Inequality and Place-Based Risk

The geographic impacts of a biological agent center around three key issues:

1. Who pays for health services after a bioweapons attack? 

A biological weapon attack, places economic stresses on affected communities already through loss of work hours, disability, and likely plummeting housing prices. Yet especially in the case of bioterrorism, the people affected may not hold any responsibility for the attack. If the intended political target of an attack is the government of the affected community, then in a sense, that government may be liable (in a sense) to cover these communities’ health care costs.

However, if that government does not cover these vulnerable communities’ health care or has no universal health care policy in general, then the most affected demographics of the attack will be those who already struggle to find access to health services and may not utilize health services frequently because of cost. If injured individuals cannot access or do not utilize health services, they may not report their cases and hence expand health consequences of the outbreak through contagion or lost productivity.

2. Urban Vulnerability

Urban sprawl makes Tokyo especially susceptible to biological weapons and limits government capacity to deal with all affected populations.

Unless the biological agent in question is design to devastate crop production in a rural area or incapacitate farmers, then the most likely site of a biological agent outbreak would be an urban area with enough population density or a specific site of government to generate widespread fear, pressure for policy change, or incapacitate government or markets. By clustering critical populations and technologies in great proximity to one another, urbanization exports place-based risks onto those communities; the only way to escape these risks is to leave.

3. Political Repercussions

In the long term, neighborhoods afflicted by the biological agent may receive social stigma, loss of economic traffic, and community fragmentation over who received better care and who took advantage of opportunities while others were incapacitated in the attack. The question of who survives and reaps the benefits after a disaster relates deeply to socioeconomic class, race, and social capital in a given area.

While a biological attack might cause turbulence in national and global stock markets, weakening immediate financial power for all individuals, demographics disadvantaged by race, ethnicity, and socioeconomic class may see preexisting stigmas compounded with negative health outcomes in the wake of a biological attack. This may especially be true if an individual or community has less financial assets, more debt, less community integration, or poor political representation. Hence, the major political incursions needed to deal with a biological weapon attack may also limit the agency of especially disadvantaged communities in and around the site of the attack.

Finally, like all major social crises, a biological weapon attack provides a critical juncture for public officials to seize on political opportunities. This could include political or financial incentives to under-report or underestimate patient cases in communities less central to public officials’ interests or in the event of local government budgetary strain.