This dissertation makes three scientific contributions to our understandings of the structural drivers of mortality inequality in the United States, focused on disparities at the intersection of race and sex. The first chapter examines the evolution of age-specific mortality inequality across the COVID-19 pandemic among White, Black, Hispanic, and Asian populations. Findings document shifting age gradients in COVID-19 mortality, as well as narrowing racial/ethnic disparities in all-cause and COVID-19 mortality. This chapter discusses how structural risks, as well as changes in the nature of the virus and behavior shaped the pandemic’s evolving impact. This second chapter examines how changes in the ideological orientation of state policy environments from 1990 to 2019 have shaped racialized and gendered disparities in mortality and life expectancy among Black and White Americans. Findings reveal a growing liberal state life expectancy advantage over the past several decades, with Black life expectancy in the most liberal contexts recently surpassing or equaling White life expectancy in several conservative contexts. Further, by showing that state-level conservative policy shifts disproportionately increase mortality among Black and female populations, particularly at younger ages and from select preventable causes of death, including HIV/AIDs and drug overdose mortality, this chapter highlights state political and policy environments as a key driver of health inequality. The third chapter examines the relationship between county jail incarceration and age-specific mortality for Black and White men and women. Findings show that jail incarceration positively associated with mortality, with more pronounced penalties for women and the steepest consequences for Black men in late life. This chapter points to the need to disentangle jail and prison incarceration to better capture the health consequences of America’s carceral system. Together, these studies make substantive contributions to the study of mortality and longevity inequality in the United States, highlighting the structural forces that lead to the unequal distribution of health burdens across populations occupying varying positions within racial and gender hierarchies.