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Relations of Power and Structural Inequalities A second theme is a focus not just on wealth and poverty as economic correlates to health disparities but also on the power relations that structure resource inequalities. Absolute and relative wealth, income, and resource differentials, and the perception of inequalities are all clearly related to poor health (Lynch 2020; Marmot 2017; Wilkinson and Pickett 2011). These all emerge from more deep-seated social, economic, and political structures that limit access to basic resources, deny equal human and political rights, and constrain agency; in short, that limit ones’ life chances. These resource and class-based inequities intersect with other forms of inequality such as racism and sexism, calling for an intersectional approach to power and inequality (Hill Collins 1990; Schultz and Mullings, eds. 2006).

For example, despite being residents of the wealthiest nation in the world, African-American males have life expectancies on par with individuals living in parts of rural India and China (Sen 1992), and African-American babies and mothers women are two and three times more likely to die in childbirth. The recent global pandemic of COVID-19 has hit the poorest segments of many nations the hardest. In the United States, Native Americans, African Americans, and Latinx groups are 2.8 times more likely to contract the virus, and African Americans are twice as likely to die from COVID-19 as white counterparts (CDC 2020; Graves 2020). These health inequities, and many others, are not accidents of occurrence or merely results of proximal measures of resource access but are reflective of deeper purposeful patterns of intersecting histories; what Farmer (2004) has called the “social machinery of oppression” and Hill Collins (1990) the “matrix of domination.”