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

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A physician's "remarkable" account of how right-wing backlash policies have mortal consequences (Minneapolis Star Tribune) -- even for the white voters they promise to help.

In election after election, conservative white Americans have embraced politicians who pledge to make their lives great again. But as physician Jonathan M. Metzl shows in Dying of Whiteness shows, the policies that result actually place white Americans at ever-greater risk of sickness and death. Interviewing a range of everyday Americans, Metzl examines how racial resentment has fueled progun laws in Missouri, resistance to the Affordable Care Act in Tennessee, and cuts to schools and social services in Kansas. e shows these policies' costs: increasing deaths by gun suicide, falling life expectancies, and rising dropout rates.
Now updated with a new afterword, Dying of Whiteness demonstrates how much white America would benefit by emphasizing cooperation rather than chasing false promises of supremacy.

368 pages, Paperback

First published March 5, 2019

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About the author

Jonathan M. Metzl

15 books157 followers
Professor and Director of the Center for Medicine, Health, and Society at Vanderbilt University; a Psychiatrist; and the Research Director of The Safe Tennessee Project, a non-partisan, volunteer-based organization that is concerned with gun-related injuries and fatalities in America and in Tennessee.

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Displaying 1 - 30 of 1,072 reviews
Profile Image for Mehrsa.
2,245 reviews3,580 followers
April 11, 2019
Midway through this bleak book, I wanted to just laugh. I believe every word of his research (which he backs up quite well)--some people would rather collect the wages of whiteness even at the cost of their own life. This is the research answer to Dubois' observation years ago about the wages of whiteness.
Profile Image for Alok Vaid-Menon.
Author 13 books21.8k followers
November 9, 2020
Political pundits overwhelmingly focus on why a small percentage of people of color vote conservatively, rather than examining why the majority of white people vote for policies and candidates that harm them in the long run. Because whiteness is seen as the default (not a race) it goes unmarked and is rarely analyzed as a motivating factor. Based on his research on right-wing movements in the South and Midwest, Vanderbilt University physician Dr. Jonathan Metzl argues that investigating whiteness is crucial to understanding the political situation in the US.

He reviews the data to show how despite the fact that polluting the environment, cutting away health care programs, and relaxing gun laws result in increased rates of death for working class white people, many still support these policies. Metzl conducts interviews and focus groups with white working-class Trump supporters highlighting how they are willing to put their own lives on the line in support of their political beliefs. In other words: they are willing to die for whiteness.

His work is inspired by Black sociologist W.E.B. DuBois who famously argued that during Reconstruction whiteness served as a “psychological wage,” granting to poor whites “a valuable social status derived from their classification as not-black.” Whiteness was a form of “compensation” that wealthy white people gave working-class white people to pacify them and prevent them from forming a powerful coalition with working-class black communities. Even though they weren’t at the top, at least they weren’t at the bottom.

White voters still mobilize with this framework of racial resentment: a belief that white Americans should remain at the top of the US social hierarchy no matter what and that equality for people of color threatens their superior “status.” Rather than creating a more just system for everyone, they would rather die than lose their dominance -- sink the whole ship rather than rise all tides. From an outsider’s perspective this might seem like self-sabotage, but from their perspective it’s viewed as “an act of noble self-denial, a sacrifice for a holier cause” (10).

Even though these conservative agendas might not specifically name race, their policies and strategies are still informed by the legacy of racism. Racial anxieties aren’t just about individual prejudice, they also manifest as laws and infrastructures. For example, for centuries gun ownership and health insurance were privileges afforded to white citizens exclusively and, as Adam Winkler describes in his book Gun Fight, the KKK began as a gun control organization. Fears of “big government” harken to the Reconstruction period when Southern states were pressured into granting political rights to newly emancipated Black people.

Racial resentment makes people fear what might happen (the government could take all of our money from taxes) rather than pay attention to what is happening right now (240K+ people dying of COVID19 and extreme state-violence against Black people). It makes people demonize racial Others (Muslims, Black people, immigrants, etc.) rather than working with them to hold politicians accountable for maintaining inequality and suffering. Ultimately, white people are left “defending an imagined sense of whiteness… even in the face of common sense” (270). In this way, these Trump supporters are not “voting against their interests” as Democrats claim. They are voting for whiteness: an ideology and worldview that makes less sense, more sensation. Suffering for all, but status for some.

