COVID-19 has forced a reckoning about how we live, and in particular how exposure to disease
risks are unevenly distributed. This contribution explores connections between the COVID-
19pandemic, chronic disease and conditions of chronic crisis among the urban poor. We suggest
two issues in urgent need of attention in the long and short term are: 1) the underestimatedburdens
of chronic disease among the urban poor, and 2) the chronic states of crises which
contribute to these chronic conditions and their under-recognition. We contend that the burden
of ‘pre-existing’ conditions in informal settlements is under-diagnosed and poorly managed in
communities. In order to address these burdens, for COVID-19 and beyond, we must recognise
they are a product of the protracted crisis which is everyday life for many of the urban poor, for
whom illness is one of the many everyday struggles and consistent quality care is out of reach. For
many people living on the margins, crisis is the norm, yet both this and its impacts on health are
underestimated; for change to be realised, this must be the starting point.
Authors
