Dying of Whiteness: How the Politics of Racial Resentment Is Killing America's Heartland

by Jonathan M. Metzl

Many people with whom I spoke longed for a middle ground in an increasingly polarized political climate

Oh fuck me not this shit again

These and other persons, whose voices appear frequently throughout this book, suggest how on-the-ground reality is far more complicated than are the polarized positions we are frequently fed—positions that benefit politicians, donors, foreign governments, or corporations by convincing different groups of Americans that they have nothing in common with each other.

Fair to a point buuuuut

At many points along the way, I became convinced that reasonable people of vastly divergent, pro-this or anti-that backgrounds might find middle ground if left to their own devices. But just as frequently, when I met with middle- and lower-income white Americans across various locales, I found support for a set of political positions that directly harmed their own health and well-being or the health and well-being of their own families.

Trevor’s attitude points to an existential question at the center of my explorations: Of what was Trevor dying? At the most basic level, he died of the toxic effects of liver damage caused by hepatitis C. When the liver becomes inflamed, it fails to filter toxins from the blood and loses the ability to produce vital compounds such as bile and albumin. Without treatment, death comes by systematic deterioration. Jaundice gives way to ascites, which then gives way to hepatic encephalopathy and coma. It’s an exceedingly slow, painful way to go out.

Yet I could not help but think that Trevor’s deteriorating condition resulted also from the toxic effects of dogma. Dogma that told him that governmental assistance in any form was evil and not to be trusted, even when the assistance came in the form of federal contracts with private health insurance or pharmaceutical companies, or from expanded communal safety nets. Dogma that, as he made abundantly clear, aligned with beliefs about a racial hierarchy that overtly and implicitly aimed to keep white Americans hovering above Mexicans, welfare queens, and other nonwhite others.

Trevor also slowly died because the dogmas and hierarchies he supported reflected the agendas of politicians who clamored that health care reform and Medicaid expansion represented everything from government overreach to evil incarnate. Anti-ACA invective found particular champions in GOP lawmakers in Tennessee, a once centrist state that turned hard right. These politicians repeatedly made sure that Tennessee did not create its own Obamacare exchange, expand Medicaid, or embrace the health care law in any way.

Thus, routine screenings, filled prescriptions, visits to doctors’ offices, and many other factors linked to better health outcomes rose steadily in Kentucky in the four years after that state expanded Medicaid. Such trends lifted the overall well-being of many Kentuckians and particularly helped people who suffered from what are oddly called preexisting conditions like hepatitis C—oddly, in my opinion, because “preexisting” assumes that a person’s existence begins at the consummation of health insurance coverage.

Yet the more I spoke with Trevor, the more I realized how his experience of illness, and indeed his particular form of white identity, resulted not just from his own thoughts and actions but from his politics. Local and national politics that claimed to make America great again—and, tacitly, white again—on the backs and organs of working-class people of all races and ethnicities, including white supporters.

Dying for a cause then amounted to a modern-day form of kamikaze. But in this case, death wasn’t announced with headlines of a flaming plane flown into a battleship. Instead, this form of death was slow, excruciating, and invisible.

I met many people like Trevor over the course of my research. People who were dying in various overt or invisible ways as a result of political beliefs or systems linked to the defense of white “ways of life” or concerns about minorities or poor people hoarding resources.

Telling on themselves

Trump supporters were willing to put their own lives on the line in support of their political beliefs. As a result, when viewed more broadly, actions that may have seemed from the outside to be crazy, uninformed, or self-defeating served larger political aims.

Sunk cost fallacy

By design, vulnerable immigrant and minority populations suffered the consequences in the most dire and urgent ways. Yet the tradeoffs made by people like Trevor frequently and materially benefited persons and corporations far higher up the socioeconomic food chain—whose agendas and capital gains depended on the invisible sacrifices of lower income whites.

Rather than landing a man on the moon, curing polio, inventing the internet, or promoting structures of world peace, a dominant strain of the electorate voted in politicians whose platforms of American greatness were built on embodied forms of demise.

I repeatedly found examples of policies, politics, or products that claimed to restore white authority but silently delivered lethality. An example that I discuss at length below: pro-gun legislators, the NRA, and gun advertisements touted the abilities of semiautomatic weapons to restore white men’s “privilege” and the “balance of power” in an ever-more-diverse world, even as firearms emerged as leading causes of white, male suicide.

First, a host of conservative political movements emerged (or reemerged) in Southern and midwestern states over the later twentieth and early twenty-first centuries that brought into mainstream US politics once fringe agendas, such as starving government of funding, dismantling social programs, or allowing free flow of most types of firearms. These movements—ranging from the Tea Party to iterations of libertarianism funded by the Koch brothers, to the Freedom Caucus, to the so-called alt-right given voice through outlets such as Breitbart—arose from vastly different agendas and points of origin.

As this played out, theories of backlash conservatism gave way to something even more powerful: practices of backlash governance.

