This is the first book to assess in a systematic and theoretically informed way the course and status of racism in the post-civil rights era. It convincingly demonstrates that racism continues to exist in contemporary American society twenty-five years after the civil rights revolution. Smith clarifies the concept of racism through a historical analysis of the doctrine and practice of white supremacy. Then, drawing on a variety of data--surveys, court cases, the academic literature, government and privately collected statistical reports and studies, and personal experiences--Smith traces the present-day manifestations of racism ideologically, attitudinally, behaviorally, and institutionally. The final chapter presents a detailed critique of the literature on the black underclass and of William Julius Wilson's thesis on the declining significance of racism in explaining the underclass. In the process, it presents a persuasive argument that the persistence and growth of the underclass is itself major evidence of the prevalence of racism today.
Robert C. Smith, MD, MACP is a University Distinguished Professor of Medicine and Psychiatry Emeritus at Michigan State University. His group defined the first evidence-based patient-centered interview, now published as Smith’s Patient-Centered Interviewing: An Evidence-Based Method (McGraw Hill, 4th edition, 2018). They also identified the first evidence-based primary care mental health model, now published as Essentials of Psychiatry in Primary Care: Behavioral Health in the Medical Setting (McGraw Hill, 2019). Educators use both books to teach medical, nursing, and other health care learners in the USA and abroad. Fed up with medicine’s resistance to improving training in mental health care, Dr. Smith decided to take the problem to the public and wrote Has Medicine Lost Its Mind? (Prometheus Books, 2025). It describes the poor state of mental health care in the US, why medicine ignores it, what needs to be done, and how the public can accomplish this politically.