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It’s this line of reasoning that leads Bostrom, Greaves, MacAskill, and others to argue that even the tiniest reductions in “existential risk” are morally equivalent to saving the lives of literally billions of living, breathing, actual people. For example, Bostrom writes that if there is “a mere 1 percent chance” that 10^54 conscious beings (most living in computer simulations) come to exist in the future, then “we find that the expected value of reducing existential risk by a mere one billionth of one billionth of one percentage point is worth a hundred billion times as much as a billion human lives.” Greaves and MacAskill echo this idea in a 2021 paper by arguing that “even if there are ‘only’ 1014 lives to come … , a reduction in near-term risk of extinction by one millionth of one percentage point would be equivalent in value to a million lives saved.” To make this concrete, imagine Greaves and MacAskill in front of two buttons. If pushed, the first would save the lives of 1 million living, breathing, actual people. The second would increase the probability that 1014 currently unborn people come into existence in the far future by a teeny-tiny amount. Because, on their longtermist view, there is no fundamental moral difference between saving actual people and bringing new people into existence, these options are morally equivalent. In other words, they’d have to flip a coin to decide which button to push. (Would you? I certainly hope not.) In Bostrom’s example, the morally right thing is obviously to sacrifice billions of living human beings for the sake of even tinier reductions in existential risk, assuming a minuscule 1 percent chance of a larger future population: 1054 people. All of this is to say that even if billions of people were to perish in the coming climate catastrophe, so long as humanity survives with enough of civilization intact to fulfill its supposed “potential,” we shouldn’t be too concerned. In the grand scheme of things, non-runaway climate change will prove to be nothing more than a “mere ripple” —a “small misstep for mankind,” however terrible a “massacre for man” it might otherwise be. Even worse, since our resources for reducing existential risk are finite, Bostrom argues that we must not “fritter [them] away” on what he describes as “feel-good projects of suboptimal efficacy.” Such projects would include, on this account, not just saving people in the Global South—those most vulnerable, especially women—from the calamities of climate change, but all other non-existential philanthropic causes, too. As the Princeton philosopher Peter Singer writes about Bostrom in his 2015 book on Effective Altruism, “to refer to donating to help the global poor … as a ‘feel-good project’ on which resources are ‘frittered away’ is harsh language.” But it makes perfectly good sense within Bostrom’s longtermist framework, according to which “priority number one, two, three, and four should … be to reduce existential risk.” Everything else is smaller fish not worth frying. If this sounds appalling, it’s because it is appalling. By reducing morality to an abstract numbers game, and by declaring that what’s most important is fulfilling “our potential” by becoming simulated posthumans among the stars, longtermists not only trivialize past atrocities like WWII (and the Holocaust) but give themselves a “moral excuse” to dismiss or minimize comparable atrocities in the future. This is one reason that I’ve come to see longtermism as an immensely dangerous ideology. It is, indeed, akin to a secular religion built around the worship of “future value,” complete with its own “secularised doctrine of salvation,” as the Future of Humanity Institute historian Thomas Moynihan approvingly writes in his book X-Risk. The popularity of this religion among wealthy people in the West—especially the socioeconomic elite—makes sense because it tells them exactly what they want to hear: not only are you ethically excused from worrying too much about sub-existential threats like non-runaway climate change and global poverty, but you are actually a morally better person for focusing instead on more important things—risk that could permanently destroy “our potential” as a species of Earth-originating intelligent life. To drive home the point, consider an argument from the longtermist Nick Beckstead, who has overseen tens of millions of dollars in funding for the Future of Humanity Institute. Since shaping the far future “over the coming millions, billions, and trillions of years” is of “overwhelming importance,” he claims, we should actually care more about people in rich countries than poor countries. This comes from a 2013 PhD dissertation that Ord describes as “one of the best texts on existential risk,” and it’s cited on numerous Effective Altruist websites, including some hosted by the Centre for Effective Altruism, which shares office space in Oxford with the Future of Humanity Institute. The passage is worth quoting in full: “Saving lives in poor countries may have significantly smaller ripple effects than saving and improving lives in rich countries. Why? Richer countries have substantially more innovation, and their workers are much more economically productive. By ordinary standards—at least by ordinary enlightened humanitarian standards—saving and improving lives in rich countries is about equally as important as saving and improving lives in poor countries, provided lives are improved by roughly comparable amounts. But it now seems more plausible to me that saving a life in a rich country is substantially more important than saving a life in a poor country, other things being equal.” Never mind the fact that many countries in the Global South are relatively poor precisely because of the long and sordid histories of Western colonialism, imperialism, exploitation, political meddling, pollution, and so on. What hangs in the balance is astronomical amounts of “value.” What shouldn’t we do to achieve this magnificent end? Why not prioritize lives in rich countries over those in poor countries, even if gross historical injustices remain inadequately addressed? Beckstead isn’t the only longtermist who’s explicitly endorsed this view, either. As Hilary Greaves states in a 2020 interview with Theron Pummer, who co-edited the book Effective Altruism with her, if one’s “aim is doing the most good, improving the world by the most that I can,” then although “there’s a clear place for transferring resources from the affluent Western world to the global poor … longtermist thought suggests that something else may be better still.”