Second, these increasingly unified forms of conservatism advanced politically through overt or implicit appeals to what has been called white racial resentment.

This was both a top-down process (politicians used racial resentment as a tool for class exploitation) and a bottom-up one (the language of white resentment became an increasingly accepted way of talking about whiteness more broadly).

To be sure, groups like the Tea Party rose to prominence for a wide array of cultural, economic, and religious reasons, many of which had relatively little to do with whiteness or race.

Im skeptical

A number of people with whom I spoke, when I explained the thesis of my book, told me that positions that appeared to reflect racism instead reflected a larger, color-blind “hatred of the poor.”

And who is stereotyped as poor?

This is not to say that any one specific person was expressly racist. Rather, frameworks of white racial resentment shaped debates about, and attitudes toward, various public policies and acts of legislation.

In 2016, former Missouri Republican Party director Ed Martin told a cheering Tea Party for Trump rally in Festus, Missouri, that “Donald Trump is for Americans first. . . . You’re not racist if you don’t like Mexicans.” (That same year, the Tea Party Patriots funded Asia-bashing advertisements featuring fictional Chinese executives in suits speaking Mandarin and laughing about how they were able to buy thousands of acres of Missouri farmland.)

Third, the policies that took shape when these once fringe forms of conservatism entered the mainstream GOP and assumed legislative power often negatively affected the health of middle- and lower-income populations. While some of these policies and actions directly affected health care, others not expressly linked to health, such as the proliferation of civilian-owned firearms, nonetheless carried profound medical implications.

When white backlash policies became laws, as in cutting away health care programs and infrastructure spending, blocking expansion of health care delivery systems, defunding opiate-addiction centers, spewing toxins into the air, or enabling guns in public spaces, the result was—and I say this with the support of statistics detailed in the chapters that follow—increasing rates of death.

Fourth, a wide array of middle- and lower-income people experienced negative health consequences from these policy decisions—again, largely because the policies involved elaborate strategies for tearing down community structures for middle- and lower-income Americans but hardly any blueprints for building them back up.

the data I track in this book reveals the shocking extent to which the health and well-being of white Americans suffered from the health effects of these policies as well. Such effects played out in public ways—such as when white concertgoers died in high-profile mass shootings linked to gun policies (or lack thereof) enacted by conservative white politicians.

Finally, as with Trevor, many lower- and middle-income white Americans continued to support these policies and ideologies—with their inherent links to narratives of imagined victimhood and domination—even after their negative effects became apparent and promises made by politicians such as Trump unraveled. Indeed, for a variety of reasons, white Americans in parts of the United States saw unprecedented drops in life expectancy over the time of my study.

Woof

instead of scrapping these state-level policies as examples of historically bad governance, they became the foundations for legislation at the national level, in the form of Trump-era tax bills, gun policies, health care strategies, and other ill-fated initiatives. All the while, the issues themselves—such as guns, health care, or taxes—accrued larger symbolic or moral meanings in ways that rendered conversations about the effects of specific policies ever-more difficult.

Succinctly put: a host of complex anxieties prompt increasing numbers of white Americans like Trevor to support right-wing politicians and policies, even when these policies actually harm white Americans at growing rates.

This is because white America’s investment in maintaining an imagined place atop a racial hierarchy—that is, an investment in a sense of whiteness—ironically harms the aggregate well-being of US whites as a demographic group, thereby making whiteness itself a negative health indicator.

Scholars and writers have long argued that the Republican Party rose to influence in the US South by taking advantage of white backlash against integration and civil rights to cajole white working-class people to vote against their own financial self-interests. Thomas Frank, in his modern classic What’s the Matter with Kansas?, writes that backlash conservatism rests on the foundation that “ignoring one’s economic self-interest may seem like a suicidal move to you and me, but viewed differently it is an act of noble self-denial; a sacrifice for a holier cause.”

My research measures just how deeply modern-day American backlash conservatism demands that lower- and middle-class white Americans vote against their own biological self-interests as well as their own economic priorities. Over the course of the narrative, I meet with white Americans who continue to support GOP policies, even as these same policies negatively affect their own health in measurable ways.

To be very clear, it is in no way my intention to expose anyone with whom I spoke as being duped or uninformed.

As the following chapters make clear, many people I spoke with were not exactly thrilled with their own political leaders and fought for reform in unexpected ways. I uncovered numerous other examples of working-class white resentment directed at other white people. As essayist Sarah Smarsh puts it, “Most struggling whites I know live lives of quiet desperation mad at their white bosses, not resentment of their co-workers or neighbors of color.”

Any approach I might adopt that suggests them, conservatives, versus us, enlightened liberals, is tempered by the fact that I, too, receive the benefit of the doubt when I walk down the street and that I am neither profiled by police nor subject to arrest and incarceration by ICE agents. I have no doubt that many of the conversations I recount in this book reflect commonalities between myself and the people I interview. It seems to me a lost opportunity to address Southern forms of whiteness as existing only in another “country,” rather than as exaggerations of systems of privilege that surround North and South, liberal, progressive, and conservative, interviewee and interviewer both.

