Inflamed: A Book Review

In Raj Patel’s latest book and Rupa Marya’s debut title, “Inflamed: Deep Medicine and the Anatomy of Injustice,” they peel back layers of just what the Covid pandemic has revealed about our society. As they open, “Your body is a part of a society inflamed. Covid has exposed the combustible injustices of systemic racism and global capitalism.” The sickness was there before, Covid just made it impossible to ignore.

In a book-wide analogy they compare the inflammation of our bodies to the inflammation of this society. In a healthy state, inflammation is a response the body mounts when “tissues and cells are damaged or threatened with damage.” This leads to a mobilization of resources to help heal what has been injured. This inflammation is meant to be a temporary state, lasting just long enough to recover from the causative injury or infection. But what happens when the body is already constantly inflamed? 

Further inflammation adds stress to the body, injuring body tissues over time. In other words, the inflammatory processes that are helpful in acute moments, become harmful when prolonged. Throw Covid into the mix, and the prognosis is even worse. Bodies already made vulnerable by inflammation, including those with the modern world’s most common diseases – heart disease, obesity, cancer, diabetes, and more – once infected with Covid were forced to respond to yet another trigger. This meant a whole new slew of inflammatory cascades, requiring the body to muster up even more resources to avoid further harm from the virus. But this further inflammation, in a body already inflamed, became too much for many people’s bodies to handle. So while the virus itself didn’t cause patients’ lungs to cloud up and make breathing harder, the inflammation from the body’s response to Covid did.   

And what causes bodies to live in a constant state of inflammation? Marya and Patel argue that it’s the inflamed society in which these bodies live. The authors take us through a variety of these environmental triggers of inflammation – from “job stress, debt, and economic precarity,” to “surviving genocide or police killings, living with industrial waste, noise, and wildfire pollution” – showing us that this injury is happening constantly. 

They refer to this environment as a “pro-inflammatory exposome,” indicating that it’s these external factors that put people in an inflamed state, priming them for even more harm when confronted with a virus such as Covid. And who is it that is most subjected to these “pro-inflammatory exposome[s]?” It’s “historically oppressed groups,… poor, Black, Indigenous, and Latinx communities in the United States” – the same people who have experienced higher death rates from Covid. 

By describing how one’s external conditions already predispose them to experiencing worse outcomes when encountering an injury or infection, Patel and Marya make it clear that this “damage is a consequence not of individual choices but of the mandates of a certain social, economic, political, and environmental ecology.” In other words, it’s not individual choices, but the capitalist system that is making them sick in the first place.

In fact they argue the choices that predispose people to inflammatory disease are anything but individual. Modern lifestyles that “increasingly limit the occasions for strenuous activity” such as “unwalkable” cities, often where the poor and people of color live, prevent the body from creating anti-inflammatory compounds. At the same time, “Modern diets contain more processed foods and less fiber, both of which… can create inflammation.” But when markets are flooded with junk food, healthier foods are more expensive and time consuming to prepare, and there’s no access to land for growing more traditional foods, of course the diets of the poor and dispossessed are going to be unhealthy. Trauma, PTSD, hotter neighborhoods, less access to clean water, forced family separations, environmental poisonings – these are also inflammation producing factors that one has little control over.

All of this to say, of course when bodies are subjected to the inflammation of every-day life under capitalism, they’re going to suffer more when confronted with additional trauma. And Covid was one such trauma, experienced on a global level, that could not be ignored. In this book, Marya and Patel make it clear that there’s no way for us to be healthy when our world is on fire. 

Speak Out Now is glad to be hosting the authors of “Inflamed,” Rupa Marya and Raj Patel, at our upcoming townhall on October 2: “The Links Between Health and Structural Injustices and How to Heal the World.” Link to the event here.