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

by Jonathan M. Metzl

Of course, voters endorsing politicians whose policies seem likely to hurt them is nothing new. Many Southern and midwestern states boast long histories of leaders who enact laws that disadvantage their own constituents and constituents who nonetheless repeatedly vote for these same politicians. As I show in the following chapters, that dynamic took on particular urgency in the decades leading up to the Trump presidency, when an emerging American conservatism promised to make white America “great” in ways that directly harmed lower- and middle-income white voters who supported conservative politics and policies in the first place.

Even on death’s doorstep, Trevor wasn’t angry. In fact, he staunchly supported the stance promoted by his elected officials. “Ain’t no way I would ever support Obamacare or sign up for it,” he told me. “I would rather die.” When I asked him why he felt this way even as he faced severe illness, he explained, “We don’t need any more government in our lives. And in any case, no way I want my tax dollars paying for Mexicans or welfare queens.”

Trevor voiced a literal willingness to die for his place in this hierarchy, rather than participate in a system that might put him on the same plane as immigrants or racial minorities.

where on-the-ground white Americans make tradeoffs that negatively affect their lives and livelihoods in support of larger prejudices or ideals. 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.

White backlash politics gave certain white populations the sensation of winning, particularly by upending the gains of minorities and liberals; yet the victories came at a steep cost. 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.

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.

Gun regulation is such a politically sensitive question in the United States that there has long been a congressional ban on funding for research on the health impact of firearms.

In these ways, 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.

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.” And in his elegiac Tears We Cannot Stop: A Sermon to White America, sociologist and pastor Michael Eric Dyson laments the “the politics of whiteness… it’s killing us, and, quiet as it’s kept, it’s killing you too.”

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.

As I thought more about it, the ban on federally funded research made less and less sense. 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. The places that needed the most research and knowledge were the places, like Cape Girardeau, that had the most guns.

Despite national attention to the issue of firearm violence, most Americans are unaware that gun crime is lower today than it was two decades ago. According to a new Pew Research Center survey, today 56% of Americans believe gun crime is higher than 20 years ago and only 12% think it is lower.

In the 1890s, Durkheim, the sociologist, introduced the concept of anomie to describe a crisis of disconnect that emerged between personal lives and social structures.

The working definition of a “crisis” often assumes an upheaval felt by a dominant group in the face of a threat or change that leaves previous power structures upended. We often hear, for instance, of a crisis of masculinity brought about by women’s suffrage, or the women’s movement, or women’s entry into the workforce, or the #MeToo movement, or any number of other social changes in which strivings for equality by women are met by uncertainty in men.

The ways we define crisis allow us to attach the language of calamity to whiteness, men, or other seemingly dominant groups, while at the same time making it harder to see the suffering of women, immigrants, people of color, and other persons who do merit a “crisis of authority”—because they are supposedly built for it, or because they have lived with crisis all along.

Such framing of crisis is also often based more in an imagined sense of nostalgia than in any lived reality, inasmuch as many men fought to maintain what they held to be their natural authority even though every man was not a king, a boss, a plantation owner, or a CEO. By definition, the majority of men needed to be underlings for the system to survive.

As Adam Winkler aptly describes it in his terrific book Gun Fight, “few people realize it, but the Ku Klux Klan began as a gun control organization” that aimed to confiscate any guns that free blacks may have obtained during and after the Civil War and thereby “achieve complete black disarmament.”12

The political emergence of the NRA went hand in hand with the exponential growth of the US gun industry and the numbers of guns it manufactured and sold. By some estimates, America’s privately owned gun stock increased by 70 million between 1994 and 2014. By 2015, American citizens owned 255 million guns, or more than one for every adult in the country—far and away the highest rate in the world. As Vox’s German Lopez explained it, Americans made up “about 4.43 percent of the world’s population [in 2015] yet owned roughly 42 percent of the world’s privately held firearms.”

White men often emerged as the embodiment of these armed liberties. In 2014, for instance, white Missouri open-carry advocates asserted their self-claimed rights to carry anywhere and everywhere by parading through the African American areas of downtown St. Louis brandishing handguns, long guns, and assault rifles.

Communication studies professor Leonard Steinhorn maintains that this shift from firearms as utilities to firearms as totems of manhood and symbols of white male identity emerged because the gun lobby and gun manufacturers positioned guns as responses to yet another crisis of masculinity in post-1960s America.

