Throughout history, human societies have been affected by various epidemic and pandemic infectious diseases. Careful archaeological and historical work has revealed that intersecting social and economic inequalities shaped the course of epidemics. Bioarchaeology and other social sciences have repeatedly demonstrated that these kinds of crises play out along the preexisting fault lines of each society. The people at greatest risk were often those already marginalized—, the poor and minorities who faced discrimination in ways that damaged their health or limited their access to medical care even in prepandemic times. In turn, the pandemics themselves affected societal inequality, by either undermining or reinforcing existing power structures. That reality is on stark display during the COVID-19 pandemic. Although the disease has memorably struck some of the world’, s rich and powerful, it is not an equal-opportunity killer. The death toll is higher in poorer and denser areas because they have already suffered from poor health, poverty, and malnutrition.