOUR TIMES MORE LIKELY TO FACE THIS CRISIS OF DEATH OR NEAR DEATH ON WHAT SHOULD BE THE BEST TIME OF THEIR LIVES.

EDUCATION DOESN'T PROTECT US.

IN OTHER WORDS, EVEN IF YOU ARE AN EDUCATED BLACK WOMEN WITH A MASTER'S DEGREE OR MORE, YOU ARE STILL MORE LIKELY TO DIE OR ALMOST DIE THAN A WHITE WOMAN WITH AN EIGHTH GRADE EDUCATION.

CLEARLY, THIS IS A CRISIS.

WHAT I TRY TO LAY OUT IS WE CALL IT AMERICA'S BLACK MOTHERS AND BABIES WITH A FOCUS ON AMERICA, BECAUSE THIS IS A CRISIS THAT AFFECTS ALL OF US.

>> WHAT IS, I GUESS, AT THE ROOT OF THIS CRISIS THEN?

SO MANY -- I FEEL AS THOUGH SO MANY PEOPLE MIGHT WONDER, HOW IS IT THAT WE GOT TO THIS PLACE?

>> I THINK THAT THE KNEE JERK REACTION IS IT'S SOMETHING WRONG WITH BLACK WOMEN'S BODIES OR THAT WE ARE DOING SOMETHING WRONG CULTURALLY OR EDUCATIONALLY.

I THINK WE HAVE PRETTY MUCH -- THAT'S BEEN DISPROVEN.

WHAT I LAY OUT IN MY BOOK AND IN THAT ARTICLE IS THREEFOLD.

ONE IS THAT THERE IS THE EXPERIENCE OF RACISM, DISCRIMINATION AND BIAS IN THE HEALTH CARE SYSTEM ITSELF, WHICH HAS BEEN WELL DOCUMENTED FOR DECADES.

THE SECOND IS SOMETHING ABOUT THE LIVED EXPERIENCE OF BEING BLACK AND A WOMAN, BIRTHING PERSON IN AMERICA, IS BAD FOR THE BODY AND THE BABY.

I DID NOT COME UP WITH THAT.

I'M A JOURNALIST.

THERE ARE SCIENTISTS WHO HAVE SAID THOSE WORDS VERBATIM.

THEN FINALLY, THERE'S SOMETHING ABOUT OUR COMMUNITIES THAT ARE INHERENTLY LESS HEALTHFUL.

BLACK COMMUNITIES AND OTHER COMMUNITIES OF COLOR ARE SUBJECT TO MORE POLLUTION, AIR AND WATER POLLUTION, LESS GOOD HEALTH CARE FACILITIES.

IT'S HARDER TO ACCESS HEALTHY FOOD.

IT'S SOMETIMES UNSAFE.

THE HOUSING ISN'T SAFE.

THE EDUCATIONAL SYSTEM.

THOSE THREE THINGS ARE REALLY WHAT IS AT THE HEART OF THIS, NOT SOMETHING THAT WE ARE DOING WRONG OR SOMETHING WRONG WITH US.

>> I WAS WONDERING IF YOU COULD UNPACK FURTHER THE HEALTH DISPARITIES AND THE EXPERIENCE OF BLACK MOTHERS AND BABIES.

I ASK THAT QUESTION BECAUSE AS PEOPLE WERE REVIEWING YOUR BOOK, A LOT OF PEOPLE DIRECTLY TIED OUR CURRENT MATERNAL -- THE WAY THAT AMERICA VIEWS MATERNAL HEALTH TO OUR PAST ENSLAVERY.

>> I THINK THAT IS FAIR.

I WAS PART OF THE 1619 PROJECT WHICH WENT BACK IN TIME TO LOOK AT -- THERE'S NEVER BEEN A TIME IN AMERICA WHERE BLACK PEOPLE AND WHITE PEOPLE HAVE HAD EQUAL HEALTH OUTCOMES.

IT HAS ALWAYS BEEN A PROBLEM.

