A socially patterned epidemic of deaths of despair is a signal feature of contemporary American society, involving rising mortality from substance use disorders and self-harm at the bottom of the class structure. PERI researcher Lawrence King along with Gabor Scheiring and Elias Nosrati compare this current U.S. public health crisis to that which ravaged Eastern Europe at the tail end of the previous century. The authors chart their common causes: violent social dislocations wrought by rapid economic change and attendant public policies. Such violent social dislocations therefore become a major determinant of overall health outcomes.

Feminists have long argued that global macroeconomic governance is deeply deficient. According to Ilene Grabel, the COVID-19 pandemic amplified existing inequalities, particularly for women, minoritized communities, communities whose livelihoods depend on the informal economy and those whose ability to thrive depend on the care economy. The pandemic also deepened inequalities between rich and poor nations. The erosion of multilateralism severely constrained the scope and character of responses to the pandemic. Its decay also magnifies and extends the effects of the crisis, thereby threatening the life chances of billions of people around the globe.

PERI researcher James Boyce argues that inequality has important consequences for the extent of pollution and natural resource depletion as well as for the distribution of the costs and benefits from environmental degradation. Inequalities in the distribution of purchasing power operate through the market, and inequalities in the distribution of political power operate through governance institutions. Boyce concludes that environmental degradation is not simply a matter of humans harming other species and ecosystems; it is also a matter of some people harming other people. To rebalance our relationships with nature, it will be necessary to rebalance our relationships among ourselves.