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

by Jonathan M. Metzl

Cuts to health delivery networks, communal safety nets, schools, and social services, alongside policies that enable the proliferation of guns, often impact m...

Racism itself can also have profoundly negative health consequences. Epidemiologist Yvette Cozier and her colleagues have uncovered associations between frequent experiences of racism—such as receiving poor service in restaurants and stores or feeling unfairly treated on the job or by the...

Sleep researcher Michael Grandner has found links between perceived racism and sleep disturbances. And public health scholar Mario Sims found that lifetime discrimination was associated with greate...

My findings in this book suggest that we make a wrong turn when we try to address racism mainly as a disorder of people’s brains or attitudes, or try to “fix” the problem simply by attempting to sensitize people or change their minds. On an aggregate level, people’s individual racial attitudes have relatively little correlation to their health.

Racial animosity rarely makes a person sick in and of itself—otherwise, there would be many more sick people of all backgrounds in the world.

For instance, sociologists Mark Beaulieu and Tracey Continelli have studied the “benefits of segregation for white communities.”

Yiiiiikes

racism matters most to health when its underlying resentments and anxieties shape larger politics and policies and then affect public health. I say this in part because many of the middle- and lower-income white Americans I met in my research were not expressly or even implicitly racist.

Lol wanna bet

Yet racism remained an issue, not because of their attitudes but because they lived in states whose elected officials passed overly permissive gun policies, rejected health care reform, undercut social safety net programs, and a host of other actions. In these and other instances, racism and racial resentment functioned at structural levels and in ways that had far broader effects than the kinds of racism that functions in people’s minds.

I found that, when tracked over time, racially driven policies in Missouri, Tennessee, and Kansas functioned as mortal risk factors for all people who live in these states. This is because illness and death patterns that followed actions such as expanding gun proliferation or massive tax cuts mimicked those once seen in relation to other man-made pathogens, such as water pollution, secondhand smoke, or not wearing seat belts in cars, or during certain disease outbreaks. Society mobilized to reduce risk and improve health when toxins dumped into the water, cigarettes, or faulty automobiles led to declining health. But when the pathogens were policies and ideologies, they instead laid the foundations for politics furthered at the national level by the GOP, the NRA, and the Trump administration.

stories like Trevor’s come to embody larger problems of an electorate that, in its worst moments, votes to sink the whole ship (except for a few privileged passengers who get lifeboats) even when they are on it, rather than investing in communal systems that might rise all tides. Anti-blackness, in a biological sense, then produces its own anti-whiteness. An illness of the mind, weaponized onto the body of the nation.

In this book, I do not mean white as a biological classification or a skin color but as a political and economic system. I do so because of historical precedent: throughout American history, supporters of pretty much all American political backgrounds and parties have risen to defend the economic and political privileges built around “whiteness” when these privileges seem under “attack.”

Similar opposition resulted when the Johnson administration introduced Medicare and Medicaid in 1965, based on widespread concerns among white Southerners that new laws would require previously segregated hospitals to integrate in order to receive federal funding.

Paying attention to “whiteness” as a political and economic system is also important because, according to the work of historians and race theorists, the seeming benefits afforded by such systems of privilege can blind working-class white populations to these system’s negative effects, opening the door for potential manipulation.

In his seminal work on Reconstruction, historian W. E .B. Du Bois famously argued that whiteness served as a “public and psychological wage,” delivering to poor whites a valuable social status derived from their classification as “not-black.” “Whiteness” thereby provided “compensation” for citizens otherwise exploited by the organization of capitalism—while at the same time preventing working-class white Southerners from forming a common cause with working-class black populations in their shared suffering at the bottom of the social ladder.

And a lot of white people stopped reading there

More recently, writer Toni Morrison states the inherent conflict of American whiteness bluntly: to “restore whiteness to its former status as a marker of national identity, a number of white Americans are sacrificing themselves.”

Again, the health risks that Dyson describes go along with substantial real-world benefits, such as not being disproportionally shot by police, deported, or mass incarcerated. Yet present-day social scientists now catalog the trade-offs that many white Americans make to maintain a system that appears set up for their advantage. As a team of researchers led by sociologist Jennifer Malat writes, white Americans increasingly represent a “paradox” of privilege, access, and social rewards on one hand and relatively poor health outcomes on the other.

There are also far too many examples of ostensibly liberal or Democratic initiatives that result in poor health for minority and low-income populations—indeed, Democrats sustained segregation in the US South for decades prior to the 1960s.