This shift coincided with the emergence of the so-called new way of the NRA that promoted guns as primary means of self-defense in an increasingly unsafe world, even as crime rates fell considerably over this same period.

The people would say… I guess the idea when there was a perception that your own safety and the safety of your family was really at play, then that would trump the niceties associated with race discussion. I think it is. Is that to say there’s racism brewing under the surface in all of this? Probably. Probably. But it was something you instructed your kids against, raised your kids against, and espoused against. But then all of a sudden, it’s like, “Okay, shit’s getting real now,” you know what I mean?

As this process plays out, the peril to white men comes not just from the instrument, the impulse, or even the legislation. Rather, privilege itself becomes a liability. White men themselves become the biggest threats to… themselves. Danger emerges from who they are and from what they wish to be. Over time, the data suggests, “being a white man who lives in Missouri” then emerges as its own, high-risk category.

Joined together, guns come to embody, truly, double-edged swords, inasmuch as the same people and communities who benefit from imagined privileges represented by their guns also live closest to suicide enablers in moments of desperation.

what’s bizarre about the Republican strategy is that it is likely to cause the most damage where many of Mr. Trump’s supporters live. Rural and suburban areas are more likely to lose insurers and see big premium increases if Obamacare goes down, because companies have less incentive to stay in markets where there are fewer potential customers and where it is harder to put together networks of hospitals and doctors.

Our focus groups explored people’s attitudes about the ACA. As this section of the book details, we found jarringly different attitudes among racial groups. African American men largely supported the ACA because the legislation potentially helped “everybody” and because they felt that anything would be an improvement over Tennessee’s crumbling health care delivery system. But many white men, like Trevor mentioned in the introduction to this book, voiced a willingness to die, literally, rather than embrace a law that gave minority or immigrant persons more access to care, even if it helped them as well.

Our focus groups highlighted another important similarity in the conversations surrounding pro-gun and anti-ACA politics in Southern and midwestern US states: both asked working-class white Americans to put their own bodies on the line in order to “defend” conservative ideologies.

And yet in a room in a housing project in the real world of the American South, cost also functioned as a proxy for the tensions of race, as questions of Who is paying for whom? and Whose labor supports whom? led to deliberations about ways to hoard health for some persons, while denying it to others.

population-level medical care is often more expensive than it is affordable, and particularly so in the United States. And, as physician and health economist Aaron Carroll succinctly puts it about health care, “sometimes good things cost money.”12

Meanwhile, certain right-wing critics openly likened ACA resistance to the stand taken by the Confederacy during the Civil War. As the conservative website Freedom Outpost described it under a headline warning that “Federal Agents Will Enforce Obamacare,” “in a move that is reminiscent of the tyrannical actions of Abraham Lincoln that led to the War of Northern Aggression, Barack Obama says that he will not wait on states to enforce Obamacare.”

On the whole, many Southern men embody what historian C. Vann Woodward once called the “divided mind” of the South, in which Southerners, and Southern white men in particular, seek the material gains of modern America while still holding fast to mores, prejudices, or historical traumas of their regional pasts.11

Brian clearly understood how he benefited from Medicaid and VA programs, but when the word government—without specifying state, federal, or other—entered the conversation, he decried intervention or assistance. “No government, no way.”

Again and again, mentions of government, ACA, health care expansion, or system reform elicited white male anxieties about the usurpation of health and economic resources by irresponsible, lazy, and often racialized others.

To be sure, the men in this particular group, what we later called the Trump rallying group, likely felt themselves to be competing against other socioeconomically disadvantaged persons for precious resources. Behind concerns about people on welfare using it up and mothertrucking Mexican immigrants draining Medicaid (even though undocumented immigrants did not qualify for the program in the first place) lay anxieties about limited funds, support services, and other essential commodities for which they might have to contest, should equal distribution become the law of the land.

Thus, lower-income men in the South espousing racist and anti-immigrant views was not hugely surprising. But the ways they did so, in the context of conversations about health, exposed tragic ironies. Here were men who depended on assistance for stents, antibiotics, operations, or oxygen tanks decrying the very networks that potentially provided lifesaving help. Their expressions of whiteness and white anxiety seemed in so many ways to work against their own self-interests; to live free and die sooner.

