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317How
Should We Allocate Health and Social Resources During a Pandemic?
as a good proxy, is distributed along a social gradient in every soci-
ety; every socio-economic group is healthier and lives longer than the
group below.4
In sum, the way we organize our societies, how we treat and
relate to each other, the social choices we make in policies, and the
persistent neglect of issues and groups all contribute to creating
and distributing health and health inequalities along a social gradi-
ent within and across societies. The broad social bases of health and
health inequalities make health and its determinants a central con-
cern for social equity and justice.5 In the same vein, the broad social
bases of the determinants of health and health inequalities that oper-
ate across countries puts them squarely at the centre of the scope of
deliberations on global equity and justice.
Social Bases of Infectious Diseases
Given such an understanding of the social bases of health as well as
of individual and social group health inequalities, it should be easy to
recognize the social bases of infectious disease outbreaks and poten-
tial epidemics and pandemics. While the origin of the virus SARS-
CoV-2 is still yet to be confirmed, we already know that the conditions
that enabled its formation were socially determined. It was not a
natural disaster or an act of God, but because of how human-animal
inter actions were addressed or neglected, through policy choices and
social practices. The spread of the virus from person to person is a
social phenomenon, and conditions that enable or restrict those social
interactions are socially determined. The spread of the virus across
countries, initially carried by persons along busy international flight
paths to major global cities, is socially determined. And, to press the
point to its conclusion, how infections take root and spread in other
countries as well as how they are or are not being controlled are deter-
mined by social choices or, indeed, neglect.6
4. Michael Marmot, The Health Gap: The Challenge of an Unequal World (New York;
London: Bloomsbury Press, 2015).
5. Sridhar Venkatapuram, Health Justice: An Argument from the Capabilities Approach
(Cambridge, U.K. & Malden, MA: Polity, 2011).
6. Isaac Chotiner, “The Interwoven Threads of Inequality and Health”, The New
Yorker (14 April 2020), online: <www.newyorker.com/news/q-and-a/the-corona-
virus-and-the-interwoven-threads-of-inequality-and-health>; Michael Marmot,
“Society and the Slow Burn of Inequality” (2 May 2020) 395:10234 The Lancet
1413.
VULNERABLE
The Law, Policy and Ethics of COVID-19
- Title
- VULNERABLE
- Subtitle
- The Law, Policy and Ethics of COVID-19
- Authors
- Vanessa MacDonnell
- Jane Philpott
- Sophie Thériault
- Sridhar Venkatapuram
- Publisher
- Ottawa Press
- Date
- 2020
- Language
- English
- License
- CC BY-NC-ND 4.0
- ISBN
- 9780776636429
- Size
- 15.2 x 22.8 cm
- Pages
- 648
- Categories
- Coronavirus
- International