The Predictable Inequities of COVID-19 in the US: Fundamental Causes and Broken Institutions

ABSTRACT:The COVID-19 pandemic in the US has inspired conversations about which features of the pandemic’s impacts were(n’t) unexpected, as well as why and how. Looming in the background of these discussions are political questions about the blameworthiness of particular institutions and leaders therein, and what COVID-19 disasters within US institutions mean for future discussions about how to reform those institutions. This paper will argue that the inequitable harms of the COVID-19 pandemic in four especially hard-hit US institutions—jails and prisons, meat processing plants, hospitals, and eldercare facilities—were: (1) not so unpredictable as claimed by some commentators, (2) traceable to institutional flaws known prior to the pandemic, and (3) can be fruitfully understood through the lens of “fundamental cause theory,” which offers a model for why and how social resources and deprivations create predictable patterns of harms from health hazards, even when the hazards are new.