Why do I think this ideology is so dangerous? The short answer is that elevating the fulfilment of humanity’s supposed potential above all else could nontrivially increase the probability that actual people – those alive today and in the near future – suffer extreme harms, even death. Consider that, as I noted elsewhere, the longtermist ideology inclines its adherents to take an insouciant attitude towards climate change. Why? Because even if climate change causes island nations to disappear, triggers mass migrations and kills millions of people, it probably isn’t going to compromise our longterm potential over the coming trillions of years. If one takes a cosmic view of the situation, even a climate catastrophe that cuts the human population by 75 per cent for the next two millennia will, in the grand scheme of things, be nothing more than a small blip – the equivalent of a 90-year-old man having stubbed his toe when he was two. Bostrom’s argument is that ‘a non-existential disaster causing the breakdown of global civilisation is, from the perspective of humanity as a whole, a potentially recoverable setback.’ It might be ‘a giant massacre for man’, he adds, but so long as humanity bounces back to fulfil its potential, it will ultimately register as little more than ‘a small misstep for mankind’. Elsewhere, he writes that the worst natural disasters and devastating atrocities in history become almost imperceptible trivialities when seen from this grand perspective. Referring to the two world wars, AIDS and the Chernobyl nuclear accident, he declares that ‘tragic as such events are to the people immediately affected, in the big picture of things … even the worst of these catastrophes are mere ripples on the surface of the great sea of life.’ This way of seeing the world, of assessing the badness of AIDS and the Holocaust, implies that future disasters of the same (non-existential) scope and intensity should also be categorised as ‘mere ripples’. If they don’t pose a direct existential risk, then we ought not to worry much about them, however tragic they might be to individuals. As Bostrom wrote in 2003, ‘priority number one, two, three and four should … be to reduce existential risk.’ He reiterated this several years later in arguing that we mustn’t ‘fritter … away’ our finite resources on ‘feel-good projects of suboptimal efficacy’ such as alleviating global poverty and reducing animal suffering, since neither threatens our longterm potential, and our longterm potential is what really matters. Ord echoes these views in arguing that, of all the problems facing humanity, our ‘first great task … is to reach a place of safety – a place where existential risk’ – as he defines it – ‘is low and stays low’, which he dubs ‘existential security’. More than anything else, what matters is doing everything necessary to ‘preserve’ and ‘protect’ our potential by ‘extracting ourselves from immediate danger’ and devising robust ‘safeguards that will defend humanity from dangers over the longterm future, so that it becomes impossible to fail.’ Although Ord gives a nod to climate change, he also claims – based on a dubious methodology – that the chance of climate change causing an existential catastrophe is only ∼1 in 1,000, which is a whole two orders of magnitude lower than the probability of superintelligent machines destroying humanity this century, according to Ord. What’s really notable here is that the central concern isn’t the effect of the climate catastrophe on actual people around the world (remember, in the grand scheme, this would be, in Bostrom’s words, a ‘small misstep for mankind’) but the slim possibility that, as Ord puts it in The Precipice, this catastrophe ‘poses a risk of an unrecoverable collapse of civilisation or even the complete extinction of humanity’. Again, the harms caused to actual people (especially those in the Global South) might be significant in absolute terms, but when compared to the ‘vastness’ and ‘glory’ of our longterm potential in the cosmos, they hardly even register. Yet the implications of longtermism are far more worrisome. If our top four priorities are to avoid an existential catastrophe – ie, to fulfil ‘our potential’ – then what’s not on the table for making this happen? Consider Thomas Nagel’s comment about how the notion of what we might call the ‘greater good’ has been used to ‘justify’ certain atrocities (eg, during war). If the ends ‘justify’ the means, he argues, and the ends are thought to be sufficiently large (eg, national security), then this ‘can be brought to bear to ease the consciences of those responsible for a certain number of charred babies’. Now imagine what might be ‘justified’ if the ‘greater good’ isn’t national security but the cosmic potential of Earth-originating intelligent life over the coming trillions of years? During the Second World War, 40 million civilians perished, but compare this number to the 1054 or more people (in Bostrom’s estimate) who could come to exist if we can avoid an existential catastrophe. What shouldn’t we do to ‘protect’ and ‘preserve’ this potential? To ensure that these unborn people come to exist? What means can’t be ‘justified’ by this cosmically significant moral end? Bostrom himself argued that we should seriously consider establishing a global, invasive surveillance system that monitors every person on the planet in realtime, to amplify the ‘capacities for preventive policing’ (eg, to prevent omnicidal terrorist attacks that could devastate civilisation). Elsewhere, he’s written that states should use preemptive violence/war to avoid existential catastrophes, and argued that saving billions of actual people is the moral equivalent of reducing existential risk by utterly minuscule amounts. In his words, even if there is ‘a mere 1 per cent chance’ of 1054 people existing in the future, then ‘the expected value of reducing existential risk by a mere one billionth of one billionth of one percentage point is worth 100 billion times as much as a billion human lives.’ Such fanaticism – a word that some longtermists embrace – has led a growing number of critics to worry about what might happen if political leaders in the real world were to take Bostrom’s view seriously. To quote the mathematical statistician Olle Häggström, who – perplexingly – tends otherwise to speak favourably of longtermism: I feel extremely uneasy about the prospect that [the calculations above] might become recognised among politicians and decision-makers as a guide to policy worth taking literally. It is simply too reminiscent of the old saying ‘If you want to make an omelette, you must be willing to break a few eggs,’ which has typically been used to explain that a bit of genocide or so might be a good thing, if it can contribute to the goal of creating a future utopia. Imagine a situation where the head of the CIA explains to the US president that they have credible evidence that somewhere in Germany, there is a lunatic who is working on a doomsday weapon and intends to use it to wipe out humanity, and that this lunatic has a one-in-a-million chance of succeeding. They have no further information on the identity or whereabouts of this lunatic. If the president has taken Bostrom’s argument to heart, and if he knows how to do the arithmetic, he may conclude that it is worthwhile conducting a full-scale nuclear assault on Germany to kill every single person within its borders. Here, then, are a few reasons I find longtermism to be profoundly dangerous. Yet there are additional, fundamental problems with this worldview that no one, to my knowledge, has previously noted in writing. For example, there’s a good case to make that the underlying commitments of longtermism are a major reason why humanity faces so many unprecedented risks to its survival in the first place. Longtermism might, in other words, be incompatible with the attainment of ‘existential security’, meaning that the only way to genuinely reduce the probability of extinction or collapse in the future might be to abandon the longtermist ideology entirely.

