Shah was born in 1969 in New York City to Indian immigrants. Growing up, she shuttled between the northeastern United States where her parents practiced medicine and Mumbai and Bangalore, India, where her extended working-class family lived, developing a life-long interest in inequality between and within societies. She holds a BA in journalism, philosophy, and neuroscience from Oberlin College, and lives with molecular ecologist Mark Bulmer and their two sons Zakir and Kush.

Shah's writing, based on original reportage from around the world, from India and South Africa to Panama, Malawi, Cameroon, and Australia, has been featured on current affairs shows around the United States, as well as on the BBC and Australia's Radio National. A frequent keynote speaker at political conferences, Shah has lectured at universities and colleges across the country, including Columbia's Earth Institute, MIT, Harvard, Brown, Georgetown and elsewhere. Her writing on human rights, medicine, and politics have appeared in a range of magazines from Playboy, Salon, and Orion to The Progressive and Knight-Ridder. Her television appearances include A&E and the BBC, and she's consulted on many documentary film projects, from the ABC to Channel 4 in the UK. Shah is a former writing fellow of The Nation Institute and the Puffin Foundation.