What happens when we recognize that people don’t always act from logic or self-interest, but from fear, emotion, and a sense of belonging? Divesting from false ideas of superiority and investing in the environment, health, and meaningful equality is what must be done going forward.
Profile Image for Morgan Schulman.
1,295 reviews46 followers
March 7, 2019
I’ve read over and over about how socialism is not popular in the US because working class Americans identify more with the idea of obtainable wealth than the idea of living in poverty, which they see is embodied by a degenerate “other”. This book really drives it home, when we example after example of poor white men dying young due to lack of access to healthcare who still decry the ACA as they identify more with rich white Republicans who tell them its liberals stealing from them to give to POC, than with their actually reality of being poor and in need of state-funded medicine. The concept of belonging to a master race is more vital than taking life-saving care that they identify with the underclass. Chilling. Makes me really worry about 2020.
Profile Image for Jaidee .
768 reviews1,505 followers
March 24, 2024
4 "illuminating, enlightening and helpful" stars !!!

A ribbon of Excellence read for 2023

Thank you to Netgalley, the doctor/researcher and Perseus Books. This was released May 2020. I am providing an honest review.

I am not going to write a long review as I do not want to confuse my readers but just to let you know that as a Canadian mystified by certain aspects of America that this was extremely enlightening. I have family in America (ohio, pennsylvania and south carolina). I lived for over a year in Savannah and Miami and have visited at least thirty states. I loved both a Georgia gal and New Mexico boi and love the American spirit, friendliness and generosity of many of the people I have met. Despite my long association and frequent visits I don't get many aspects of America and this book really helped.

The author is a psychiatrist and public health expert who also does social science research. He very helpfully explores the dynamics of working class whites in Missouri, Tennessee and Kansas. He believes that the rich white republicans have sold a load of shit to these people and kindled racial distrust and fear in order to further certain agenda items that benefit big business and the wealthy. As I am reading a book on American Conservative thought currently I am aware that Republicans are not truly Conservative but often xenophobic, mean spirited and self serving. I am not going to lie though I do not have much more faith in Democrats and the ridiculousness and polarity of wokeness and identity politics. Anyhow back to the book....

He explores through research, focus groups, sociological and historical theorizing and even some psychodynamic thinking the following three areas

Missouri and the laxity in gun laws that have led to poor whites engaging in accidental and intentional suicides and murders.

Tennessee and the long resistance to socialized medicine.(health insurance)

Kansas and the huge drop of education standards and quality of life due to short sighted and substantial tax cuts.

I learned so very much about some regional subcultures.

Thank you so very much !

Profile Image for Mara.
1,949 reviews4,322 followers
September 9, 2019
An incredibly informative & thought provoking book that had a lot of descriptive power for the attitudes that I see here "on the ground" in Tennessee. As so many other reviewers have mentioned, this is basically a case study on just how steep DeBois' "wages of whiteness" have become in an increasingly polarized political landscape that preys upon marginalized white communities' racial fears in ways that ultimately end up hurting those communities. You can think of this as a psychologist's 2020 version of "What's the Matter with Kansas?" I think the writing itself is a little too dry to put this in the top echelon of nonfiction, but I really enjoyed this one & would definitely recommend
Profile Image for Dan Connors.
369 reviews41 followers
June 5, 2019
You can't hold a man down without staying down with him- Booker T. Washington