The term “structural violence” was introduced in a 1969 essay by Norwegian sociologist Johan Galtung, the main founder of peace and conflict studies and of the Journal of Peace Research. He defined peace as the absence of not only direct physical violence—ranging from interpersonal to collective violence—but also indirect structural violence, caused by forces such as poverty, marginalization, and exploitation. According to Weigert (1999:432), the notion of peace as more than the absence of war originates with Quincy Wright (1942:1305), who in A Study of War wrote that “the positive aspect of peace—justice—cannot be separated from the negative aspect—elimination of violence.” Galtung (1969:183) further conceptualized “positive peace” as the “absence of structural violence” and explicitly linked structural violence to unequal power, especially “the power to decide over the distribution of resources,” which results in “unequal life chances” (1969:171). He claimed that structural violence led to more death and suffering than physical violence, an observation later confirmed by Köhler and Alcock (1976), who estimated that the fatal consequences of structural violence globally for 1965 were about 130 times greater than for direct violence (Gilligan 1999). Galtung illustrated the idea of structural violence as avoidable harm by noting that deaths from tuberculosis in the eighteenth century were unavoidable, “but if [a person] dies from it today, despite all the medical resources in the world, then violence is present,” and he similarly argued that “differential social impact” from earthquakes is preventable(Galtung 1969:168, 186). Since then, others have linked the structural violence of poverty and environmental destruction to the increased risks and consequences of “so-called natural disasters, where conscious policies have made populations vulnerable and unprepared for predictable harms triggered by dramatic weather events” (Demenchonok and Peterson 2009:53; Kagawa 2005).

Once the hurricane passed, people came out of their houses and saw their neighborhoods destroyed. Without electricity or cell phone service, people had no way to contact loved ones. Some still experience lasting effects. The teachers observed that their once-happy students now had emotional difficulties in the classroom. The island’s suicide rate spiked. One man described feeling helpless as he offered support to someone who had lost everything. Hurricane Maria also broke up families, as people fled the island to the mainland. Hurricane Maria also reminded the people of Puerto Rico that they lack rights other Americans enjoy. The concept of structural violence is worth understanding here. Structural violence is inequity and harm caused by social structures. Puerto Rico being a commonwealth and not a state, is unique from other regions in the United States hit by natural disasters, a disparity reflected in the slow federal recovery efforts after Maria. A large part of the recovery was aided by locals and donations. Even before the hurricane, Puerto Rico was deep in debt. The island’s poverty rate exceeds that of our poorest state, Mississippi. Residents of Puerto Rico cannot vote in mid-term or Presidential elections unless they have a permanent address within the United States. This has rendered Puerto Rico invisible to the rest of the world. Hurricane Maria exposed the colonial structures that have led to these inequalities. The suffering of the people of Puerto Rico was aggravated when their pain was minimized. When the actual death toll from Hurricane Maria was revealed to be 2,975 and not 64 as previously reported, President Trump dismissed this as a smear tactic against his presidency.

Absolutely central to our approach is a blurring of categories and distinctions between wartime and peacetime violence. Close attention to the “little” violences produced in the structures, habituses, and mentalites of everyday life shifts our attention to pathologies of class, race, and gender inequalities. M ore important, it interrupts the voyeuristic tendencies of “violence studies” that risk publicly humiliating the powerless who are often forced into complicity with social and individual pathologies of power because suffering is often a solvent of human integrity and dignity. Thus, in this anthology we are positing a violence continuum comprised of a multitude of “small wars and invisible genocides” (see also Scheper- Hughes 19 9 6 ; 1997; 2 0 00b ) conducted in the normative social spaces of public schools, clinics, emergency rooms, hospital wards, nursing homes, courtrooms, public registry offices, prisons, detention centers, and public morgues. The violence continuum also refers to the ease with which humans are capable of reducing the socially vulnerable into expendable nonpersons and assuming the license - even the duty - to kill, maim, or soul-murder.

We realize that in referring to a violence and a genocide continuum we are flying in the face of a tradition of genocide studies that argues for the absolute uniqueness of the Jewish Holocaust and for vigilance with respect to restricted purist use of the term genocide itself (see Kuper 1985; Chaulk 19 9 9 ; Fein 1990; Chorbajian 1999). But we hold an opposing and alternative view that, to the contrary, it is absolutely necessary to make just such existential leaps in purposefully linking violent acts in normal times to those of abnormal times. Hence the title of our volume: Violence in War and in Peace. If (as we concede) there is a moral risk in overextending the concept of “genocide” into spaces and corners of everyday life where we might not ordinarily think to find it (and there is), an even greater risk lies in failing to sensitize ourselves, in misrecognizing protogenocidal practices and sentiments daily enacted as normative behavior by “ordinary” good-enough citizens.

The central question that interests us here is the following: What is really new with respect to modernity? And by this I mean not only what develops and redefines experiences, tendencies, and processes of other worlds, but, also, what was produced in the present model of global power’s own history. Enrique Dussel (1995) has proposed the category “transmodernity” as an alternative to the Eurocentric pretension that Europe is the original producer of modernity. According to this proposal, the constitution of the individual differentiated ego is what began with American colonization and is the mark of modernity, but it has a place not only in Europe but also in the entire world that American settlement configured. Dussel hits the mark in refusing one of the favorite myths of Eurocentrism. But it is not certain that the individual, differentiated ego is a phenomenon belonging exclusively to the period initiated with America. There is, of course, an umbilical relation between the historical processes that were generated and that began with America and the changes in subjectivity or, better said, the intersubjectivity of all the peoples that were integrated into the new model of global power. And those changes brought the constitution of a new intersubjectivity, not only individually, but collectively as well. This is, therefore, a new phenomenon that entered in history with America and in that sense is part of modernity. But whatever they might have been, those changes were not constituted from the individual (nor from the collective) subjectivity of a preexisting world. Or, to use an old image, those changes are born not like Pallas Athena from the head of Zeus, but are rather the subjective or intersubjective expression of what the peoples of the world are doing at that moment change and that they affect not only Europe but the entire globe. This is not a change in a known world that merely altered some of its traits. It is a change in the world as such. This is, without doubt, the founding element of the new subjectivity: the perception of historical change. It is this element that unleashed the process of the constitution of a new perspective about time and about history. The perception of change brings about a new idea of the future, since it is the only territory of time where the changes can occur. The future is an open temporal territory. Time can be new, and so not merely the extension of the past. And in this way history can be perceived now not only as something that happens, something natural or produced by divine decisions or mysteries as destiny, but also as something that can be produced by the action of people, by their calculations, their intention, their decisions, and therefore as something that can be designed, and consequently, can have meaning (Quijano 1988a).