IF YOU LOOK BACK AT WHAT WAS HAPPENING FOR US DURING ENSLAVEMENT, ESPECIALLY WITH REPRODUCTION -- SOMEONE SAID IT TO ME RECENTLY.

IT'S LIKE WE DEALT WITH FORCED LABOR IN A DOUBLE MEANING OF FORCED LABOR.

ONE IS WE WERE FORCED TO WORK TO RAISE THE ECONOMY, RAISE THE FORTUNES OF THE SOUTH AND CEMENT THEM BY PROVIDING FREE LABOR.

BUT WE ALSO CREATED MORE FREE LABOR BY BEING FORCED TO REPRODUCE.

IF WE HAVE HAD INJUSTICE IN REPRODUCTION FOR 400 YEARS, IT'S NOT SURPRISING THAT NOW THAT ROE V. WADE HAS FALLEN THAT WE WOULD BE HIT HARDEST AND LONGEST.

>> SO WHEN YOU ALSO TALK ABOUT BLACK BIRTHING PEOPLE OF BEING HIT HARDEST AND LONGEST, I WAS WONDERING IF YOU COULD EXPAND ON A CONCEPT CALLED WEATHERING, WHICH I FOUND TO BE VERY INTERESTING AND SOMETHING THAT I DON'T THINK GETS ADDRESSED ENOUGH WHEN TALKING ABOUT HOW RACISM AFFECTS THE BODY.

>> WEATHERING IS A VERY INTERESTING CONCEPT COINED BY DR. ARLENE JERONIMUS.

SHE'S BEEN STUDYING IT SINCE SHE WAS AN UNDERGRAD AT PRINCETON.

HAVING TO HAVE HARD COPING AGAINST DISCRIMINATION WEATHERS THE BODY.

EVERY TIME YOU HAVE TO DEAL WITH SOME KIND OF STRESS, AN EXTREME STRESS ESPECIALLY, YOUR THE -- YOUR HEART RATE GOES UP, BLOOD PRESSURE, STRESS HORMONE LEVELS.

CERTAINLY, THIS IS A SURVIVAL MECHANISM.

IT TURNS DANGEROUS WHEN IT HAPPENS OVER AND OVER.

YOUR BODY IS WORKING OVERTIME.

IF THAT HAPPENS OVER AND OVER AGAIN, WHICH IS WHAT HAPPENS TO PEOPLE WHO ARE DISCRIMINATED AGAINST, WHICH HAS HAPPENED LONGEST AND WORSE FOR BLACK PEOPLE, IT CAUSES THE BODY TO PREMATURELY AGE.

THAT IS CALLED WEATHERING.

THE SAME WAY A HOUSE WOULD WEATHER A STORM.

IT KNOCKS THE PAINT OFF.

IT PUTS THE SHINGLES -- IT MAKES THE SINGLES FLY OFF, WINDOWS BREAK.

SHE'S VERY POETIC.

SHE ALSO NOTED THAT BLACK PEOPLE AND OTHER PEOPLE OF COLOR ALSO WEATHER THE STORM.

WE HAVE COMMUNITY.

WE HAVE KINSHIP.

WE HAVE NEIGHBORHOOD COHESION.

WE HAVE LOVE.

I REALLY LIKE THAT CONCEPT, WHICH IS -- I'M SAYING CONCEPT, BUT IT'S VERY WELL PROVEN.

SHE AND OTHERS HAVE BEEN TALKING ABOUT IT FOR DECADES.

BUT IT CAUGHT ON MORE RECENTLY BECAUSE OF COVID.

YOU SAW RIGHT AWAY THAT PEOPLE WHO WERE OLDER HAD WORSE HEALTH OUTCOMES.

BUT THEN ALSO PEOPLE -- BLACK PEOPLE HAD WORSE HEALTH OUTCOMES AT YOUNGER AGES.

IT WAS DIFFERENT.

IT WAS LIKE A TEN-YEAR AGE DIFFERENCE IN WORSE HEALTH OUTCOME.

EVERYONE INSTANTLY WENT TO HER AND THOUGHT, YOUR WEATHERING HYPOTHESIS EXPLAINS THIS.