I loved this book! It takes a complicated issue like the decline of white power in America and throws tons of data at it in thee crystal clear sections.
As a resident of Missouri, I could identify with all three sections that I've seen happen all around me.
The first section covers the issue of gun laws and the state of Missouri. Using brutal statistics, the author shows how white identity and survival has become paramount in the gun debate, with Missouri on ground zero. I was not aware that Missouri had gun registration laws before 2007, but Metzl goes into detail on how the state has changed since the laws were loosened up. Gun violence has risen, with a devastating impact on rural whites via an increased suicide rate. To add contrast, the author compares Missouri and its looser laws with Connecticut and its tougher gun laws in the wake of Sandy Hook. The comparison does not go well for Missouri.
The second section covers affordable health care, specifically in Tennessee. It compares that state to its neighboring state of Kentucky, which expanded medicare and embraced the Affordable Care act. Again, white identity convinced Tennesseeans that government health insurance was too expensive, especially if it covered undeserving minorities too.
And the final section covers Kansas and its ill-fated experiment in 2012 where a huge tax cut was imposed with devastating results for the state economy. Promised gains never happened and roads, schools, and infrastructure suffered to such an extant that the law had to be reversed five years later. Again, the issue is government spending, a popular target with some white because its seen as too helpful to non-whites. Schools in Kansas suffered greatly and the author pointed out that most of us don't notice the decline of schools so much because our children cycle through them so quickly. Parents today have no idea how good things were even ten years ago.
As a white male, this book made me want to shake my head so much it almost did a 360, There's nothing wrong with being white or male, but to expect your needs to trump those of everybody else is both selfish and short-sighted. At some point this century whites will no longer have a monopoly on power. They imagine Armageddon when that happens. I imagine something much more complicated and hopefully better.

Wonderful book.

Profile Image for Malia.
Author 7 books660 followers
August 16, 2021
What a worthwhile read! Though it is heavy on statistics, the author presents them in a very human, accessible and impactful way. He chose to focus on education, gun control and healthcare and how those factors play an integral part in the well-being and prosperity of people and communities. I thought this was a smart approach, and he has clearly done his research, which at times was so thorough I was almost a little overwhelmed.
Truly an insightful book, even if it left me feeling slightly frustrated and sad, in the sense that there is such a tremendous disconnect between people in this country. This is certainly one I won't be very quick to forget!

Find my book reviews and more at http://www.princessandpen.com
Profile Image for Michael Perkins.
Author 6 books471 followers
October 25, 2022
"It may be said of the Reconstruction era that the southern aristocracy took the world and gave the poor white man Jim Crow. He gave him Jim Crow. And when his stomach cried out for the food that his empty pockets could not provide, he ate Jim Crow, a psychological bird that told him that no matter how bad off he was, at least he was a white man, better than the black man."

-Martin Luther King

======

from the book....

Trevor had no health insurance and severe liver disease put him in the hospital.

“Ain’t no way I would ever support Obamacare or sign up for it,” Trevor 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.

==========

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.

==========

How Democrats Lost the Working Class Vote

https://www.goodreads.com/author_blog...
364 reviews50 followers
April 24, 2019
Why are we doing this to ourselves? Why do we continue to elect politicians who enact policies that make us poorer, sicker, less safe, and less educated? Although the book gives much attention to the fact that many people do this out of a misguided sense of rights and privileges, I still find it incredible that we have such a sense of wanting to be top dog that we elect people who are so vengeful toward those in the lower income groups. I also found it quite depressing that even when confronted with facts people still acted/voted against their own best interests. We seem to be determined to enter a downward spiral of ever worsening infrastructure, healthcare, and education in order to maintain a perceived special privilege of whiteness.
Profile Image for Michael Bailey.
51 reviews8 followers
January 2, 2021
If you're liberal and love flimsy statistics to make you feel superior to Republicans, then you're going to love this book. If you're someone who is skeptical about cherrypicked statistics and are put off by the tell-tale stench of unchecked confirmation bias, this book might not be for you. I fall into the latter category and found this book entirely unpalatable.

I suspect that I agree with the author on most political issues. I support Obamacare. I don't like guns. I support public education. We likely agree on far more than we disagree. Where we disagree is in his attempt to apply questionable statistics to show how the political preferences of conservative white people are not only wrong but killing them. The thesis just drips with the sort of partisan rhetoric that masquerades as thoughtful inquiry today.

I had picked up this book thinking that it was in the vein of "Hillbilly Elegy", a thoughtful examination of working class white America. Instead I was treated to yet another white intellectual telling white liberals that they're so much better than white conservatives.
Profile Image for Karin.
1,492 reviews55 followers
April 4, 2019
This is a must read. Metzl examines the implications of loose gun control laws, delaying expansion of federal medical programs, and reducing public school funding and how it hurts those white people who support it. Lots of interesting research, and he walks you through his methodology. Books on race and the far right are very popular now, but this one seems to stand out on a unique, and well executed, premise.
Profile Image for Ellen.
1,588 reviews456 followers
January 17, 2021
Metzl, who lives in Tennessee and was raised in Kansas, looks at three states: Missouri, Tennessee, and Kansas through the lens of several "hot" topics: gun control (Missouri), health care (Tennessee), and education (Kansas). He examines the Democratic claim that many Trump supporters are voting against their own interests.

