A stark and very commonly observed fact is evident when rates of morbidity and mortality are arrayed by socioeconomic status (SES), race/ethnicity, or stigmatized identity. All too often, these facts show that society’s poorer members, those disadvantaged by racial hierarchies, and those resident in the stigmatized side of an us-them divide live in worse health and die younger than their counterparts. For example, concerning socioeconomic status, evidence suggests an enduring and perhaps even growing association between indicators of socioeconomic status and mortality (Sasson & Hayward, 2019) that is also evident in multiple European countries (Mackenbach et al., 2015). Evidence concerning mortality by race shows that inequalities between Black people and White people were reduced between 1999 and 2011 but then plateaued at an unequal level through 2019 and increased dramatically in 2020 (Caraballo et al., 2023). Evidence focused on disability-free life expectancy rather than mortality shows large gaps favoring non-Hispanic White people compared to both non-Hispanic Black and Hispanic people (Bauldry et al., 2023). Groups that experience societal stigma also frequently experience a mortality disadvantage. There is evidence, for example, of a mortality disadvantage for people who identify as sexual minorities (Hatzenbuehler et al., 2020) people with mental illnesses (Walker et al., 2015), people who have been incarcerated (Fernandez et al., 2022), and people with disabilities (Landes, 2024). Health inequalities like these are not only very common in modern times but have existed at similar levels for quite some time (Antonovsky, 1967). The evidence also indicates that the inequalities are not just evident in particular situations but are found for example in every state in the United States (Montez et al., 2019) and in multiple countries in Europe (Mackenbach et al., 2015). Additionally, across all these circumstances, from disadvantages as different as low socioeconomic status and the experience of a mental illness, the facts show that the health inequalities are not segregated to one particular type of disease but rather extend to many different diseases. The existence of health inequalities across time and place and the nature of the social disadvantage experienced pose a critical problem of explanation. What makes such a variety of health inequalities emerge with such regularity? The regularity is even more puzzling when we consider that the major diseases and risk factors that appeared to account for the inequalities seen in earlier periods, i.e. deadly infectious diseases such as diphtheria, measles, typhoid fever, and tuberculosis fueled by over-crowding and poor sanitation in low socioeconomic status (SES) homes and communities, have been virtually eradicated in the developed world. Rather than disappearing, health inequalities in mortality have persisted and now reflect new major causes of death including cancers and cardiovascular illness, fueled by sometimes newly identified risk and protective factors (Phelan et al., 2010).