This research charts the structural transformations of American capitalism and attendant shifts in the distribution of health and illness at the dawn of the 21st century. Through the analytic lens of the political economy of public health, I shed novel light on the upstream determinants of America's overdose epidemic, which is claiming tens of thousands of lives every single year, and on deepening social inequalities in life expectancy, all-cause mortality, and premature mortality risk. Economic decline, notably in the form of deindustrialisation, has fractured working class communities and spawned a highly stratified social structure. In response to this development, American social policy has undergone a distinctive transformation involving a historically unprecedented expansion of the penal system. This has resulted in the rapid swelling of the correctional population, reaching almost 7 million people in 2012, of whom over 2.2 million find themselves behind bars. Despite the salience and magnitude of these phenomena, virtually no existing research has investigated the connections between deindustrialisation, incarceration, and America's public health crisis. This thesis fills this gap by using new data from U.S. states and counties between 1980 and 2014 to examine the social, economic, and political roots of increasing health inequality.