Ezra's Bookshelf

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

by Jonathan M. Metzl

Health & MedicineRace & Identity

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White Americans in the heartland are dying from policies their elected representatives enact, and physician Jonathan Metzl investigates why. Through fieldwork in Missouri, Tennessee, and Kansas, he documents how opposition to the Affordable Care Act left working-class whites without health insurance, how permissive gun laws increased suicides, and how cuts to public education harmed the children of voters who supported those cuts. The pattern Metzl identifies is racial resentment translated into policy preferences that harm the very people who hold them. Metzl, a psychiatrist and sociologist at Vanderbilt University, combines epidemiological data with extended interviews and participant observation. He talks to dying men who refused Medicaid expansion because they associated it with benefits for undeserving others. He attends gun shows where sellers explain that firearms are protection against racial threat. He visits schools struggling after tax cuts, where white students suffer alongside the minorities the cuts were meant to disadvantage. The book does not reduce its subjects to victims of false consciousness; Metzl takes seriously the historical grievances and cultural values that shape their choices. But he insists on documenting the costs: the years of life lost, the deaths that need not have occurred, the futures foreclosed. Readers seeking to understand how racial politics and public health intersect will find this work disturbing and essential.

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