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

by Jonathan M. Metzl

“I don’t think any of us blame the gun,” Billie replies without a hint of defensiveness. “It’s not the gun’s fault. I still own many guns. Guns are important to us and to our liberties. Heck, I’m teaching my nieces to shoot in case they need to protect themselves.”

From. Fucking. WHAT?!

These replies are not surprising. Guns are a part of the culture in white rural Missouri, and often proudly so. Guns mean protection, self-preservation, and patriotism, as my cab driver Jim told me. And perhaps phrasing the question in the way I do, and the fact of my being an outsider, implies on some level that I ascribe culpability to the culture itself and to its inhabitants, even though this is not my intention.

And perhaps for this reason, the same guns that the NRA, Amendment 5, and SB 656 define as “weapons of defense and attack” become objects in need of communal protection. Protection even within a circle of people in pain, a circle defined by a radius in which fateful bullets forever changed, altered, and ended futures and lives.

From this perspective, the initial framework that became apparent, as I stepped back and began to process what I saw and heard, was neither whiteness nor race per se—I will get to these topics shortly and in detail. Rather, I thought first about the contested politics of risk.

Risk is generally the first and greatest focus for suicide researchers. This makes sense when you think about it. A main goal of suicide research is to anticipate which persons are most likely to harm themselves in order to then prevent their self-destructive actions.

We must intervene before because intervening during or after is rarely an option. Identifying risk is of little solace in retrospect.1

In pretty much all other forms of suicide except suicide by firearm, researching risk appears rather straightforward. Researchers develop hypotheses based on their areas of expertise, apply for research funding, and map trends. For instance, researchers in psychiatry map suicide patterns using frameworks of psychiatric diagnosis.

These scientific approaches help society create lists of warning signs, events out of the ordinary, pre-event triggers, and other changes to the norm that help people better understand and assess suicide risk. Research also forms the foundation for activism in suicide-prevention communities.

For example, the American Foundation for Suicide Prevention’s public-information website lists expert knowledge about “Risk Factors and Warning Signs”: “Something to look out for when concerned that a person may be suicidal is a change in behavior or the presence of entirely new behaviors… (such as) acting recklessly, withdrawing from activities, isolating from family and friends.”

Such efforts are particularly needed at the current moment because American suicide rates are on the rise. “U.S. Suicide Rate Surges to a 30-Year High,” read an August 2016 New York Times headline, above an article that detailed how “suicide in the United States has surged to the highest levels in nearly 30 years… the increases were so widespread that they lifted the nation’s suicide rate to 13 per 100,000 people, the highest since 1986.” Subsequent research suggested that rates were particularly high in rural areas of the United States.

Research also shifts the discourse about suicide from shame and blame to empathy and community. Suicide was long considered an offense toward God or a crime when approached through religion or the law. Christian dogma in seventeenth-century Europe promoted the notion that suicide was a sin. People actually dragged the bodies of suicide victims facedown through the streets before throwing them onto garbage heaps.

Yet there is a crack in this enlightenment narrative. What if suicide researchers are barred by their own government from obtaining federal funding to research or compile data about the leading method of lethal suicide in the United States? The method of suicide that kills more Americans than all other intentional means combined, including hanging, poisoning, overdosing, jumping, suffocating, or cutting? The method that kills more Americans than all of the murderers, robbers, terrorists, and attackers put together as well?8 This is not a what-if scenario—it was a reality in the United States for much of the early parts of the twenty-first century.

That rider is known as the Dickey Amendment, and it stripped the Centers for Disease Control (CDC) of funding for gun violence prevention research and stipulated that “none of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control.” Prevention is a particularly important word in this sentence because it means that researchers must climb an immensely high wall if they wish to conduct federally funded research about guns—unlike pretty much every other kind of risk and pretty much every other kind of disease known to mankind.

Researchers must then scramble to obtain funding from a number of private foundations or, in some instances, reframe their research or hide its purpose in order to receive baseline amounts of funding.

Supporters of the ban—generally Republicans—assert that the restrictions are needed to block a “public health bias” or “tainted public health model” that inexorably pushes for gun control.

Shocking that

Alice Chen, executive director of the group, explained that “we have heard from doctors everywhere who have talked about patients they’ve cared for who have been affected by gun violence. They’ve been shot, their family members have been shot, they’re living with the consequences 20 years later. And research is an obvious thing that needs to be done in order to help everybody figure out the right solution.”