What if any is the difference between colonization and genocide? Prof Mignolo: There is a difference, though I never really thought of it. The first thing that comes to mind is that genocide is a consequence of colonialism. Another question is can this be claimed for all genocides? Prof Tlostanova: Holocaust, for example. Prof Mignolo: Ooh. Let’s start the other way round. One of the features of coloniality is its connection to economy based on dispensability of human life, which is seen as a commodity: you sell sugar or you sell slaves. Genocide means we do not care. Therefore, genocide is possible because certain human lives are dispensable. Iraqi lives are more dispensable than American lives. Holocaust, however was based on stripping human life of legal rights, as Hannah Arendt writes. So it was not about the dispensability of human life in terms of economy but it presented bareness of life in relation to the state and law. For white European bourgeoisie Christians the really horrible part of holocaust was not the crime itself but the fact that it was committed against white people using the technique Europe learned in its colonies. Economic dispensability of human life that build the system of the economy liberals and Marxists call capitalism came back on the level of the state. Jews were internally inferior. I will not say that all genocides have been a consequence of coloniality, but I would make these two connections. The third one could be Rwanda. There colonialists, especially of the second wave after the Enlightenment created the idea of national identity. Before there existed communities of faith, not of birth. Genocide there was therefore a consequence of conditions colonialists left behind. We could think of other genocides … How can we think Stalin’s genocide? Prof Tlostanova: I was just thinking about it. It was not framed in racial terms, though many scholars today question this. They ask if Stalin’s genocides were connected with people’s ethnic origins and race or only with class. There was no racial discourse in Soviet Union but crimes were often committed on racial grounds – nobody has ever put Russian in jail for nationalistic reasons while all other nationals were imprisoned, if their belief in the Soviet idea was not strong enough. I think it was based on race although it was masked as a class fight. Prof Mignolo: So there is the underlying notion of dispensability of human life as an economic category, while genocide on the level of the state also includes the idea of elimination of an enemy. Be it Hitler’s Aryan state or Stalin’s communist state. Prof Tlostanova: But Hitler tried to make Jews economically efficient as well. In concentration camps there was the McDonald’s logic – before Jews were killed they took everything of use and value from them – clothes, hair, teeth … Stalin made enemies build things, sometimes useless. They have built the Moscow State university. What about the genocide as a tool for eradication of culture or religion? Prof Mignolo: I think this in included in the notion of dispensability of the human life – be it organs or something else. Another thing is if these are used to present the enemy you want to eradicate. Islam or the criminal inside the society, or the Communists in the US during the Cold War. There seem to be two types of genocide – one motivated by economics – and here we do not have the notion of an enemy … it is just a tool. Prof Tlostanova: You do not kill on purpose, it is a consequence of use. Prof Mignolo: Yes, you have a horse to work or you have a slave to work. He is not your enemy – on the contrary, it is useful – it is a tool. You buy it, sell it, use it. A different kind of genocide is when you have to eradicate. However, eradication does not necessarily imply genocide. In colonial Peru there was eradication of ideology. They did not kill, they just converted to Christianity. They wanted to conquer souls. Prof Tlostanova: That is why I think coloniality is wider and deeper than genocide. You can leave people alive but you wipe everything out of their minds to put something else there. In a way this is also a genocide – you leave them their physical lives but you take away their inside … Prof Mignolo: We call it epistemic lobotomy. Now that I think of, the cleaning of ideology might had been a fore-runner of Hitler’s work. Except that Indians of the time were not the menace for Christian theologians like Jews were for Hitler. Christians are very clear of who their enemies are – at that moment in history it was Islam and Protestants. Catholics controlled the game but they wanted a dangerous enemy eager to destroy them – this was also the Bush discourse after the 9/11. Prof Tlostanova: This is a very American discourse. It is the only way how to keep America together and form its national identity. To be together against someone. In Europe I think there is bigger common base of religion, roots, culture …

In the account developed so far, the wrong of colonialism consists in the establishment of a form of association that fails to offer equal and reciprocal terms of interaction to all its members. To put this more precisely, an ideal association is one that reflects equality and reciprocity along two dimensions. The first has to do with the creation of associative norms. It draws attention to the process through which such norms are first established, and to the correct mode of participation in setting them up (condemning, for instance, their unilateral imposition). The second relates to the principles around which that association is structured. It draws attention to the substantive criteria of political cooperation and asks us to ensure that equality and reciprocity are reflected in the design of institutions facilitating that cooperation. Colonialism is wrong because it violates the ideal in the first but often also in the second of these dimensions (and in fact most historical practices of colonial association unambiguously departed from both).

The devastation in Puerto Rico is heartbreaking. As much as 95 percent of the US island remains without power after the destruction brought on by Hurricane Maria last month. Swaths of people still can’t get supplies, including food and fuel, and it’s hard for them to reach out to the rest of the world, with communication lines cut off. Based on the latest government estimates, 16 people have died — but that’s an outdated number (from Wednesday), and many observers say it could rise to the dozens or even above 100 when all is said and done.

This isn’t because the disaster was unpredictable. Once Hurricane Maria took form, all of the National Hurricane Center’s 17 full advisories in the four days preceding landfall projected Maria would hit Puerto Rico.

In Puerto Rico, cheap labor and generous tax breaks—since 2017, more than $100 billion worth—have made US-based pharmaceutical firms the biggest economic players in town. Drug manufacturers have brought in tens of thousands of jobs, albeit with a tax-break price tag of more than $1 million each. But a new report by the nonprofit Center for Popular Democracy and advocacy group Hedge Clippers suggests that Big Pharma’s footprint on the island has come with other serious costs: illegal dumping of toxic waste, pollution and depletion of groundwater, and violations of other vital Environmental Protection Agency regulations. The report, released Tuesday, paints a disturbing picture, holding US pharmaceutical corporations at least partially responsible for Puerto Rico’s disproportionately high rates of asthma and cancer. The sum of its findings: a pattern of environmental racism resulting in more than a dozen Big Pharma–related Superfund sites, with the complicity of federal and local authorities.

Puerto Rico is home to some 500 EPA-designated, toxin-packed Superfund sites, half of which were “active” as of July, meaning they pose an ongoing risk to the surrounding communities and ecosystems. Eighteen of its active sites are on the EPA’s “national priorities list,” which tracks areas most likely to release harmful compounds; of those, 15 are linked to the pharmaceutical industry. And Superfund sites don’t include every area where industries have improperly disposed of hazardous waste—just the most serious health and environmental threats.