What Metzl is considering, in interviews, focus groups, and statistical analyses, is not only the majority stances on these issues but just as importantly what interest do they serve? Are liberals missing the point in not looking at how opinions are formed within a cultural milieu and what they mean to the people holding them?

On the other hand, the conclusion I drew from this book (whether or not that is the author's intention) is that many people in this country value whiteness over any other self-interest. Metzl describes the case of a man dying of an illness which can be treated but for which he has no health insurance. The man, however, is a vehement opponent of the Affordable Care Act (Obamacare). Along with other subjects in the book, his belief that government intervention in health care--or other safety nets--benefits immigrants and "welfare queens". It seems to me that their investment in whiteness as a privileged state leads them to ally with the wealthy few who most benefit from dismantling government.

Metzl leaves us with the question of what kind of society we want to create: one in which various groups are competing with each other for resources, divided by race or class or political affiliation, or one in which all the people work collaboratively to create a society which most benefits all of its members.
Profile Image for Ella.
736 reviews152 followers
July 28, 2019
This is a hard book to review. I didn't know all of the anecdotal evidence, but I have a pretty decent amount of information on how things like one's views on guns or healthcare in the US correspond to racial views. I have seen it up close and personal, and I have never believed that we just have one problem completely unrelated to another, so much of this book (like so many others in the last few years,) was more evidence on what I already have seen evidence and research on.

However, it may be able to help some people understand how insane it is to, for instance, refuse to vote for healthcare when you are suffering from a serious disease just so someone from another country or of another race can't have that same healthcare. Honestly, though, if I believed evidence and research would change these minds, I would feel far more optimistic.

So, if you or someone you know is looking for a basic primer on how tribalism has taken over politics in the US, this would be a good place to start. It's a bit dry, but he throws in enough interviews and tells interesting stories to hold interest.

The reason for my "I liked it" 3 stars is that I really would like some of these books to go deeper. I've been reading the same book for a long time, and when writing for a general audience, I don't think we need a million books all saying the same thing just because someone did a little bit more research (that's what professional and scholarly journals are for.)

It won't harm anyone to read this book, but I'm not sure anyone will be helped either.
Profile Image for Lynn.
3,386 reviews71 followers
May 12, 2019
Important Book

Metzl writes about Whites, mostly males who choose to vote for laws and elected officials who literally kill them rather than be put on the same pedestal as Welfare Queens, African-Americans, and Latinos. He covers Missouri for gun laws, Tennessee for healthcare and Kansas for government funding. He helped me understand the background of these beliefs. We need to do more to end this.
Profile Image for David.
764 reviews185 followers
June 7, 2019
Whenever I read anything, I keep post-its nearby – there might be a statement or passage here and there that I’ll want to think about or reference later. Usually, by the end of a reading, I’ll have placed a handful of post-its throughout a book.

But my copy of ‘Dying of Whiteness’ now has about 50 post-its inside. It’s really good (and important) stuff here. One could even say ‘urgent’.

Dr. Metzl – it appears – took on the research for this project just before The Thing in the White House became POTUS, almost as if anticipating that a Republican (ahem) administration seemed inevitable. Had that turned out to not be the case, perhaps this book wouldn’t now exist. However, that * did* happen, and we’re stuck with the consequences (are we ever!) – and the good doctor’s book (published last month) offers up remarkable insight (and hard facts) to absorb as we muddle through this mire as best we can.

(Speaking of ‘mire’, it’s no accident that a [R] campaign slogan was ‘Drain the swamp!’ If one thing is significantly true about the [R]s, it’s that, whatever they say, the opposite tends to be the genuine reality. Thus, they didn’t drain the swamp but, instead, intended to build one – and then did.)