This work at least tried to rectify inequality through policies that promoted principles of diversity and social justice, but were rendered impossible by political agendas that defunded supporting governmental programs and agencies. All the while, politics fueled by racial resentment eroded faith in hallmark American democratic institutions more broadly.

I kept thinking that at some point, the drive for self-preservation might trump political ideology. Why would someone reject their own health care, or keep guns unlocked when their children were home? Yet because of the frames cast around these and other issues hued with historically charged assumptions about privilege, it became ever-more difficult for many people with whom I spoke to imagine alternate realities or to empathize with groups other than their own. Compromise, in many ways, coded as treason.

Corporate-gun-lobby-backed politicians, commentators, and advertisements openly touted loosened gun laws as ways for white citizens to protect themselves against dark intruders, while white open-carry advocates paraded through largely African American sections of downtown St. Louis brandishing semiautomatic handguns and long guns. Meanwhile, black men who attempted to demonstrate their own open-carry rights were attacked and jailed rather than lauded as freedom-loving patriots.

When I began to sift through the statistics for gun injury and death in Missouri, I quickly realized that the primary victims of gun mortality were not criminals or inner-city gang members, as the NRA and some politicians implied. Rather, as gun laws were liberalized, gun deaths spiked… among white people. This was because white Missourians dominated injuries and deaths via gun-related suicides, partner violence, and accidental shootings—and in ways that outpaced African American gun deaths from homicides.

Through a back door into data on mortality, I detail how legislation that substantially deregulated gun purchases set Missouri on a path toward becoming a top state for gun suicide, even among other pro-gun states, and that the primary victims of these trends were white Missourians, particularly white men living in rural areas.

lax gun laws ultimately cost the state roughly $273 million in lost work between 2008 and 2015 and ultimately led to the loss of over 10,506 years of productive white male life.

These types of attitudes complicate attempts to sell health care reform in rural America and might doom progressive calls for “Medicare for all”—since attempts to promote expanded health care rarely address the racial anxieties surrounding government health care in places like Tennessee.

social programs such as Medicare and Medicaid carry particular racial histories and as a result convey intonations about networks that connect the well-being of white Americans with the actions and contributions of persons from other racial or ethnic groups. Here as well, racial anxiety comes at a cost.

The book’s final section takes us to Kansas, where citizens struggle with the aftermath of a Tea Party–fueled economic “experiment” led by controversial Governor Sam Brownback, in which the largest income tax cut in state history turned the state budget surplus into a substantial deficit. Parents and school administrators describe how politicians often framed the resultant cuts to Kansas public schools as ways to punish “wasteful” minority districts who supposedly splurged on “party busses” instead of classrooms. And indeed, early budget cuts overwhelmingly impacted schools in low-income minority districts. But these initial cuts were not enough to fill the gaping holes in state budgets. Soon, as a thoughtful Kansas state legislator told me, “the fire that we set in the fields burned all the way up to the home.”

When the data began to roll in, it turned out that white student populations saw flatlining test scores and rising high school dropout rates—trends that correlate directly with poor health later in life. As but one example, 688 additional white students dropped out of Kansas public high schools in the first four years of budget cuts than would have done so otherwise.

Getting shot leads to one form of mortality; not going to the doctor when you get sick or dropping out of high school leads to another. It’s sometimes a matter of speed versus slow decay. As such, the narratives I tell in the three parts of the book differ in important ways. For instance, gun and health insurance policies affect health and mortality rates far more directly than do taxation and education spending policies.

Yet these issues overlap, not just because of their centrality to present-day GOP political platforms but because of connections to particular histories of race and place in America. For nearly two centuries, gun ownership was a privilege afforded mainly to white citizens in states such as Missouri, and guns became particular symbols as a result. Health insurance similarly represented a privilege afforded only to whites in many Southern states: through the antebellum period, insurers covered black bodies as property.

These histories imbue debates about guns, health care systems, taxes, and schools with larger meanings about race in America and about American whiteness. The history of race in America also helps explain why these topics cut to the heart of present-day debates about what it means to provide resources, protections, and opportunities for everyone in a diverse society versus providing securities and opportunities for a select few.

At the same time, prior to the emergence of the Tea Party and other far-right movements, so-called purple states also represented centrist examples where people with differing ideologies worked together to try to find common, if often unstable solutions to polarizing societal problems. Missouri claimed a long history of gun rights but also enforced some of the strictest handgun laws in the nation. Bipartisan groups of Tennessee lawmakers aimed to create a Southern oasis of health care in which every citizen of the state had health insurance. Kansas boasted some of America’s best public schools. Then, polarization took over, and things changed.

Polarization my ass.

MY FOCUS ON the health risks of American backlash politics for white Americans is in no way meant to minimize the larger effects of racism in the United States. It should be taken as a matter of fact, but all too often is not, that systems in which race correlates with privilege have devastating consequences for minority and immigrant populations.