Even traditionally nonpolitical medical journals join in. A landmark editorial penned in 2017 by the editors of the Journal of the American Medical Association (JAMA) argued that Dickey represented an ongoing “attempt to suppress research into gun violence.”

I know all too well from my earlier research that, despite an overall focus on healing, biomedicine has been used to promote problematic ideologies and agendas. Indeed, part of why we need oversight bodies like the CDC in the first place is to continually assess research objectivity and promote gold-standard research methods.

Dickey potentially pushed gun violence prevention researchers into the trap of needing to prove basic or obvious hypotheses at the expense of more nuanced ones. For instance, it would hardly seem shocking from a population-level perspective that more people get shot in places where there are more guns, or that locales with basic restrictions on the purchase and carry of firearms see better health outcomes than locales that have none.

More to the point here, the debate over the research ban also often focuses on research regarding gun homicide, while giving secondhand status to the implications for suicide.

Yet part of the initial impetus for the Dickey Amendment resulted from the outcry from the gun lobby about a 1992 study in the New England Journal of Medicine (NEJM) titled “Suicide in the Home in Relation to Gun Ownership,” which tested the hypothesis that “limiting access to firearms could prevent many suicides.” After an extensive analysis of nearly a thousand cases, the authors found evidence supporting the notion that “the ready availability of guns increases the risk of suicide in the home” and advised that “people who own firearms should carefully weigh their reasons for keeping a gun in the home against the possibility that it may someday be used in a suicide.”

In the fifteen years after the ban went into effect, federal funding for firearm injury prevention fell 96 percent, and peer-reviewed academic publishing on firearm violence fell by over 60 percent. Scholars who depended on federal funding and publication to advance professionally were often advised to stay away from researching gun violence prevention because of the potentially harmful effects on their careers.

Rather, the frustration arises because it will be increasingly difficult for researchers to study what balanced suicide prevention might look like in parts of the country like Cape Girardeau, where there are so many guns in people’s daily lives. Because of the ban and its downstream effects, researchers rarely study why a small number of gun owners chose to turn their guns on themselves while many others do not.

They cannot determine the most effective points of intervention to prevent deaths among lawful gun owners or within particular social networks. They cannot compare various safe-storage methods in rural communities to find out whether gun lockers, trigger locks, or smart-gun technologies work best in households with guns and children.

They cannot even receive a grant to study the potential psychological ben...

In most all other kinds of illness and injury-prevention research, federal funds help create large multisource databases of what is called morbidity and mortality, or illness, injury, and death, from which researchers can then track trends over time. For instance, an influenza researcher might access a large database to track how many people got sick from the flu over a ten-year period in a certain county and cross-check that with data that detailed how many people received the flu vaccine.

gun violence prevention researchers have had no such luxury. Without access to federally supported databases devoted specifically to gun-related injuries or interventions, researchers are often left to rely on backdoor strategies to answer even the most basic questions about gun-related patterns in the United States.

This system is far from perfect, but at present, death represents the best available metric to study one potential outcome of gun possession without actually doing a study on guns.

From the perspective of death data, there is relatively little debate that more gun suicides occur in homes, cars, garages, schools, and yards where there are more guns than in homes, cars, garages, schools, and yards where there are fewer guns.

Quietly, beneath the radar of public outcry, researchers used death data to uncover associations between guns in people’s home...

Simply knowing a person’s cause of death, however, does not answer the questions asked in the room at the Cape Girardeau Public Library or the questions I wanted to pursue after hearing the stories. Questions not just about how to stop or prevent this awful trend but about how to empathically understand relationships among guns, families, and communities without casting blame.

For instance, I wanted to know whether the risk factors printed on the refrigerator magnet were the right ones for predicting gun suicide in places like southern Missouri. Undoubtedly, many of the departed suffered from feelings of loneliness, hopelessness, and despair. It also seems possible that the magnet risk factors read like a guide for identifying ways that researchers thought about suicidality when they thought only of the despair of Sylvia Plath, Kurt Cobain, Robin Williams, or other people who suffered long histories of mental anguish and previous suicide attempts and psychiatric hospitalizations leading up to final, fateful acts.