In this book’s conclusion, Metzl reminds us that his purpose was to study “the kinds of mutual trade-offs white Americans make in order to defend an imagined sense of whiteness.” (~”imagined” being the operative word.) “...white Americans bet their lives on particular sets of meanings associated with whiteness, even in the face of clear threats to mortality or to common sense. A central political script then emerges in ways that, in its worst moments, defines the boundaries of white America in relation to real or imagined others who want to take what it has or be what it is.”

One-issue voters are possibly the worst. But when the one issue is that people will vote for someone whose policies are in complete alignment with "I'm white and proud of it!"... well, as Dr. Metzl says, the result is lethal for *all* Americans - even the white-and-proud.

And why all the paranoia? Well, although The Thing and his thugs don’t know one iota about governing a country, they sure know what makes their supporters tick: fierce insecurity and gullibility. And they also know that the voters are loyal Republicans (“…even in the face of clear threats to mortality or common sense.”). It’s easy to exploit what’s in their souls. And it’s just as easy to lie to them as it is to lie to everyone else. When it turns out they’ve been duped, then to a large degree they either won’t know it, or won’t admit it, or won’t care. They are on a mission, in ways not necessarily shared by officials and constituents – and it doesn’t have to be rational on either side.

That’s a very scary thought. Nationwide, the floodgates have been opened in ‘favor’ of the much-less-informed-and-evolved. They’ve waited too long for that to happen – they aren’t going to easily let that go. Worse, that gives root to the idea that The Thing could – with easily renewed determination on the part of the voters - end up with another term in office. Apparently no cost is too high to ‘save’ the whiteness, even if the whiteness literally dies in the process.

It’s bonkers.

For his study, Metzl focuses on three major areas of concern to all Americans and breaks down how considerable threats play out one-by-one in three states: gun control in Missouri, health care in Tennessee, and education in Kansas. (The short chapters involving interviews of locals are of particular interest.) This is all very eye-opening information for anyone who reads this book – and anyone who cares about where we are now in this country should read it.
Profile Image for Kasey Wilson.
2 reviews3 followers
January 13, 2021
I might have given this book 3 stars - fine and relatively informative, but also probably could have been a bibliography of the works Black scholars and activists have already done. The main themes called out are that racism is structural and Whiteness is dangerous (for everyone, including White people). Nothing that hasn't been said before.

But then I got to the conclusion, where the author claims that cuts to police funding are bad for public health, alongside and in the same ways that cuts to healthcare and social programs are. At best, this is incorrect. But that he talks about it specifically in the context and timeframe of the Ferguson uprisings after Michael Brown's murder, pushed it into also being wildly offensive.
Profile Image for Scott Rhee.
2,310 reviews161 followers
February 28, 2024
Beyond all the statistics, graphs, interview transcripts, and anecdotes within Jonathon M. Metzel’s 2019 book, “Dying of Whiteness: How the Politics of Racial Resentment is Killing America’s Heartland”, there is a horror movie, one that has been giving white people nightmares since white people landed on these shores. It’s called “The Non-White Others”, and it is literally driving white people insane.

Let’s be honest: Racism is at the heart of nearly every policy that has been enacted in this country. It has been the not-so-secret motive behind every war this country has been involved in, from the American Revolution (partly slavery) to the Mexican-American War (mostly slavery) to the Civil War (totally slavery) to Vietnam (hatred of yellow people working in rice paddies). It’s the trigger behind most, if not all, mass shootings in this country. It’s what got Trump elected.

White people have always been, still are, and probably always will be terrified of anyone that is non-white. They (the “they”, as in “us vs. them”) are either going to steal your spouse, rob your house, take your job, or bring your property values down. They are lazy, shifty, dirty, angry, less intelligent, and always looking for a hand-out. They are rapists, super-predators, or just worthless drains on the system, and they probably come from a “shithole country”. Sure, Melvin who works in the meat department at the grocery store is one of the “nice” black guys, and Marcie, the Chinese receptionist at the bank is a sweetheart, but as a group, blacks and Chinese and Mexicans and Koreans and Pakistanis and all those other non-whites are secretly up to no good. White people know this. They may not say it, but they feel it.

