The Death Gap explores the disparities in health outcomes across different socioeconomic and racial groups in the United States. In doing so, Ansell addresses the predominant discourses and the ideological underpinnings of health inequality. Ansell’s own views are influenced by certain traditions: Two prominent figures he cites as inspiration are Friedrich Engels and Rudolf Virchow.

Friedrich Engels (1820-1895) was a 19th-century German philosopher and social scientist. He is known for his collaboration with Karl Marx and his work in social theory. In his seminal work, The Condition of the Working Class in England (1845), Engels documented the appalling living conditions and health disparities faced by industrial workers in Manchester, England. Manchester was at the forefront of the Industrial Revolution which, according to Engels, significantly aggravated the living conditions of the working class. Therefore, Engels argued that these improper working conditions were a result of the capitalist system, which prioritized profit over the wellbeing of the labor force. Engels posited that the exploitation inherent in capitalism created an environment where the working class was systematically deprived of adequate housing, nutrition, and healthcare, leading to premature death and chronic illness.

Engels’s insights resonate throughout Ansell’s The Death Gap, particularly in the way Ansell highlights the systemic nature of health inequalities.