Why do African Americans live sicker and die younger? The Skin You’re In argues that answer involves two key reasons: The first is the legacy of slavery, followed by racial segregation. Racism rooted in America’s sociopolitical DNA set the European settlers and enslaved African newcomers to the “new world” on dramatically divergent paths for generations. After slavery’s end, ongoing legal segregation and racial terror cemented their divergent fates. Racism causes constant stress. Stress causes the human body to react with an either fight, flight or freeze response. No human, regardless of race, can thrive successfully long term while under constant stress. The geographic separation of people based on race causes exposure to health hazards to differ among groups. For example, toxic waste sites are more likely to be in predominantly African American communities. Cigarettes and alcohol are more likely to be marketed to Black communities. And, resources that support healthy lifestyles are less available in Black neighborhoods, such as full quality supermarkets, full-service restaurants, and physicians in private practice. So, poor health is a natural predicatable outcome of any group -- regardless of their so-called race -- living under such adverse conditions.