Metzl’s book is a thorough examination—-backed up by facts, statistics, and actual quotes from everyday (racist) Americans—-of how and why white people almost always vote against their best interests, not because they don’t know that the policies or candidates they are voting against will actually improve their lives but because they don’t want the Mexicans or the blacks or the Chinese or the other lazy immigrants to benefit from them.

So, white people will continue to fight to own guns, which—-according to virtually every study—-exponentially increases their chances of being killed by gun-related homicide or suicide, as well as putting those of us who don’t like guns at higher risk for gun-related violence.

White people will continue to vote against universal health care or health care reform that will actually improve—-and extend—-their lives, ostensibly because it’s “socialism”, but, in actuality, because they don’t want the government to help the blacks and the hispanics.

White people will continue to vote for austerity policies that will cut funding for education, social services, and infrastructure repairs, so the school systems that made people move to the suburbs in the first place will start to fail miserably, and the bridges and roads will start falling apart, but, hey, the rich motherfuckers in their wealthy gated communities will get a tax break, at least.

White people are fucking stupid.
Profile Image for Simon Bullock.
169 reviews12 followers
December 6, 2019
Dying of Boredom: How to stretch an essay into a novel by Jonathan Metzel. Read a chapter or two get the gist and move on, repetition upon repetition, ad nauseum.
Profile Image for Becky.
1,648 reviews1,949 followers
November 18, 2024
Reading this right before the election was a mistake.


Bold of me to assume that we had learned from last time. Bold of me to assume that maybe this was just a small subset who would rather vote against their own interests to keep others from accessing opportunity and benefits than vote for the good of everyone.

Whoops. Silly me.

I did find this book depressingly enlightening though. It was a good mix of small subsets of focus groups, with larger scale analytics and statistics, along with interviews and the author's own anecdotal stories.

This book tells me that we have a hell of a lot of work to do, and we should have started doing it hundreds of years ago.

Shit.
331 reviews3 followers
April 3, 2019
I thought this was very helpful in attempting to understand why lower income whites vote for people like Trump who create policies that hurt these very voters. Using the lenses of gun laws in Missouri, education funding in Kansas, and health care policies in Tennessee, Metzl shares interviews with voters who explain their reasoning along with statistics about how policy changes affected health outcomes. It's sobering to realize "working-class white Americans (will) put their own bodies on the line in order to 'defend' conservative ideologies."
Profile Image for Robin.
330 reviews3 followers
May 2, 2019
This is essential reading for anyone who is trying to understand why people vote the way they do. He has the numbers- the effects of conservative ideological policies on the people who vote for them. Racism is the original and enduring sin of this country. And it’s killing all of us.
202 reviews4 followers
October 28, 2022
A liberal white male author writing a book to support his liberal ideation. Free healthcare and hand outs for all. No guns, except for the ones the government uses to protect themselves, and we’ll all apparently live longer, greater lives.
Profile Image for Anna.
522 reviews8 followers
February 24, 2020
Since the 2016 election, there has been endless, ceaseless, never ending, a seemingly boundless number of stories covering Trump voters in "real America". Each article or news segment seem to come to the same conclusion, that they are "economically anxious". But if that's the case, why are they continuously voting for politicians with policies that don't benefit them? That actually cause them more harm in the end? That's losing them more money, more jobs, and more of their lives? What if there was actually something beyond the economic anxiety?

The thesis the book hits on over and over again is that the people are voting for these policies because of racism; and how some politicians were able to capitalize on that. The constant pitting of "us" (white people) versus "them" (non-white people). They're coming to take "your healthcare", "your jobs", "your public education", "your lives" - "all the stuff your hard earned money is paying for is going to those other people".

The book starts with the anecdote about Trevor, a man who will die sooner rather than later without the medical intervention that he is constantly voting against because he would rather die than vote for something that would benefit him and people he sees as others - "illegals", "immigrants", "Blacks", "Mexicans". Because that would mean that they are his equals, but he doesn't see it that way.

It's one of the quotes available right here on Goodreads:
“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.


None of these people would consider themselves racist. But even in the interviews in this book, they go out of their way to talk about how important it is for their white voices to finally be heard or how awful it is that their tax payer money is going towards helping "those others", so better not fund things at all. The author doesn't just use the interviews to justify his claims, he has data. Lots and lots and lots of data.

