The outbreak of the 2019 novel coronavirus, or SARS‐CoV‐2, and the disease caused
by it, COVID‐19, has disrupted life around the world. Indeed, as a pandemic, COVID‐19
has led to rampant human suffering and deaths, posing threats not only to public health
and health security but more generally to societal stability and wellbeing across
levels of analysis, whether local, national, or global. The pandemic has impacted
virtually all sectors of society and is changing the world, even against the backdrop
of other conflicts and competition, within and across countries and populations. However,
COVID‐19 has disproportionately impacted certain individuals and groups—identified
particularly by factors, such as race, class, gender, disability, age, displacement
and homelessness, and migration status, among others—reflecting longstanding disparities
and inequalities not only in health and health care but in society more generally.
In the same vein, COVID‐19 has further highlighted imbalances in power and resource
distributions relative to technology and knowledge divides, supply chain disruptions,
and demographic and rural‐urban disparities in health‐care access and capacities and
overall resources. Together, these circumstances constitute questions of social justice
as a fundamental determinant of health and societal wellbeing.
The concept of social justice is typically understood relative to notions of human
rights, with particular emphasis on bettering the lives and life chances of peoples
who have been marginalized or treated as the “other” in society relative to various
identifying factors, as mentioned above. The uneven impacts of COVID‐19 on such populations
have occurred for several reasons, including already existing social, environmental,
and health inequities. Limited health‐care capacities and resources in many parts
of the world have affected responses to the virus. For example, across countries and
communities, health‐care systems have faced problems of surge capacity for hospitalization,
treatment, and other essential services during the pandemic. Existing health problems
and underlying conditions also add to the likelihood of comorbidities, which, in turn,
mean more dire reactions to the virus. Furthermore, consistent exposure to environmental
health hazards, such as contaminated water and industrial air and land pollutants
and toxins, is linked to more severe COVID‐19 outcomes. The unequal distribution of
benefits and burdens in society, as expressed in health inequalities and responses
and the disproportionate suffering of disadvantaged and vulnerable groups from the
virus and its effects, calls for an examination of how the pandemic plays to, complicates,
and intensifies social inequities and problems.
This situation emphasizes the need to attend to social disparities that make society
in general more susceptible to the pandemic. The advent of COVID‐19 has served to
underscore—and has exacerbated—social, political, economic, and environmental inequalities
and inequities, borne especially by already vulnerable and disadvantaged populations.
Serious problems in relation to health and health‐care infrastructures and provisions,
working and living conditions, access to clean water, and so on, represent serious
threats to wellbeing in general. Recognizing specifically disadvantaged populations
and communities as particularly vulnerable to the ravages of the pandemic, related
threats to public health also are translated and understood within broader struggles
for social and environmental justice and human rights. Accordingly, addressing the
global challenge posed by the virus calls for investigating its effects on some of
the world's most pressing problems, pointing not merely to questions of public health
and medical preparedness in isolation but necessarily in relation to social justice
as a health determinant and efforts to eliminate resulting gross disparities across
countries and populations.
The working and living conditions of many vulnerable and disadvantaged peoples continue
to create risks in the larger scheme of pandemic effects, marking situations in which
their health is already compromised—for example, lacking clean water and sanitation
facilities, and lacking access to quality health care, including inequalities in diagnosis
and treatment. Persons of lower social circumstances and statuses—defined especially
by relative deprivation in terms of income, wealth, occupation, and education—have
been marked by poor health conditions and outcomes. Such groups have been the most
impacted by the disease, in terms of health, working, and living conditions, and include
those living and working in industries and under conditions that leave them especially
vulnerable to pandemic exposure (e.g., migrant farmworkers, health‐care workers, food
processing plant workers, etc.). Typically living in medically underserved and impoverished
situations, the profoundly disparate health conditions marking these populations have
been magnified in the wake of COVID‐19 in keeping with persistent social inequalities
and inequities. These things go hand in hand with poor educational capacities, limited
employment opportunities, below living wages and earnings, crowded living conditions,
reliance on public transportation, food crises, etc. However, having said that, the
COVID‐19 crisis is changing the world and affecting people's lives in a variety of
ways, not only in direct reference to health disparities but to a range of more general
social, economic, and technological divides. The social, political, and economic implications
of, for example, how and to whom services are provided during the pandemic can have
implications far beyond the individuals and communities directly or immediately involved,
affecting possibilities for COVID‐19 transmission across society and overall societal
wellbeing.
Public health policies that focus on biomedical and technological interventions without
attending to social factors and circumstances are bound to fail. While some efforts
aimed at reducing disease transmission, such as personal protective equipment, sanitizing,
and physical distancing, can be effective, the fact is that, even with the best of
intentions for compliance, the living and working conditions of some individuals and
groups and the lack of resources in some locations render it next to impossible to
stringently follow recommended practices. While addressing questions of social justice,
employment, and vulnerable populations in both direct and indirect relation to COVID‐19
and other relevant health concerns, the geographic distribution of the active virus
requires maintaining an integrated perspective that considers the different locations
and populations in which the virus has taken hold.
Policy foci in this regard are on the effects of the COVID‐19 pandemic and widespread
concerns regarding subsequent societal disruptions. Challenges to humanity in responding
to the pandemic have made it clear that further research is needed to illuminate and
provide a greater specification of the social and structural factors that determine
capacities for dealing with health threats and related preparedness. Basic topics
include how COVID‐19—and future health disasters—can affect the individual, group,
and place‐specific health and general wellbeing, and how related factors can contribute
to or help ameliorate health disparities and inequities, including issues of preparedness
and planning, particularly in terms of resource distributions. Research also is needed
to inform efforts to recover physically and economically from the pandemic and to
improve life conditions, with access to affordable health care, educational opportunities,
and economic advancement.
In some ways, the pandemic might be viewed as offering opportunities to “do better,”
not to go back to a normal state that was far less than ideal for large swaths of
the world's population, but to put programs and policies in place that will address
related social problems and improve current societal relations and conditions for
all. Although scientific advances are occurring relative to combat the disease, the
world still faces uncertain times in relation to the pandemic, and reactions to COVID‐19
constitute an analytical project aimed at challenging social, political, and economic
forces that determine observed disparities. A more critical and expansive perspective
is required to better understand related morbidity and mortality rates and patterns,
especially from the perspective of social justice, and to plan interventions accordingly
to engage the global challenge that is the pandemic.