Disease and discrimination are processes linked to class in the early American colonies. Many early colonists fell victim to mass sickness as Old and New World systems collided and new social, political, economic, and ecological dynamics allowed disease to spread.

Dale Hutchinson argues that most colonists, slaves, servants, and nearby Native Americans suffered significant health risks due to their lower economic and social status. With examples ranging from indentured servitude in the Chesapeake to the housing and sewage systems of New York to the effects of conflict between European powers, Hutchinson posits that poverty and living conditions, more so than microbes, were often at the root of epidemics.