Aims:
This study explores how health inequalities during the COVID-19 pandemic have been socially and politically constructed, using Michel Foucault’s concept of biopolitics. With a focus on Seine-Saint-Denis, the poorest department of mainland France, this research examines the way structural factors tied to class and race are largely contributing to the shaping of different health outcomes across distinct groups of individuals.

Methods:
A mixed-methods approach was employed, combining secondary quantitative and qualitative analysis. Government reports, statistical data, and academic literature were reviewed to assess socioeconomic indicators, health disparities, and pandemic-related mortality rates. An intersectional framework was used to analyse structural determinants of health within the population of Seine-Saint-Denis.

Results:
Seine-Saint-Denis experienced one of the highest COVID-19 excess mortality rates in France. Key contributing factors include precariousness, a high concentration of essential low-skilled workers, overcrowded housing, and pre-existing health inequalities – disproportionately affecting poorer and racialised populations. Findings suggest these disparities are not incidental but are instead driven by structural factors embedded in the State’s biopolitical apparatus, which relies on establishing hierarchies in the value of lives to ensure the population’s survival as a whole.

Conclusion:
The study highlights how biopolitical mechanisms regulate life and death by reinforcing structural inequalities during the global pandemics. It further exposes the way these inequalities are located at the intersection between class and race. Public health policies could integrate a more intersectional approach that addresses socioeconomic and racial disparities to mitigate future health crises.

Anaelle Giraux-Arcella is a resident doctor working for the NHS in Scotland, with a background in both medicine and social science. She earned a BSc in Global Health and Social Medicine from the university of King’s College London, followed by an MBChB in Medicine at the University of Aberdeen, Scotland. Her research focuses on the social determinants of health, biopolitics, and bioethics. Whilst practicing medicine, she continues to pursue research in social science, with the aim to ally clinical practice with public health to drive systemic changes in the future.