scorecardresearch Skip to main content
Book Review

How the politics of racial resentment is hurting the health of white voters

An attendee at a January gun-rights rally in Olympia, Wash.Ted S. Warren/AP/file/Associated Press

In the past few years, newspapers began reporting some troubling data about a demographic group not normally seen as particularly endangered: White people, especially middle-aged white men, were ending their lives at a higher rate than other populations. Gun-related suicide, in particular, was beginning to look like an epidemic among the very demographic that sits atop the race and gender hierarchies in our troublingly unequal nation. White voters made up the bulk of support for loosening gun laws in places like Missouri, one of the states Jonathan Metzl examines in his provocative new book, “Dying of Whiteness.’’ But the political equation, in which white voters overwhelmingly supported easing firearm restrictions, boomeranged; “as gun laws were liberalized,” Metzl writes, “gun deaths spiked . . . among white people.”

Part of this is because suicide attempts by gun are more likely to result in death than other methods. But the data also reveal the paradox at the heart of Metzl’s research: that when it comes to issues like guns, health care, and government spending, politics rooted in racial resentment among white voters has often led to outcomes that harm the very people who embrace those policies and the politicians who promote them.


Metzl, a psychiatrist, studied three issues in three states: guns in Missouri, health care in Tennessee, and government funding (particularly of elementary education) in Kansas. What he discovered was a deep vein of racially coded arguments that undermined, in many cases, support for initiatives that would benefit a wide swath of people. Talking with members of a suicide survivor support group, Metzl heard grief and pain mingled with a stubborn refusal to blame easy gun access for the damage wrought. For white gun owners, as one sociologist Metzl quotes found, “gun ownership became a defense of internalized notions of racial order as well as an external personal safety.”

The same is true with health care in Tennessee, a state with a high poverty rate where many who could have benefited from Medicaid expansion nevertheless opposed it. Trevor, an uninsured man dying of liver disease, tells Metzl that he’d “rather die” than support Obamacare. “[I]n any case,” he goes on, “no way I want my tax dollars paying for Mexicans or welfare queens.”


White men, even those who are poor, still benefit from their privilege, of course; they are less likely to be shot by the police or incarcerated for nonviolent crimes. But the degree to which they increasingly vote against their own interests continues to puzzle. “Why would someone reject their own health care, or keep guns unlocked when their children were home?” Metzl asks. “I kept thinking that at some point, the drive for self-preservation might trump political ideology.”

Ah, Trump. He hovers over the book like a storm cloud. Much of Metzl’s research was undertaken before the last presidential election, but 45 is the politician who most aptly embodies the book’s paradigm. At one point during a 2016 focus group in Tennessee, Metzl writes, as white men being interviewed about the Affordable Care Act talked about undocumented immigrants and their fears of outsiders who “come over here and have babies,” he and his research assistant looked at one another. “In that moment, we later confirmed, we were asking ourselves the same question: Holy [expletive], could Trump actually win?” The president’s campaign locked into these white voters’ fears — the free-floating anxiety about “welfare mothers, Mexicans, gangs, and other abject others who undermined the system” — and won their support and loyalty because of it.


In Kansas, many still cling to Trump, despite his unwavering support for former Republican Governor Sam Brownback, who shared the president’s views on guns, abortion, immigration, and Obamacare. Brownback’s tax-cut “experiment’’ led to the decimation of a formerly highly-regarded public school system (“We voted for him,” one Kansan says, “shame on us”), along with major cuts to vital services. Of course, budget cuts don’t kill anyone as quickly as a bullet can, nor as dismally as a lack of health insurance. But Metzl argues that dropping out of high school is associated with a shorter lifespan (by up to nine years), and dropouts among Kansans have increased dramatically since the Brownback experiment. Kansas has turned its back on Brownback but not his political ally. Why? “They just felt like, as white men in America, their voice wasn’t being heard,” another Kansan told Metzl. “Trump gave them their voice back.”

Metzl isn’t the first to identify this strain of racist self-sabotage, and he’s generous in crediting other scholars. But he brings a unique blend of psychiatric insight and data analysis — as well as some nifty philosophical insights into what people mean by concepts of risk, cost, and community — to a problem that will no doubt persist even beyond our current presidency. Still, he ends on a note of hope. “We know from American history that our communal, electoral power allows us to build vibrant social networks, safer communities, and better education systems,’’ he concludes, “when we decide to do so.”



How the Politics of Racial Resentment Is Killing America’s Heartland

By Jonathan M. Metzl

Basic, 352 pp., $30

The Boston Globe may earn a portion of sales from products that are purchased through our site as part of our Affiliate Partnerships with retailers.

Kate Tuttle, president of the National Book Critics Circle, can be reached at