Abstract: Patterns of population health are keen reflections of structural inequities in societies, yet they are rarely subject to the requirements of democratic justification that other systemic inequalities provoke. Nor are health systems generally subject to societal scrutiny regarding fidelity to normative commitments of dignity and equality. Increased recognition of social determinants of health has challenged the narrow biomedical view of health as a stochastic phenomenon. More recently the sweeping devastation of the COVID-19 pandemic has laid bare structural injustices across many democracies, which contributed to widely disparate rates of infection and mortality.