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For example, a disenfranchised cultural group’s socioeconomic status can both set that group up for toxicant exposures and be the outcome of such exposures, experienced earlier. To wit: for years various factories discharged contaminants into the St. Lawrence River, upstream of Akwesasne Mohawk territory (which spans the US-Canada border). Fishing, hunting, and gathering became problematically dangerous: Developmental and reproductive abnormalities co-occurred with high pollutant levels, as did depressed thyroid activity, and obesity. Worse, one generation’s exposure-linked problems reduce life opportunities (e.g., educational achievement) for subsequent generations, compounding the toll as social distinctions become self-reinforcing (Schell 2012; Schell, Ravenscroft, Cole, Jacobs, Newman, and Akwesasne Task Force on the Environment 2005).

The demographic impact of COVID-19 follows a similar pattern: diseases more common in minoritized groups due largely to the legacy of their disenfranchisement (e.g., diabetes) increase the risk for infection and death from COVID-19. Concurrently, living and occupational conditions for such groups entail a higher risk for exposure. These inequitable arrangements simultaneously support an economy that benefits its investors and owners.