Jonathan M. Metzl breaks the book into three distinct sections. The first covers Missouri and guns, the second covers Tennessee and healthcare, and the third covers Kansas and education. Through a mix of on the ground interviews at each of these locations and data analysis (Metzl is the Director of the Center for Medicine, Health, and Society, at Vanderbilt University), he is able to breakdown just how much the people he interviews are being screwed over by the policies they support and then cut through the noise and get to the real reason of why they support those policies.

I listened to the audiobook and paged through the book for the graphs and charts and sources. The audiobook is well edited because it makes everything understandable without the need to necessarily reference the graphs and charts in the book. However, there are times where the listener is inundated with equations and the results of the plug and chug- having done that to people before myself, I know that it can cause people to zone out and tune out completely. I actually recommend the physical book itself because it does make things like his data easier to follow.

What America really needs to figure out how to deal with is the rampant "racial anxiety" - racism, that exists. The Booker T. Washington quote that's used in this book, "To hold a man down, you have to stay down with him" pretty much exemplifies what is happening. Perhaps instead, we as a nation should embrace the aphorism, "a rising tide floats all boats". Easier said than done.
Profile Image for Casey.
925 reviews54 followers
August 1, 2023
A disheartening book on the self-harm voters created in three Midwestern states -- Missouri, Tennessee, and Kansas. An important study worth five stars, though the statistics and graphs made for slow reading. The interviews are sad but enlightening.

GUNS. A few notable passages (some shortened or paraphrased):

Page 61: A gun dealer issued a Man Card to those answering a series of "manhood questions" so that their manhood can be "restored."

Page 66: According to the book Gun Fight by Adam Winkler, after the Civil War, the KKK began as a gun control organization to "achieve complete black disarmament."

Page 70: White Missouri open-carry advocates asserted their rights to carry by parading through the African American areas of downtown St. Louis brandishing handguns, long guns, and assault rifles.

Page 71: A white man strolled through the aisles of the Walmart in Winder, Georgia, buying groceries, in a Trump T-shirt with a semiautomatic rifle strapped to his back.

Page 71: In contrast, a sixty-two year-old African American man entered a Walmart in Tampa, Florida with a legally owned pistol strapped to his waist, only to be tackled and put in a choke hold by a white vigilante who held him to the ground while shouting, "He's got a gun!"

Page 73-4: A professor maintains that this shift from firearms as utilities (e.g. for hunting) 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 post 1960s America. The civil rights and women's movements brought increased competition while wages and manufacturing jobs declined precipitously.

Page 74: During the past two decades, the NRA promoted guns for self-defense, even as crime rates fell considerably over this same period.

Page 75: Guns became the totems for particular versions of white identity politics that rose with the Tea Party and soon encompassed the entire GOP.

HEALTHCARE. This section is copied from Michael Perkins' very good review from October 25, 2022.

Trevor had no health insurance and severe liver disease put him in the hospital.

“Ain’t no way I would ever support Obamacare or sign up for it,” Trevor 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.

SCHOOL FUNDING. Big tax cuts can destroy schools and many students' futures, as happened in Kansas.

Highly recommended!
Author 6 books253 followers
March 1, 2021
As timely as it is depressing. As millions of Americans wander an alternate reality way less fun than anything ever experienced by the cast of Sliders, they are increasingly desperate to not only sound as confused and deluded as possible, but also to basically ruin their lives for the sake of a vague, meritless, and shitty-life-syndrome exploiting political dogma.
Metzl doesn't really explore so much the what-the-fuck so much as the why, and the value here lies on the lack of polemics. His is a steady hand, sifting through data on gun control, health care, and public services (especially schools) in case studies of, respectively, Missouri, Tennessee, and Kansas. Metzl's thesis is simple: people believe stupid political shit that basically endangers their lives, their health, and other people's lives. Lacking any sense of common good, interviewees are more willing to literally die than get health care assistance through so-called "socialist" medicine. Folks he interviews actually say this! What?! Whatever, peeps! Guess you'll die!
Metzl is calmer than I am, I suppose, and has quite a lot of data to back up his basic, practical arguments. Should be required reading.
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184 reviews13 followers
June 5, 2020
To be well-rounded, I try to read books outside of my normal worldview every once in a while. I'm one of those guys who dislike identity politics and thinks many people are blinded when seeing through the lens of race. I was hoping to learn something through this book to nuance my view of that position. Unfortunately, I did not. While the author is well-spoken and educated, I cannot say I came away from this book with much new knowledge or any changed opinions. I felt that I doubled-down in recognizing the failures of critical race theory.