Jfc dude. They were "conservatives" until Johnson wrenched the party into the modern era. And he was racist too.

Liberals and progressives have at times used disdain for conservatives, or a sense of superiority over them, as ways to mask their own ways of promoting inequity.

Fair though

When politics demands that people resist available health care, amass arsenals, cut funding for schools that their own kids attend, or make other decisions that might feel emotionally correct but are biologically perilous, these politics are literally asking people to die for their whiteness.

I’ve written this book because, as a physician, I’ve become increasingly concerned about population-level policies constructed with disregard for population-level health. And as a researcher, I began to realize that the overarching negative health effects of these policies resulted not from people’s deep biases or fear of minorities lodged deep in their brains but from specific electoral, economic, and policy decisions made at particular moments in time.

Couching politics in racial mistrust also makes it harder for white America to see how we—and I include myself as a white American here—would benefit self and country far more by emphasizing economic, legislative, and everyday cooperation rather than by chasing the false promise of supremacy.

In the book’s conclusion, I argue that the way forward requires a white America that strives to collaborate rather than dominate, with a mind-set of openness and interconnectedness that we have all-too-frequently neglected.

Rather, our nation urgently needs to recognize how the systems of inequality we build and sustain aren’t benefiting anyone. Forms of white disconnect emerging today—and not coincidentally, at the very moment when US white populations begin to imagine an end to demographic dominance—instead encourage a host of anxieties and decisions that threaten the well-being of a great many people.

These histories, myths, and ideologies go a long way toward explaining the complex tension between promises of restored “greatness” on one hand and practices of self-sabotage on the other. Better awareness of this paradoxical tension might allow us to better promote an alternative investment in collaboration and equality—in many instances, by addressing ideologies of whiteness head-on rather than by proxy.

The recent histories of Missouri, Tennessee, and Kansas thus serve as object lessons and cautionary tales that suggest how the racial system of America fails everyone. The health trajectories of people in these states also offer dire warnings against emulating gun policies like Missouri’s, health care systems like Tennessee’s, and tax cuts like those inflicted on Kansas across the entire United States.

At the other end is Kim, thirty-nine, whose father called her and then killed himself while they were still on the phone—it’s been less than six months now.

Jesus

I came to Missouri to better understand the real-world consequences of gun suicide and gun death, in large part because the state often serves as ground zero for gun violence prevention researchers.

However, in the past twenty years, an increasingly conservative and pro-gun legislature and citizenry had relaxed limitations governing practically every aspect of buying, owning, and carrying firearms in the state. In the six years prior to my 2016 visit to Cape Girardeau, the Missouri legislature ended prohibitions on the concealed and open carry of firearms in public spaces, lowered the legal age to carry a concealed gun from twenty-one to nineteen, and repealed many of the requirements for comprehensive background checks and purchase permits.

And in 2016, Missouri lawmakers overrode their governor’s veto to enact Senate Bill 656, the so-called guns everywhere bill. Among other stipulations, SB 656 eliminated requirements for training, education, background checks, and permits needed to carry concealed weapons in Missouri. Bill 656 also annulled most city and regional gun restrictions, vastly expanded so-called Castle Doctrine coverage—the notion that “a man’s home is his castle and he has a right to defend it… free from legal prosecution for the consequences of the force used”—and extended “stand-your-ground” protections for people who took lethal action against perceived dangers outside the home as well.

At the same time, research suggested that gun injuries and deaths rose after it became easier for people to buy and carry firearms. For instance, a team of investigators led by Daniel Webster, director of the Johns Hopkins Center for Gun Policy and Research, analyzed crime data from Missouri and found that the state’s 2007 repeal of its permit-to-purchase (PTP) handgun law “was associated with a 25 percent increase in firearm homicides rates.”

Between 2008 and 2014, the Missouri gun homicide rate rose to 47 percent higher than the national average. Rates of gun death by suicide, partner violence, and accidental shooting soared as well. In 2014, gun deaths topped deaths by motor vehicle accident for the first time in the state. News outlets referred to Missouri as the “Shoot Me State.”

The Missouri I recalled was a Show Me State marked by attempted compromise. Leaders came from various ranks of society and represented a wide array of constituencies. As recently as 2000, when the election handed the state senate an even number of Democrats and Republicans with neither side holding a majority, party leaders arranged for a unique power-sharing agreement that split power among them.

Over the course of the early twenty-first century, rightist agendas came to dominate the state legislature in ways that loosened gun laws, slashed public spending, blocked health care reform, and undercut social safety net programs. Meanwhile, racial tensions came to full boil in November 2014, after Darren Wilson, a twenty-eight-year-old white police officer in Ferguson, shot and killed an unarmed African American teenager named Michael Brown.