2017 was a remarkable year of natural disasters in the USA. Hurricane season is nothing new, but amidst a changing climate, the severity of storms and the magnitude of their damage presents new threats and challenges to public health. Between 19 August and 19 September, three hurricanes hit the southern USA.1 Hurricane Harvey formed on 17 August 2017, and lasted over a week, with the majority of the flooding and damage concentrated in Houston, Texas, USA. Harvey caused widespread flooding and left hundreds of thousands of people without electricity. Hurricane Irma formed on 30 August, the most intense part of the storm hitting northern Caribbean islands and Key West in Florida. In the USA, Irma caused strong wind damage, intermittent electrical damage across Florida and millions of dollars in agricultural damage. Finally, Hurricane Maria formed on 16 September in the Caribbean, focusing its destruction on Dominica and the US territory of Puerto Rico. In Puerto Rico, Maria caused widespread destruction of the power grid, vegetation and housing. The storms wreaked havoc, destroying lives and infrastructure, with lasting consequences for public health, mental health and longterm physical health outcomes including depression, post-traumatic stress disorder, disability and vector-borne diseases due to prolonged flooding.2–4 What stands apart, however, and has not been discussed by the public health community, is the differential treatment received in each case from the US federal disaster response efforts. There are many different reasons why the responses may have been different—geography, disaster fatigue and/or issues of citizenship and race/ethnicity. However, most critically and irrevocably, disaster responses that differ substantially for reasons other than storm severity and needs of the affected area may affect the public health as well as the health equity of the individuals and communities living through the disaster and the recovery. This work is limited by data constraints. We used all data publicly available to establish comprehensive timelines of staff and funding directed from Federal Emergency Management Agency (FEMA) to hurricane-affected areas. However, the data was not reported by FEMA in consistent time increments. To establish more consistent timelines and complete gaps in the data, we were in contact with FEMA to request staffing and funding counts across time periods. FEMA did not respond to data requests. To examine differences in disaster responses across the three hurricanes, we focus on measures of federal spending, federal resources distributed and direct and indirect storm-mortality counts. Federal spending estimates come from congressional appropriations and FEMA records. Resource estimates come from FEMA documents and news releases. Mortality counts come from National Oceanographic and Atmospheric Administration (NOAA) reports, respective vital statistics offices and news reports. Damage estimates came from NOAA reports. In each case, we compare the responses and the severity at critical time points after the storm. Disparities in the federal hurricane responses Our results show that the federal response was faster and more generous across measures of money and staffing to Hurricanes Harvey and Irma in Texas and Florida, compared with Hurricane Maria in Puerto Rico. This result would be unsurprising if Hurricane Maria was less damaging than Irma and Harvey. However, Hurricanes Harvey and Irma made landfall as category four hurricanes,1 5 and Maria hit Puerto Rico as a ‘high-end’ category 4, or just below the threshold of a category 5 hurricane.6 Maria caused more damage in Puerto Rico than Irma in Florida or Harvey in Texas in terms of loss of electricity and housing destruction,1 5 6 with overall damage estimates comparable to Harvey, and greater than estimates for Irma.1 Assuming that infrastructure costs are higher in Texas and Florida, and therefore more expensive to repair, compared with Puerto Rico, the high damage estimates in Puerto Rico emphasise the severity of storm damage. Thus, assuming that disaster responses should be commensurate to the degree of storm severity and need of the population, the federal response is questionable and the degree of variation between the disaster responses is problematic. Figure 1 shows measures of FEMA dollars awarded to individuals and families by the number of days after landfall. Within the first 9 days after the hurricanes hit, both Harvey and Irma survivors had already each received nearly US$100 million in FEMA dollars awarded to individuals and families, whereas Maria survivors had only received slightly over US$6 million in recovery aid. Within the first 2 months post-landfall, Harvey and Irma survivors each received nearly US$1 billion (figure 1, Harvey US$1.28 billion and Irma US$899 million). Maria funds did not hit 1 billion until 4 months after landfall. The same trend holds for total federal dollars received by survivors, including FEMA dollars, national flood-insurance payouts and loans from the Small Business Association. Federal staffing can also indicate response to natural disasters and is critical to recovery efforts, acutely in terms of rescue, as well as long-term stabilisation. Examples of staffing efforts include FEMA employees and the National Guard. Long-term staffing efforts are determined by ongoing need for recovery and repair. Figure 2 shows staffing levels by the number of days post-landfall. Within 9 days of landfall, there were 30 000 federal employees posted in Texas, 16 200 posted in Florida and 10 000 posted in Puerto Rico. At the peak, 19 000 federal employees were posted in Puerto Rico, 1 month after landfall, well short of the peak for Texas of 31 000. The amount of food, water, tarps and helicopters were lower and slower for delivery in Puerto Rico then their counterparts in Texas and Florida.7 8 Differences in responses to the hurricanes are also evident in the delivery and timing of federally appropriated funds to affected communities. Figure 1 above shows the delivery of part of the federally appropriated funds to affected communities as designated through intended agencies. Overall, congress responded to the disasters across the course of three separate spending bills from September to December 2017. In September 2017, Congress authorised US$15.25 billion in Hurricane Harvey and Irma disaster aid, with US$7.4 billion allocated for FEMA’s Disaster Relief Fund, US$450 million for the SBA’s Disaster Loans Program Account and US$7.4 billion for HUD’s Community Development Block Grant (CDBG) programme to support local relief for Irma and Harvey.9 The second bill was passed on 26 October 2017, providing additional supplemental appropriations for disaster relief requirements for all three hurricanes.10 The bill provided US$18.67 billion for the Disaster Relief Fund, where US$10 million must be transferred to the Department of Homeland Security Office of Inspector General for audits and investigations related to disasters and cancelled US$16 billion of the debt held by the National Flood Insurance Program.10 In this October bill, up to US$4.9 billion was allocated for Puerto Rico in the form of a Community Disaster Loan, as opposed to the CDB grants allocated in September to Texas and Florida.10 11 On 9 January, Puerto Rico was denied that US$4.9 billion loan from the October bill, for having a cash balance deemed too high to receive the loan, with the Treasury Department seeking further proof of lack of liquidity.12 The third bill, which was passed in both chambers in December but was not signed until 9 February 2018, contributed to the delayed payout in funds to Puerto Rico.13 Sec. 21 210 of the third bill established that the Governor of Puerto Rico must establish a 12-month and 24-month recovery plan14 endorsed by the Oversight Board15 established under Puerto Rico Oversight, Management and Economic Stability Act requiring monthly reports to Congress. Texas and Florida are able to receive funds without conditional approval of recovery plans. The Trump Administration often argues that the delay of money and goods to Puerto Rico is based on geographic limitations. Yet, disaster appropriation funding to Puerto Rico took over 4 months post-landfall to reach a comparable amount of money received by Florida and Texas in half the amount of time. The additional 2 months to distribute critical aid is not likely explained by geography, but likely a product of the congressional negotiations outlined above, seeking to demonstrate that Puerto Rico had no sufficient assets to deploy and required financial assistance. Similarly, federal staffing rates in Puerto Rico reached comparable levels in three times the amount of time as Texas and 30 times the amount of time for Irma. The magnitude of this variation seems difficult to explain by geography, particularly in the context of an ongoing disaster. This analysis was not able to find estimates of medical expenses or personnel supporting Puerto Ricans on the ground in the USA after relocation to mainland US after Maria struck. Many Puerto Ricans now living on the mainland were presumed to enrol in Medicaid if eligible to cover medical costs.16 17 The estimates provided here of federal dollars distributed to survivors include money distributed to all Puerto Rican applicants, whether relocated to mainland US or still residing in Puerto Rico. The data showing FEMA aid to individuals and families includes rental assistance to Puerto Ricans now living in the continental US after Maria. All of this is underscored by the mortality counts across each hurricane. Hurricane deaths are measured by direct and indirect deaths. NOAA defines direct deaths as ‘[d] eaths occurring as a direct result of the forces of the tropical cyclone’.1 These would include individuals who drowned in storm surge, rough seas, rip currents and freshwater floods.1 Indirect deaths are defined as, ‘[d] eaths occurring from such factors as heart attacks, house fires, electrocutions from downed power lines, vehicle accidents on wet roads, etc.’1 As shown in figure 3, Hurricane Harvey was responsible for 68 direct deaths and5 35 indirect deaths from electrocution, motor-vehicle crashes and isolation from necessary medical services.5 Hurricane Irma caused a total of seven direct deaths, with an additional 85 indirect deaths.1 Of the deaths Irma caused that occurred in the USA, four direct deaths and 80 indirect deaths were in Florida.1 The indirect deaths were primarily caused by falls during preparations for Irma’s approach, vehicle accidents, carbon monoxide poisoning from generators, chainsaw accidents and electrocutions, with 14 occurring from overheating due to air conditioner failure in a nursing home.1 For Hurricane Maria in Puerto Rico, NOAA notes that the death toll is highly uncertain. The count for direct deaths by the federal government at this time is 65, with federal reports listing an unknown number for indirect deaths.6 The Puerto Rican Government and George Washington University reviewed mortality data, and in August 2019 released updated, official mortality estimates.18 Total excess mortality is used as the current, most accurate available proxy for indirect deaths from Hurricane Maria. It is a modelled number based on changes in the mortality rate predisaster and postdisaster rather than careful examination of death certificates, due to inaccuracies in reporting cause of death on death certificates in Puerto Rico. This research indicates that total excess mortality post-landfall between September 2018–February 2018 total 2975.18 The risk of death was found to be 45% higher, persisting through the end of the study period for individuals living in municipalities of low socioeconomic development,18 greatly exacerbating pre-existing health inequalities. There have been no other substantial changes in acute threats to mortality besides Hurricane Maria that may account for the significant increase in deaths immediately post-landfall.18 19 Even taking the official death toll at face value, the mortality counts for Maria—as an indicator of need and severity—are commensurate with both Harvey and Irma, requiring a response at least on par with both prior responses. Considering the severe undercount of indirect deaths associated with Maria, the federal response has been inadequate. Conclusion This paper demonstrates that the disaster responses to hurricanes Harvey, Irma and Maria were different to the degree that they do not align with storm severity or prevention and recovery needs and may substantially affect deaths and recovery rates. Increases in mortality and adverse health outcomes due to differentiated disaster response and recovery efforts may promote inequity among populations that receive less aid.

