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This Essay contextualizes the racially disproportionate impacts of COVID-19 in the United States within a framework of settler colonialism in order to broaden the understanding of how structural inequality is produced, imposed, and maintained. A settler colonialism framework recognizes that the United States is a present-day settler colonial society whose laws, institutions and systems of governance continue to reenact the three processes upon which the United States was built—Indigenous elimination, anti-Black racism, and immigrant exploitation. This Essay connects these foundational processes—and their underlying White supremacist logics—to the disparate health impacts of COVID-19 on Indigenous, Black, and immigrant of color communities in the United States. By offering a framework that uncovers the root causes of ongoing patterns of systemic oppression, this Essay hopes to inspire reform efforts that seek to alter such patterns by advancing reform efforts that are grounded in truth, justice, and reconciliation.