>> NOW TO BACK UP TO PERHAPS A HIGHER VIEW, HOW DOES THIS CONSTANT AFFECT OF WEATHERING BROUGHT ON BY CHRONIC AND PERSISTENT RACISM IN THIS COUNTRY -- HOW IS THIS AFFECTING ALL OF AMERICA?

HOW IS IT COSTING EVERYONE?

>> WELL, AMERICA HAS THE WEALTHIEST -- WE ARE VERY LENGTHY.

WE ARE AMONG THE WEALTHIEST NATIONS.

WE ALSO HAVE THE BEST HEALTH CARE.

WE HAVE -- IT'S HIGH TECH.

WE SPEND THE MOST OF ANY COUNTRY IN THE WORLD ON HEALTH CARE.

YET, OUR HEALTH CARE STATUS AS A COUNTRY ISN'T GREAT.

IN OTHER WORDS, WE HAVE EXTREMELY HIGH LEVELS OF INFANT MORTALITY COMPARED TO OTHER WEALTHY COUNTRIES, THOUGH WE SPEND MORE.

AT THE OTHER END OF THE SPECTRUM, WE HAVE A LOW LIFE EXPECTANCY COMPARED TO OTHER WEALTHY COMPANIES.

OTHER DISPARITIES EXIST IN BETWEEN.

WHY WOULD THE RICHEST COUNTRY -- THIS VERY RICH COUNTRY WITH THE BEST HEALTH CARE, WE SPEND SO MUCH ON HEALTH CARE, HAVE WORSE HEALTH OUTCOMES?

THEN YOU LOOK AT THE INEQUALITY IN THE SYSTEM, LOOK AT BLACK PEOPLE ACROSS LINES AND IT MAKES SENSE.

IT'S A TERRIBLE MAKING SENSE.

BUT IT DOES AFFECT ALL OF US.

IT'S NOT JUST THE BLACK HEALTH STATUS.

IT'S THE HEALTH STATUS FOR THE COUNTRY AS A WHOLE.

YOU MENTIONED THE HEALTH OUTCOMES OF A WELL EDUCATED, PERHAPS HIGH EARNING BLACK PERSON COULD ACTUALLY OR EXPECTANT PARENT COULD BE WORSE THAN A WHITE PERSON WHO IS LESS EDUCATED AND EARNING LESS MONEY.

I'M WONDERING, WHAT ROLE DOES THE MEDICAL COMMUNITY PLAY IN THIS?

HOW CAN IT BEGIN TO ADDRESS -- IF WE SPEND SO MUCH MONEY ON HEALTH CARE, IT'S NOT ACKNOWLEDGING OR ADDRESSING TEACHING OUR HEALTH CARE PROFESSIONALS ABOUT THE PHYSICAL AFFECTS OF RACISM PART OF THAT.

>> I'VE BEEN THINKING A LOT ABOUT THIS.

I TALK TO A LOT OF MEDICAL STUDENT GROUPS AND PHYSICIANS.

I WANT TO MAKE CLEAR THAT I DON'T THINK THIS IS A PROBLEM OF INDIVIDUAL DOCTORS WHO GO INTO MEDICINE BECAUSE THEY ARE TRYING TO DO HARM TO PEOPLE.

BUT IT'S SYSTEMIC.

I GOT A NOTE FROM A FRIEND OF MINE.

SHE WAS TALKING ABOUT THIS TERRIBLE THING THAT HAPPENED TO HER WHEN SHE WAS PREGNANT.

I SAID, DID IT HAPPEN BY A DOCTOR?

SHE SAID, NO, IT WAS AN EMS PERSON WHO -- THIS WOMAN IS SO SOPHISTICATED.

SHE WAS ACCUSED OF DRUG SEEKING.

SHE ASKED -- THE FIRST THING THEY ASK IS WHAT DRUGS ARE YOU ON WHEN SHE WAS HAVING A SEVERE MISCARRIAGE.

THAT KIND OF THING, I HEAR IT EVERY DAY FROM BLACK WOMEN.

