July 2, 2023, Paper: "Since late 2021, the US has experienced the highest cumulative rate of deaths from Covid-19-related causes of any developed country in the world. Why this is the case invites serious analysis. The thesis of this chapter is that the high rate of economic inequality in the US—together with the social and geographic inequalities that are closely associated with economic inequality—explains a large part of the difference. A large body of research has demonstrated the very high, and rising, levels of inequality in wealth and income in the US. Not only labor market income inequality, but also post tax-and-transfer income inequality, are higher in the US than in any comparable OECD country. In turn, as a result of the recursive relationship between top-end income growth and wealth accumulation, wealth concentration has risen as well. Wealth inequality in the US is also highest among the countries in the advanced industrial world. The chapter outlines a model of a three-way relationship among socio-economic, health, and spatial inequalities. Each of the links in this triangle is related through a web of recursive relationships in which each element is both a cause and outcome of the other two. Together, moreover, they exert a longer-term effect on public values and attitudes, and the resulting realignment of political forces. The shifting of American policies and institutions away from provision of public goods and services, toward economic policies that favor the accumulation of incomes and wealth at the top and stagnation of economic conditions for the middle and bottom parts of the distribution, and toward ideological polarization and negative partisanship, in turn feed back into the deepening of all three types of inequality. The severe impact of Covid-19 on the US, both in death rates and economic well-being, reflects the confluence of these trends."