The consequences of denying SSI to U.S. citizens with disabilities residing in Puerto Rico has been and continues to be catastrophic. PWDs already experience higher rates of poverty than their nondisabled peers, and when one adds lower income benefits it places them in a cycle of extreme poverty they will likely never escape. This disparity negatively impacts the Puerto Rican economy, as it limits funds to stimulate economic development and financial activity. In addition, the implications for U.S. citizens who receive SSI on the mainland and move to Puerto Rico are punitive, as their SSI benefits are canceled once a PWD changes residency.

Puerto Ricans are U.S. citizens, but they are only entitled to all the benefits and rights of citizenship as long as they don’t live in their homeland.

This is due, in great part, to U.S. Supreme Court decisions from the early 20th century known as the Insular Cases , which declared residents of so-called “unincorporated territories” unworthy of the same constitutional rights and benefits as citizens of the states and the District of Columbia. The Insular Cases said these people were unworthy of rights because they were “alien races” and “savage tribes.”

Within the beautiful and idyllic landscape of Puerto Rico, where tropical beauty intertwines with vibrant culture, a tale of two islands unfolds. If we were to draw an imaginary blue line from Manatí down to Juana Díaz, we would realize that the median household income to the west is as low as $22,419. In contrast, in Puerto Rico to the east of the line, the median household income is as high as $32,949, and in the San Juan and Guaynabo area as high as $43,479.

Beneath the shimmering surface of the paradise we call home, an undeniable chasm separates the haves from the have-nots. Like dark clouds overshadowing the Island's potential, income inequality and poverty cast a shadow on countless Puerto Ricans' lives.