With each visit over recent years, I could not help but notice that the tenor of the state became increasingly tense, polarized, and ever-more-heavily armed.

Tom, who wore a holstered gun while shopping for toiletries at a Walmart in Independence, told me that he appreciated the ability to protect himself against possible threats at all times. An advertising consultant from Columbia named John told me that he liked being able to carry a concealed firearm when he visited printing factories and other work sites. “The thought that I can bring a gun just makes me feel safer,” he explained.

Me. Operative word.

Conversely, numerous Missourians described anxieties about guns and armed civilians in public spaces.

Any number of African American citizens voiced concern about the charged implications of white citizens brandishing guns in mixed-race settings. In Kansas City, I met a Vietnam veteran named John, who told me that he now thinks twice about shopping at Sam’s Club.

John used to stop by the wholesale megastore on his way home from his job as a home health care provider. That was before he saw armed white men strolling through the aisles. For John, the result was often intimidation.

For Cassandra, an African American pastor in St. Louis, situations such as the ones described by John illustrated a double standard through which society coded white gun owners as “protectors” and black gun owners as “threats.”

The city’s official website describes Cape Girardeau as a “regional destination for healthcare, education, shopping, and employment.” But the city and the surrounding region recovered slowly from the recession of 2008, and stability remained elusive for many people and small businesses. Opioid and heroin abuse also became growing problems in the 2010s. In 2015, the average per capita income was $24,479, and 16 percent of people lived below the poverty line.9

The centrality of gun culture to people’s daily lives in Cape Girardeau struck me immediately on my arrival to town—in fact, it was hard to miss. Practically everyone waiting or working in the small airport wore some sort of camouflage.

Even the dogs bore camouflage—a woman in a camo jacket led a guide dog decked out in a camouflage bandanna. Were we in the woods on a fall day, these people would likely have been invisible. But because we were in a small regional one-room airport, they simply blended in with one another.

We drove out of the airport and immediately passed a business called Shooters Gun Shop Inc., soon followed by a series of billboards for gun ranges, gun shops, and gun shows. I asked Jim about the ubiquity of firearms and camo, and he gave a thoughtful reply. “I’m sure it must seem strange coming in from the outside,” he said, “but for us, it’s what we’ve grown up with.”

Guns also feature prominently in the stories people tell at the support group and in the lengthy one-on-one interviews I conducted with group members and other people from Cape in the days and weeks following the gathering at the library. For pretty much everyone I speak with, the language of patriotism and protection collides with memories of extraordinary trauma and pain.

Billie says this in part for my benefit—she reached out and invited me to observe a meeting after I posted an essay about my research on a Missouri listserv. Billie also raises the specter of firearms because doing so gives permission for people to share some of the more excruciating remembrances of their losses.

Kyle was good with his hands and found work restoring old cars at a local body shop. Like many young people in southern Missouri, Kyle also struggled with opiate addiction but seemed to have kicked the habit, only to fall into heavy drinking.

“And don’t forget the funeral,” Rick adds. “The funeral?” asks Billie. “Where we come from, you say goodbye with an open casket. That’s how it’s done,” Rick answers. “But Kyle was… gone. There was nothing left that looked like our son. I worked so hard with the undertakers, there was hardly anything left.” He begins to weep. “We got the left arm. In the end, we got the left arm.”

Kim speaks next. “It was pretty much the same for me. My dad never needed guns when we was growing up. An’ then he got worried about protection, security, you know, and terrorism and intruders. I have no idea why; maybe that’s what everyone was saying.” She, too, begins to cry. “So my ex and I… we took him out and taught him to shoot. I had no idea that he would ever… he called me in the middle of the night, told me it was all my fault. Did it right then. And why? It’s the same thing, when someone shoots himself in the head; all you can do is cremate them. You’re searching for… memories.”

To be sure, the group reaches a point in the conversation in which outpourings of pain and despair turn to strategies for moving forward and helping others. “I would do anything to help other people so that their families don’t have to go through this nightmare,” June says at one point in the conversation. “What can we do to prevent more suicides?” Dawn, Billie’s coleader, asks.

At the same time, I cannot help but notice that, unlike my imagined lung cancer or impaired driving meetings, not one person makes a critical comment about guns, bullets, gun manufacturers, or gun laws. No one suggests that rethinking the role of guns in personal and public life might impact suicide.