Two million covid-19 deaths have brought the violence of unequal societies squarely into public discussion—“social murder” as Kamran Abbasi has argued in The BMJ.1 What recourse do we have, he and others2 have asked, when elected authorities are too incompetent, or too callous, to address public health failures? In many cases, these failures follow society’s existing fault lines, exacting the greatest toll from those least enfranchised, such as those marginalized by racism, classism, or discrimination based on religion, ethnicity, or other factors.3-5 The strikingly unequal distribution of death from covid-19, concentrated among marginalized people, signals deep societal flaws and raises questions about how to advance societal performance in health.

 

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