Every time a person in the Global South displaced by climate catastrophe or armed conflict migrates in search of shelter and a means of subsistence, every time someone in a high- income country such as the USA or the UK cannot access health care in an emergency, and every time foodbank users try to do so clandestinely for fear of the stigma weaponised against ‘losers like them’, then no sociological explanation for what is happening to them is complete without a micro- to- meso- to- macro- account of why they find themselves in such unnecessary and intolerable predicaments. We live in the UK in a fractured society, and one which is located in an increasingly fractured or shattered world. In his comprehensive review of the empirical literature, Danny Dorling (2023) refers to our ‘shattered nation’ and describes the UK as a ‘failing state’. ‘The UK’, he writes,

Given the emphasis throughout this volume on the sheer causal power of prevailing social structures and cultural recipes in general, and of the ruling class or current hegemonic bloc in particular, this seems like a council of despair. But despair is not an option. This chapter visits general and specific policy options.

The ambitions of this contribution already extend well beyond typical considerations of sociology and health inequalities in fractured communities in the UK and across the globe. Having said that, they are nevertheless constrained, both by what it is possible to cover in a short volume like this and by my own limited expertise. I have addressed global inequalities of health and living and touched on climate change and the omnipresent threat of warfare in a rapidly changing world.