Sickness and Scarcity: Epidemics, Public Health, and Poverty Through History
MTA
Exploring the two-way relationship between disease and poverty from plague to COVID-19
2nd Edition
The book "Sickness and Scarcity: Epidemics, Public Health, and Poverty Through History" comprehensively explores the enduring, reciprocal relationship between disease and poverty across centuries, from the Black Death to COVID-19. It argues that epidemics thrive where deprivation concentrates risk, such as in crowded housing, unsafe workplaces, and weak infrastructure, and in turn, these outbreaks deepen scarcity by stripping incomes, depleting savings, and fracturing societal institutions. Each chapter uses a specific historical epidemic or public health challenge—like cholera in industrial cities, tuberculosis in tenements, malaria tied to migration, or HIV/AIDS fueled by structural violence—to illustrate how biological events are intricately entangled with material conditions, policies, and power dynamics.
The narrative emphasizes that public health successes are never purely technical, but are rather political projects aimed at redistributing risks and resources. From the sanitary movement's efforts to build sewers and improve urban living, to vaccination campaigns, and labor and civil rights movements demanding safer conditions and equitable care, the book highlights interventions that worked by addressing the social determinants of health. It also critically examines failures, such as the coercive nature of colonial public health initiatives during smallpox eradication or the devastating impact of structural adjustment policies on healthcare systems in the Global South, revealing how interventions can exacerbate existing inequalities or undermine trust.
The book delves into contemporary challenges, including antimicrobial resistance, the intersection of climate change and conflict with diseases like cholera, the vulnerabilities of informal settlements, and the health crises in carceral systems. It highlights how modern phenomena like global supply chains and the gig economy create new vectors for disease and deepen the precarity of "essential workers." Furthermore, it discusses the promise and pitfalls of digital epidemiology, emphasizing the digital divide and the importance of data justice.
Ultimately, "Sickness and Scarcity" concludes with a hopeful yet demanding proposition: building resilient health systems requires prioritizing primary care, supporting community health workers, and implementing robust social protection programs like cash transfers and paid sick leave. These measures are presented not as luxuries but as foundational investments that buffer shocks, speed recovery, and are essential for preventing future epidemics and achieving health equity. The book underscores that to effectively combat disease, societies must address the root causes of poverty and inequality, making the fight for health intrinsically a fight for justice.
This book is written for public health professionals, clinicians, policymakers, and students seeking historical context for designing integrated anti-poverty health policies. It will most benefit those working at the intersection of health and social equity who need evidence-based insights on how epidemics exploit social vulnerabilities and how systemic interventions can build resilience.
January 19, 2026
66,193 words
4 hours 38 minutes
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