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Abstract

Experience with past epidemics made it predictable that people living in poverty, people of color, and other marginalized groups would bear the brunt of the coronavirus pandemic due to the social determinants of health (SDOH). The SDOH are subdivided into structural and intermediary determinants. Structural determinants include forms of subordination (discrimination and poverty) that influence intermediary determinants (health care, housing, and employment). The COVID-19 pandemic has magnified and accelerated the harms caused by these determinants, limiting health equity among historically marginalized groups and low-income populations. Black, Latino, and Indigenous populations have higher COVID-19 infection and mortality rates, higher rates of unemployment, less access to health care, and greater risk of eviction during the pandemic, among other significant inequities. Without robust and swift government interventions, the impacts of the pandemic will be wide and deep. This Article analyzes mechanisms of these determinants in the pandemic setting and provides solutions using the health justice framework.

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