In an age of outsourcing and globalization, this resistance became one of white men’s remaining marketable skills, deployed to guard the old ways through modes of resistance and self-sacrifice that made them perfect consumers and foot soldiers for the Tea Party, the National Rifle Association, and the Trump campaign.

What did all of this mean? Did falling rates of health care coverage in Tennessee actually matter in the real world? Studies show a roughly 25 percent higher risk of death among uninsured persons when compared with privately insured adults. Insurance does not by itself prevent or cure diseases. However, we found a related phenomenon in our study of the available data: not only did people in Kentucky have more access to physicians and medical care compared to Tennesseans, but Tennesseans paid more for what care they did receive.15

A 2009 study by a group of scholars in Boston, including a rising Harvard law professor named Elizabeth Warren, found that 62.1 percent of all US bankruptcies in 2007 were medical. Ninety-two percent of these medical debtors had medical bills over $5,000, or 10 percent of pretax family income, and the remainder met criteria for medical bankruptcy because they lost significant income due to illness or mortgaged a home to pay medical bills.

the context of people’s lives determine their health, and so blaming individuals for having poor health or crediting them for good health is inappropriate. Individuals are unlikely to be able to directly control many of the determinants of health.

From economic or medical perspectives, these claims were made of little more than hot air. But from the perspective of race in America, they seemed all too familiar. Mirroring and amplifying the tensions of our groups, Trump essentially asked lower-income white people to choose less coverage and more suffering over a system that linked them to Mexicans, welfare queens, and… to healthier, longer lives.

But reality turned out to be less than dreamy for many Kansans. It turned out that, contrary to hyperbolic reports of government waste, the state had frequently used tax revenue to pay for roads, bridges, traffic lights, aqueducts, conduits, and causeways—structures often supported by communal governance, and for which wealthy persons who receive tax breaks do not often clamor to invest their surplus funds. Tax revenue also secured the fiscal reputation of the state, enabling the various lending and borrowing vital to a functioning economy.

To be sure, economists and citizens voice valid concerns about governmental debt and national overspending (though these concerns seem to have evaporated for GOP politicians during the debate around the 2017 tax bill). Yet US austerity politics often emerge when money remains in people’s bank accounts and resources flow through the system, as if preaching a starvation diet when the stores are full of grain. In this sense, US austerity arguments do not so much ask citizens to buckle down in the name of national unity as to reallocate resources from the many to the few.

This leads to another tension driving American austerity politics: its connections to, and implications for, race and racism. A long literature details relationships between tax cuts, austerity, and race. In the US context, much of this work highlights how tax cuts disproportionately benefit rich white males at the expense of other groups of people in society. Tax cuts also lead to shortfalls in government services and programs that frequently assist women and minorities.

Cuts to social programs affect many working-class white populations as well and in ways that have long vexed liberals and Democratic politicians—since many poor white populations continue to support GOP tax cuts.

Austerity codified hierarchy: the rich got richer, and instead of promoting largesse, tax “relief” made sure that the system that assured their dominance remained ever-more inevitably in place.19

Defunding public schools in Kansas, the home of Brown v. Board, thus carried profound unspoken resonance. This history suggests another reason why white Kansans supported economic and fiscal agendas that offered most of them little in the way of material returns.

For an increasingly vocal cohort of Kansans, the downside of austerity hit home when it affected their children. Events on the ground began to upend the belief that the consequences of tax cuts were happening somewhere else, to someone else. “School cuts definitely started out as something that people thought were only geared toward inner-city, black, and Hispanic schools and districts,” one administrator explained. “That’s how they were sold at first.” Over time, however, the radius extended. Annie McKay, the director of Kansas Action for Children, explained to me that, “while some communities were better insulated at first, the fires were eventually getting to the edges of those communities as well, metaphorically speaking, and the sort of very radical extreme tax policy changes were destroying the way of life throughout the state.”

But then something remarkable happened. For a brief moment at least, conservative arguments about the benefits of austerity failed to hold sway. The notion that less was more, or that “dollars spent” had no correlation with student achievement, elicited increasing disbelief among the populace. It was as if schools, and their connections to the prosperity of future generations, represented a space in which it was acceptable for otherwise conservative voters to critique backlash governance. Recall, for instance, that voicing reservations about guns or ACA rejection was tantamount to treason in Missouri and Tennessee.

US adults without a high school diploma can expect to die nine years sooner than college graduates.