THESE ARE IN MY FRIEND GROUP.

PART OF THIS -- IT'S BEEN WELL DOCUMENTED THAT BLACK PEOPLE AND OTHER PEOPLE OF COLOR HAVE A WORSE TIME IN THE MEDICAL SYSTEM.

IT'S NOT JUST ANECDOTAL.

WHAT I LOOK AT IS A 2002 REPORT OF 480 OTHER STUDIES THAT TALKED ABOUT THIS DISCRIMINATION THAT BLACK PEOPLE AND OTHER PEOPLE OF COLOR, BUT ESPECIALLY BLACK PEOPLE EXPERIENCE MORE OFTEN IN THE HEALTH CARE SYSTEM.

THERE WAS ONE STUDY THAT I REMEMBER THAT REALLY HIT ME.

IT WAS ABOUT AMPUTATION.

IT LOOKED AT PEOPLE WHO HAD DIABETES AND EVERYTHING WAS LEVEL, THE SEVERITY OF THE DIABETES.

IT LOOKED AT THEIR HEALTH INSURANCE.

IT LOOKED TO BLACK AND WHITE PATIENTS.

BLACK PATIENTS WERE MORE LIKELY, EVEN WHEN OTHER THINGS WERE EQUAL, TO HAVE A LEG AMPUTATED.

I DON'T THINK INDIVIDUAL EVIL DOCTORS OR HEALTH CARE PROVIDERS ARE GOING IN TO DO HARM.

BUT SOMEBODY IS MAKING A DECISION BASED ON, PERHAPS, AND PROBABLY, IMPLICIT BIAS TO CUT OFF SOMEONE'S LEG MORE OFTEN IF THEY ARE BLACK.

>> HOW DOES THIS COUNTRY -- ESPECIALLY THE MEDICAL INDUSTRY -- BEGIN TO ADDRESS THIS?

>> I AM A VERY HALF GLASS FULL PERSON.

I'M SEEING CHANGES.

I AM SEEING MEDICAL STUDENTS WHO WERE POLITICIZED DURING THE BLACK LIVES -- THE HEAT OF THE BLACK LIVES MATTER MOVEMENT.

THEY WERE IN HIGH SCHOOL.

THEY WERE IN UNDERGRADUATE COLLEGE.

NOW THEY ARE IN MEDICAL SCHOOL.

THEY ARE SAYING, WE DON'T WANT TO GO INTO A SYSTEM THAT'S UNFAIR.

MEDICAL SCHOOLS THEMSELVES, THE ADMINISTRATION, SOMETIMES GRAPPLING WITH THIS.

MEDICAL SOCIETY, NURSES -- GROUPS OF NURSES AND MIDWIVES GRAPPLING WITH THIS TO TRY TO DO BETTER.

I APPRECIATE THAT.

I APPRECIATE THAT THERE IS AN ENERGY AND A WILLINGNESS TO ADDRESS THIS PROBLEM AND NOT SHY AWAY FROM IT.

BECAUSE IT REALLY IS HARMING PEOPLE, AND IT'S HARMING OUR COUNTRY AS A WHOLE.

>> I WOULD LIKE TO THANK OUR GUEST, LINDA VILLAROSA, AGAIN A "NEW YORK TIMES MAGAZINE" CONTRIBUTING WRITER AND FORMER "ESSENCE" EXECUTIVE EDITOR, AUTHOR OF THE NEW BOOK "UNDER THE SKIN: THE HIDDEN TOLL OF RACISM ON AMERICAN LIVES AND ON THE HEALTH OF OUR NATION."

LINDA, THANK YOU SO MUCH FOR TAKING TIME TO JOIN US ON "METROFOCUS."

>> THANK YOU.

I REALLY APPRECIATE YOU AND ALL THAT YOU DO.

>> "METROFOCUS" IS MADE POSSIBLE BY SUE AND EDGAR WACHENHEIM III, THE PETER G. PETERSON AND JOAN GANZ COONEY FUND, BERNARD AND DENISE SCHWARTZ, BARBARA HOPE