After Hurricane Maria, there was a significant outmigration to the United States (Hinojosa and Melendez 2018b). Many of the migrants can be considered refugees, as many of them returned months later to Puerto Rico. According to the population estimates prepared by the Census Bureau, the net outmigration from July 2017 to June 2018 amounted to 123,399 individuals, 80 percent more than the net outmigration recorded in the previous period. However, the return of refugees continued throughout the 2018-2019 period, to the point that, from July 2018 to June 2019, there was a net immigration to Puerto Rico from the United States of 7,733 individuals, the first net immigration to Puerto Rico observed in decades (US Census Bureau 2019). With regard to damages to vulnerable houses, the administrative data gathered by the Federal Emergency Management Agency (FEMA) indicate the extent of the hurricane's wrath on vulnerable households. As of January 3, 2017, 1.09 million claims for assistance in reconstructing houses were filed by FEMA, representing 88 percent of Puerto Rican households. Figure 10 shows the most affected counties. Most of these applications were denied, and only 0.1 percent received the maximum grant ($33,000). Culebra (the small island to the east) had zero maximum grants for 543 claims; Hormigueros had zero for 5,098; Quebradillas had zero for 7,832; and Sabana Grande had zero for 7,658 households affected. Lajas had one maximum grant for 7,484 claims and San German had one maximum grant for 10,207 claims. In terms of income inequality, Puerto Rico had one of the worst Gini coefficients in the world before Maria (Puerto Rico Institute of Statistics 2018). According to the first human development report of Puerto Rico, in 2012, it ranked as the country with the fifth highest income inequality in the world, with a Gini coefficient of 0.55, which was an increase from 0.535 in 2006. Similar to the United States, where the inequality indicators are based on the American Community Survey, in the case of Puerto Rico these inequality indicators were based on the Puerto Rico Community Survey. There are no data on consumption inequality on the island.

Puerto Rico has not always been in an economic depression. According to the world data gathered by Angus Maddison (see https://www.rug.nl/ggdc/historicaldevelopment/maddison/original-maddison), from 1955 to 1980, the economy of Puerto Rico was among the top growing countries in the world. In particular, the Gross Domestic Product per capita in 1980 was 210 percent higher than in 1955. Such growth was double the world's rate (83 percent) during that period and ranked the island among the top-14 countries in the world in terms of income per capita growth. The economic model at the time was rather simple: attracting manufacturing corporations from abroad based on federal and local tax incentives. One of the major drawbacks of this model was its high fragility. That is, the economic model of industrializing by becoming a tax haven for U.S. corporations, without linking foreign investment to local sectors or growing domestic capabilities in other sectors, was becoming weak since at least the 1980s, and this problem was related to institutional limitations (Catala-Oliveras 2007; Quinones and Seda-Irizarry 2016). In 2005, a year before Puerto Rico's great depression (a long and deep downturn in the GNP) began, the Economic Commission for Latin America and the Caribbean (ECLAC) stated that one of the fundamental problems of Puerto Rico's economy was its low job creation (Martinez, Mattar and Rivera 2005). A year later, Puerto Rico entered a depression, the greatest in more than 100 years (Caraballo-Cueto and Lara 2018). That is, if one uses U.S. manufacturing as the reference or control group, it may be observed that trade liberalization affected manufacturing employment in both Puerto Rico and the United States, but Puerto Rico had a larger fall despite having much lower wages than the United States that reduced its exposure to foreign competition. What happened in 2006 to cause the economy to enter such a depression? In 2006, a federal tax incentive for U.S. manufacturing located on the island was removed, without a federal complement to the local industrial incentives program. This was the decision of the U.S. Congress and its president when they phased out Section 936 of the U.S. Tax Code over a ten-year period beginning in 1996. That effect, combined with trade liberalization, exacerbated the structural weaknesses of Puerto Rico's growth model, triggering the economic depression. Given that manufacturing employment had also declined in the United States and in many other high-income economies, how much of this decline in manufacturing can be related to the removal of Section 936? According to the data gathered by the Federal Reserve Bank of St. Louis, during the period 1990-2006, manufacturing employment in the United States declined by 20 percent, but in Puerto Rico it declined by 30.8 percent. For instance, in 1996, the average wage in multiple occupations in Puerto Rico was between 6 percent and 59 percent lower than the same occupations in the United States (Simpson 1998). These wage differentials did not disappear later: according to the Quarterly Census of Employment and Wages (QCEW), the annual average pay for manufacturing in Puerto Rico in 2001 was $25,319 compared to $42,969 in the United States. Non-academic reports have pointed out other factors that triggered the economic crisis in Puerto Rico. One of them was the Krueger Report (Krueger, Teja and Wolfe 2015), and another was the report by the New York Federal Reserve (2012), which related the crisis to the federal minimum wage, to welfare programs, and to fiscal mismanagement, among others. Even though those factors may have had some effect on the crisis, they are not free from controversies. For instance, the arguments that welfare programs were excessively generous was challenged by Cordero-Guzman (2016), who argues that it is not common that individuals participated in different welfare programs at the same time, and the statement that the federal minimum wage caused unemployment in Puerto Rico was challenged by Caraballo-Cueto (2016), who found that at least in 2007-2009 the minimum wage had virtually no employment effects in the aggregate. Many indicators show the deepness of the economic crisis. For instance, the Real Gross National Product (inflation-adjusted GNP) in fiscal year 2017 (July 1-June 30, 2016) was below the GNP of 1998, and public debt represented over 98 percent of the GNP. Public debt is defined as bonds and loans of the central government, government-owned corporations, and municipalities. If one includes debt in employees' retirement funds, the ratio rises to approximately 170 percent of the GNP. Even though average income in the United States in 2016 was 232 percent higher than in Puerto Rico, percapita public debt (excluding retirement funds) in Puerto Rico was $21,818 in 2016, while in the United States, it was $9,657. (1) Other macroeconomic proxies pointed in a similar direction. Real personal consumption in 2017 was close to the level of 2005, as shown in Figure 1. This is not surprising when one considers the number of jobs lost during this great depression. According to the data published by the Puerto Rico Planning Board, from 2006 to 2017, close to 274,000 jobs were lost and the real average wage remained static. In Figure 1, we can also observe that real personal consumption increased after Hurricane Maria during fiscal year 2018, but by a moderate 1.1 percent. This probably reflects the effect of post-Maria reconstruction, when at least $13.8 billion was disbursed by the federal government and insurance companies (Quiles 2019). Based on these reconstruction funds, the fiscal plan of April 2018 predicted that the 2019 GNP would grow 6.7 percent. At the time of the writing of this paper, the 2019 national accounts of Puerto Rico had not been published, but based on the economic activity index, which has a high correlation with the GNP, it would be difficult to assume that the economy grew by more than 2 percent during fiscal year 2019. What many economists and the fiscal control board (the Board) agree with is that this economic crisis in Puerto Rico is not cyclical, but structural, and that reconstruction will create ephemeral economic growth and, thus, structural policies are needed. The disagreements emerge in the recommendations. Some (e.g., Krueger et al. 2015) emphasize the role of supply-side reforms such as privatizations, austerity, and labor market reforms, but those were established over the last ten years with no observable positive impact on economic growth or on social equality. For instance, the labor market reform was approved in 2017, and the Secretary of the Labor Department admitted that it only created two hundred jobs (Cortes Chico 2018). Examples of privatization are Highway 22, whose toll rates increase every year, and the Luis Munoz Marin Airport, whose privatization hinders the development of Ceiba's airport, the largest and yet underutilized airport in Puerto Rico. In the case of austerity, the large reduction in government employees (shown in Figure 1 above) did not pull the economy out of its depression. Researchers from the International Monetary Fund (IMF) state that "Austerity policies not only generate substantial welfare costs due to supply-side channels, they also hurt demand--and thus worsen employment and unemployment" (Ostry, Loungani and Furceri 2016, 40). We argue for other sets of policies in section five below.

