A forceful critique of how and why states failed to protect marginalized communities in their responses to the COVID-19 pandemic and the implications of ignoring the existing emergencies that exacerbated the pandemic’s devastating effects.
 
The COVID-19 pandemic inaugurated a state of emergency unprecedented for most Americans. Some could observe this emergency from the relative safety of their homes by working remotely, conducting routine medical appointments over video calls, and getting groceries by delivery. At the same time, those in marginalized communities got sick and died without access to the same privileges, sometimes even at the expense of others. After all, someone had to ship goods from warehouses, someone had to clean the hospital, and someone had to shelve and deliver groceries.
 
In this book, sociologist Claire Laurier Decoteau attempts to document and theorize the emergencies of COVID-19 by looking at the experiences of Chicagoans and the policies that shaped those experiences. She describes the uneven racial impact of COVID-19 on Black and Latinx Chicagoans as a crisis within a crisis, caused by a convergence of emergencies: a state of emergency that protected white supremacy and wealth, the slow emergencies racially marginalized populations have faced due to the long-term gutting of care infrastructure and deindustrialization, and the sacrifice “essential workers” were asked to make to protect the United States economy. As Decoteau shows, the city’s “racial equity” project attempted to manage these converging emergencies by building up epistemic infrastructure and manipulating epidemiological data. City officials used data to determine which communities would be given scarce resources, but once positivity or death rates declined, resources were retracted and redistributed elsewhere. The city focused on the urgent and spectacular while ignoring the long-term disinvestment in marginalized communities, including healthcare resources. Decoteau makes clear that the emergencies precipitated by COVID-19 long predated the pandemic, and that we will continue to live with their compounding crises if we do not tackle their structural underpinnings.
 

Because autism is an increasingly common diagnosis, North Americans are familiar with its symptoms and treatments. But what we know and think about autism is shaped by our social relationship to health, disease, and the medical system. In The Western Disease Claire Laurier Decoteau explores the ways that recent immigrants from Somalia to Canada and the US make sense of their children’s diagnosis of autism. Having never heard of autism before migrating to North America, they often determine that it must be a Western disease. Given its apparent absence in Somalia, they view it as Western in nature, caused by environmental and health conditions unique to life in North America. 

Following Somali parents as they struggle to make sense of their children's illness and advocate for alternative care, Decoteau unfolds how complex interacting factors of immigration, race, and class affect Somalis’ relationship to the disease. Somalis’ engagement with autism challenges the prevailing presumption among Western doctors that their approach to healing is universal.   Decoteau argues that centering an analysis on autism within the Somali diaspora exposes how autism has been defined and institutionalized as a white, middle-class disorder, leading to health disparities based on race, class, age, and ability. The Western Disease asks us to consider the social causes of disease and the role environmental changes and structural inequalities play in health vulnerability.