Resiliency is important because the vast majority of people who try suicide by means other than firearm survive their initial attempts.

gun suicide often has its own temperament, its own pace, its own urgent, mercurial linearity. Turning a firearm on oneself (or a loved one in some cases of armed domestic murder-suicide) can fall into a category that experts call “impulsive”—a spontaneous response to immediate stressors, such as a romantic breakup, job loss, fight, or rejection.

One landmark study of impulsive suicide attempts in Texas found that 24 percent of young people spent less than five minutes between the decision to commit suicide and the actual attempt, that 70 percent took less than an hour, and that “male sex” and a history of having been in a physical fight—but not depression—were found to be risk factors for these impulsive suicide victims.

Roughly 85 percent of firearm suicide attempts result in death. For this reason, firearms rank at the top of what researchers call “case-fatality charts” that list the percentages of people who die from the different methods of suicide. As suicidologists describe it, guns top the list because of their “inherent deadliness,” “ease of use,” and “accessibility”—in other words, because of many of the same qualities that draw people to guns in the first place.

Given the quick interval between thought and action and the lethality of firearms, scholars often argue that the use of a gun shifts the discourse on suicide from why to how. As the Harvard public health research report describes it, gun suicide often represents “an irreversible solution to what is often a passing crisis.”

What would it even look like to intervene beforehand on a five-minute, armed impulse not linked to depression? It would stand to reason that risk factors for the five-minute, armed group might look different from how they might for a person with a long history of severe depression, like Sylvia Plath. In other words, how do you make a refrigerator magnet for that?

While the block on gun research funding might in its conception be aimed at scholars who are ostensibly (and for the most part incorrectly) identified as diehard liberals or anti-gun zealots, its real-world effects were most profoundly felt in the rooms, towns, and communities with the most firearms and the most pressing needs to promote best practices for gun safety and gun suicide prevention.

This doesn’t mean that research inherently promotes any one agenda or automatically aims to take away anyone’s gun. The best research respects the culture and the traditions it studies and should feel grateful to be let in. Yet, in the Cape at least, it seemed clear to me that better research and a more robust knowledge base could have lessened the blame and guilt that survivors felt for missing so-called warning signs, especially if the signs they were told to monitor were not wholly relevant in their particular cases.

A skew toward death by suicide for any one race or ethnicity seems somewhat confounding. From what we know, thoughts of suicide probably affect all demographics of people. Freud defined drives toward death and self-destruction (todestriebe) as central aspects of human development. More to the point, present-day studies suggest little variability among ethnic groups regarding what is called suicidal ideation—or thoughts of self-harm.

Perhaps as a result, non-gun suicide attempts are diversely distributed among races and genders, with particular demographic groups showing particular trends. For instance, women of all ethnic and racial backgrounds are far more apt than men to overdose on pills; African American men are at high risk after release from incarceration; Hispanic and American Indian and Alaska Native young adults skew toward suffocation/hanging at startling rates; and Asians/Pacific Islanders have shown relatively high rates of suicide attempt–related hospitalization.

white Americans dominate death-per-suicide-attempt categories for one main reason: they remain dramatically overrepresented in civilian death data about firearm suicides.

Put another way, 92 percent of gun suicides in the United States were committed by non-Hispanic white persons.

Of course someone might think, Doesn’t this data simply reflect how the majority of people in the United States self-identify as white? While this statement is true, these shocking trends held even when the numbers were sifted through what statisticians call age-adjusted and crude rate calculations, which balance out the numbers of suicides in relation to total populations. It’s also important to consider that the percentage of non-Hispanic whites in the United States declined over the latter twentieth and early twenty-first centuries.

According to the US census, the percentage of non-Hispanic white people in the United States hit an all-time low of 62 percent in 2013 and kept falling every year after that. And yet over this same time period, 2009–2015, white populations consistently committed 92 percent of all gun suicides.

As we can see in more detail below, the death numbers effectively represented gun suicides committed by white, non-Hispanic men.

From 2009 to 2015, non-Hispanic white men accounted for nearly 80 percent of all gun suicides in the United States, despite representing less than 35 percent of the total population.

US census race and ethnicity categories are frequently critiqued as oversimplified and in any case represent people’s self-reports rather than underlying biological realities.

Race categories also frequently represent social and political biases—until relatively recently, for instance, American society did not consider Jews and Italians to be “white.”