Rationale #3: Economic Disruption. In 1978 and 1980, the Court in Torres and Rosario noted the federal government’s concerns about the eco- nomic disruption that would come from extending federal public benefits to Puerto Rican residents.257 The federal government has cited in its briefing that “published studies have concluded that SSI and SNAP payments are as- sociated with important work-disincentivizing effects.”258 The federal gov- ernment has also represented that “Congress could . . . rationally conclude that these effects [could] be more severe in Puerto Rico” because of the island’s weaker economic situation compared to the rest of the United States.259

It is beyond dispute that the federal government’s economic policy to- wards Puerto Rico is markedly different today. At the time Torres and Ro- sario were decided, Congress had legislated significant tax incentives for corporations doing business in Puerto Rico.260 Congress repealed those tax exemptions in 1996.261 Furthermore, Congress recently created an oversight board to oversee Puerto Rico’s budget in light of the economic fallout from Hurricane Maria and the island’s bankruptcy.262 But it is not clear which way these changes cut.263 Should courts interpret this legislative activity as evi- dence that the Torres/Rosario rationales are outdated and therefore the equal protection challenges can proceed? Or should courts look at this new con- gressional activity as evidence that Congress is actively legislating in this area and the courts should get out of the way?

Rationale #2: The Cost of Treating a Territory Like a State. The federal government rightly points out that judicial review of “distinctions that Con- gress draws in order to make allocations from a finite pool of resources must be deferential,” and that “protecting the fiscal integrity of Government pro- grams, and of the Government as a whole, is a legitimate concern of the State.”254 That said, a federal court must be able to identify a valid reason for the cost savings.255 And in its briefing in both Vaello-Madero and Peña- Martínez, the government did not identify a reason why Congress would treat some Americans who live in territories differently from other Ameri- cans who are eligible for the federal benefits on the basis of their poverty, disability, or age. This is an awkward rationale for programs with nationally defined benefit amounts, as it costs the same amount of money to award SSI benefits to an eligible citizen in Puerto Rico as it does to award those benefits to someone in Florida, Vermont, or the Northern Mariana Islands (CNMI).256 Singling out otherwise-eligible Americans because they reside in territories is the kind of arbitrary decision equal protection is supposed to protect Americans against.

Rationale #1: Federal Income Tax. The federal government has argued in both cases that the fact that Puerto Rican residents only pay federal income tax on certain sources of income provides a rational basis from excluding them from SSI, SNAP, and the Medicare subsidies.244 That’s true: residents of Puerto Rico do not pay federal income tax on most types of income.245 Unlike other Social Security benefits which are paid for through payroll taxes (taxes that Puerto Ricans pay), SSI is paid for by general tax revenue, includ ing income tax receipts.246 Yet, while the Supreme Court in Rosario states that Puerto Ricans “do not contribute to the federal treasury,” recent tax re- ceipts suggest otherwise.247 Puerto Rico contributes roughly $4 billion in an- nual tax revenue to the federal government, exceeding the contribution of several states.248

More importantly, this is a confused justification for excluding any group of Americans from SSI. As a means-tested program, SSI’s eligibility rules are not based on past or future federal tax payments. SSI is a program that only kicks in when an applicant has been shown to have insufficient work history to qualify for Social Security Disability Insurance and has little or no income.249 The idea that Congress could use a logic of contributory in- surance to justify a noncontributory (i.e., means-tested) program is odd.250 The same is true for SNAP. No other group of Americans are excluded from SNAP because they do not pay income taxes. While it is difficult to find na- tional data on tax receipts by these recipients, it is highly unlikely that many Americans who receive SNAP, SSI, or Medicare Part D have any federal in- come tax liability.251 As the First Circuit noted, an individual cannot have more than $8,796 in countable annual income to receive SSI, which is signif- icantly less than the standard deduction of $12,400 for single tax filers, let alone for the blind and elderly.252 Perhaps that is why there is no other case where the federal government has defended its exclusion of a group of peo- ple from a welfare program on the basis of federal tax contributions.253

It’s worth noting that while the fix for the Child Tax Credit’s family-size exclusion is permanent, the national expansion of the credit is only temporary. Congress should therefore act to make full refundability of the credit permanent as well as additional improvements in the credit. If they don’t, the credit’s anti-poverty effects in Puerto Rico (and elsewhere) will surely decline.

It’s also important to note that families in Puerto Rico claiming the Child Tax Credit must do so directly with the IRS, whereas they can claim the EITC through Puerto Rico’s Treasury Department. Given the historical absence of these credits in Puerto Rico and the novelty of the expansions, uptake is expected to build gradually over time. Intensive outreach efforts, including campaigns from EA and YDI, will help as many families as possible take advantage of these credits.