The author is blinded by the identity politics dogma and the incoherence it applies to his arguments is obvious. Confusingly, Metzl introduces "whiteness" as not tied to being white, but instead a mindset. This is a terrible redefinition and it makes things more confusing. If whiteness isn't tied to race, to what is it tied... conservative politics? What does it mean when a black person believes in the same policies as one of the white people he describes? This is the kind of definitional maneuver that, when applied to public news, justifies absurd statements like Kanye West is no longer black by supporting Trump. It is poor enough of a definition that he doesn't seem to stick to it. Despite this explanation in the introduction, "whiteness" only seems referenced with regards to white people throughout the book.

The book starts with how "whiteness" is tied to gun culture, and how guns are killing people. The syllogism is approximately this: white people = guns, and guns = people dying, therefore white people = people dying. He parrots mostly standard democratic talking points and by tying in some personal interviews and statistics. He addresses approximately no strong standard conservative responses and thus makes arguments that feel quite weak.

But it is the tying of races to behavior that is so dangerous. Imagine if one were to make parallel arguments for other races. He ties white people to guns because of historical and modern tendencies to favor them over other races. It's the same logic that allows crazy right-wingers calling black people criminals because they historically commit more crime. We need to examine the behavior, the ideology, not the skin color.

After guns, he critiques other aspects of conservative principles (opinions on healthcare, reductions in social spending, etc) by tying them to whiteness. And then he again blames whiteness for being what kills people. This book would have been better if it was framed as how conservative politics was affecting society. I might not agree with all its conclusions but I would have given it an extra star or two. But by making it about race, the author abandons cogency for politically correct dogma.

The author is smart and measured in his words but not so in the basic assumptions that undergird the foundation of this argument. I cannot recommend this book to anyone, as there are more useful critiques of conservative ideology that are not shaded by racial dogma.

View my best reviews and a collection of mental models at jasperburns.blog.
360 reviews17 followers
October 26, 2019
I put off reading this book until I heard the author speak on a podcast. When he made it clear that he wasn't casting the people he interviewed as stupid, but rather trying to meet them on their own ground and see what it looked like to him, I decided to pick it up, and I'm very glad I did.

Metzl studied gun deaths in Missouri, the denial of the ACA expansion in Tennessee, and the austerity effects of the Kansas budget on its previously high-ranked school system. In every case, he discovered that people's beliefs (and myths) about who was getting something for free, or who was a clear and present danger, affected people's willingness to make dangerous decisions about their own lives. He backs up his interviews with very detailed data calculating number of hours of life lost in each case (and yes, school outcomes correlate with life expectancy).

He is very careful to keep track of the fact that life expectancies of Black people and Hispanics are worse in the first place and at least equally negatively affected by the decisions that are imperiling White lives. But he wants to take a hard look at what White people are doing to ourselves.

He's a good thoughtful writer, a compassionate man, and an M.D., and his book is worth reading.
429 reviews7 followers
April 24, 2019
I read Hillbilly Elegy, Strangers in Their Own Land and now this book. Each "explains" our current situation where people seem to be voting against their own interests. This one is the best. Looks at Missouri, Tennesee, and Kansas as, in many ways, beacons for gun control, health insurance reform and education and then the Tea Party/Trump strom hit. Each went from among the best to the worst. Meetings with support groups, citizens, and local politicians describe how guns, access to healthcare, and education are tied to racial fears and the sense that the white identity is threatened and lost and the ensuing backlash. The author is a physician and makes the case that whiteness as an identity is a concept people feel is worth dying for....literally, by guns (the protection and independence totem), lack of healthcare (I don't want "them" to have it), and cutting education ("a waste of money just to get "them" up").

Well written, provocative and sad but with glimmers of hope as people realize they are literally shooting themselves in the foot.
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