Inequality Kills Us All

COVID-19’s Health Lessons for the World

This pandemic has revealed grim facts about the health status of our country compared to that of others: the US has the most reported cases and deaths from COVID-19 in the world.

Even before the pandemic, our mortality was going up, despite the Affordable Care Act and massive efforts to promote healthy lifestyles. Yet the public remains unaware that all the other rich nations–and quite a number of poor ones–have better health outcomes than we do. Why? When we speak of investing in health, accessing health, and paying for health, we’re really talking about health care. Health itself takes a back seat in the discussions.

Author Stephen Bezruchka

Medical care and personal behaviors, the usual remedies for poor health, are overshadowed by two critical concepts: economic inequality kills, and early life lasts a lifetime. Income and wealth inequality is akin to an odorless, colorless, highly toxic gas that kills us from the usual causes—heart disease, cancers, and now COVID-19. Yet Americans are totally unaware of this lethal force, a kind of social murder. In addition, roughly half of our adult health is programmed well before we go to school. Healthier nations privilege this period by providing paid parental leave and strong supports for early life.

Inequality Kills Us All details what produces health in a population and prescribes the required “medicine” to prevent our being dead first among rich nations. The causes of our poor health are political, so the remedies must also be political. Americans must learn “the causes of the causes,” and then work together to change society in ways that result in our becoming a healthy society.

Publisher:  Routledge, Available NOVEMBER 28, 2022 in paperback, hardcover, and e-book. Pre-ordering is cheaper.  You can get it from your favorite bookstore.

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Foreword by Richard Wilkinson, who catalyzed the initial studies on inequality and health, beginning with his 1976 letter to the British Government that resulted in their 1980 report Inequalities in Health. His influential 1992 BMJ paper titled: Income distribution and life expectancy spawned hundreds of studies affirming that inequality is bad for us.


COVID-19 exposed how our unequal society leaves us vulnerable to poor health. In his new book, Stephen Bezruchka helps us to see the urgency of the problem, and makes a case for the changes necessary for creating a healthier world.

Capitalism, as Piketty showed us again, generates and deepens inequality. Bezruchka’s book shows us how that inequality shortens lives across the world even among those who celebrate capitalism. This important book also drives home a crucial lesson for public health we need to draw from our very diverse Covid experiences.

When the pandemic hit, we imagined a silver lining – “at least we’ll realize that we’re in this together.”  That laughable naiveté evaporated as the virus disproportionately savaged America’s have-nots. Stephen Bezruchka, one of the subject’s wisest scholars, documents how Covid-19 is merely a sped-up version of decades of festering health inequality.  This superb book will convince anyone other than ideologues that something is brutally wrong with American health.

Inequality Kills Us All diagnoses nations as if they were patients, showing how poverty and riches are both human inventions that come with serious public health consequences. The always insightful and provocative Stephen Bezruchka was an emergency physician who then taught Nepali doctors in remote areas there before becoming a public health professor. He teaches how policy choices determine longevity and quality of life, and how smarter policies would reduce harm while spreading more joy.

This book should be a must-read for politicians, policymakers, and the public. It shows how and why the Covid-19 pandemic wrought such havoc in America, and how inequality set the scene for that chaos and is the biggest public health challenge of our time. We ignore the evidence assembled so skillfully here at our peril.

In the midst of a public health crisis of unimaginable magnitude, Stephen Bezruchka diagnoses the central, interlocked issues – from biological to social – that explain how and why the COVID-19 pandemic manifested in the United States, with many lessons for countries around the world. His autopsy of the pandemic provides a clear sense that those in power should feel shame about the role that politics has played both in developing the longstanding conditions that primed society to experience a highly unequal pandemic and in delivering at best an anemic response during the pandemic. It also gives a clear-eyed sense of the way forward, should we heed the messages provided throughout this important book.

The moribund patient is the American population. The disease is structural violence. Bezruchka has been tracking US vital signs for over three decades. . Our symptoms are centuries old with unaddressed institutional inequities, cultures of rigged meritocracy, over-consumption, greed and waste for the few, but under-service, overwork, under-pay, disenfranchisement and invisibility for the many. The tragic, ongoing dual pandemic of COVID failure and systemic racial violence has brought all this to light. Inequality Kills Us All presents diagnostic and preventative medicine we cannot do without. Bezruchka reminds us that our social ills, health crises and political breakdowns are ineffably intertwined. Our solutions must also be collective, cooperative and from the ground up. Let this brilliant volume of evidence-based medicine for the body politic begin our collective resuscitation.

© 2024 - Stephen Bezruchka