Jonathan Metzl is one of the many amazing authors I heard speak at the 2018 Anti-racism book festival. His book, Dying of Whiteness: How the Politics of Racial Resentment is Killing America’s Heartland has been on my TBR shelf since I heard him that day. Perhaps it was beshert (intended), though, that I finally got to it after I’d finished Isabel Wilkerson’s Caste. Wilkerson provided the hypothesis that “many people … . align themselves not with those whose plight they may share, but with those whose power and privilege intersect with a trait of their own. People with overlapping self-interests will often gravitate toward the personal characteristic that accords them the most status. Many make an existential, aspirational choice. They vote up, rather than across, and usually not down.” Metzl provides the data that prove that hypothesis.
I have to admit I didn’t find Dying of Whiteness easy to get through (neither was writing this response, which has been half-finished for weeks). It is well-written but the data sometimes felt more academic than could hold my attention for my "leisure" reading. The stories, though. The stories Metzl shares are riveting. The book is centered around three situations in which white Americans, with their votes, their money, and their behavior, choose caste over their own well-being (Metzl does not use the word caste): guns in Missouri, health care in Tennessee, and schools in Kansas.
In Missouri, with a more-guns, more-access attitude toward firearm ownership, white men die of gun-related suicide in such high numbers that white men disproportionately drive the overall gun mortality rates in the state. Metzl does a lot of work to quantify the risk and the cost of the lax gun laws, with careful statistical analyses that compare mortality rates in Missouri with other states whose legislatures have made different choices. In addition to the statistical analyses, Metzl and his research team conducted a large number of interviews with (white) folks who’d lost a loved one to suicide by gun. Despite their grief, the culture makes them unable or unwilling to even consider interrogating the access to guns as a problem. “I don’t think any of us blame the gun,” says one interview subject in a support group of those who’ve lost loved ones to gun suicide (p 32).
The through-line that these interviews and Metzl’s analysis of the language around gun policy highlight is some implicit and explicit racial bias baked into white folks’ attitudes toward guns. In a nutshell, white America generally believes that violence from Black people is a real and dangerous threat that can (only?) be countered by white gun-ownership. This nutshell attitude has led to decades of increasing numbers of white gun ownership and access and the subsequent uptick in white suicide by firearm (white men are 35% of the population but 80% of firearm suicide deaths, p 37). Despite this data, guns remain seemingly revered by white culture in the Missouri communities Metzl investigates. Metzl notes, “A widely cited opinion study published in the journal PLOS ONE found that ‘attitudes towards guns in many US whites appear to be influenced … by illogical racial biases’ related to the ‘fear of black violence and crime.’” (p 49) These racist biases have proven more powerful than grief and the human desire to avoid unnecessary death.
In Part II of Dying of Whiteness, Metzl investigate attitudes toward the Affordable Care Act (ACA), also known as Obamacare. It is from this research the truth of the title of the book comes into stark relief. In the book’s introduction, Metzl tells the story of Trevor, a white man in his early 40s who was uninsured and dying of the damaging effects of Hepatitis C and a hard-partying lifestyle in his younger years. Though Trevor would have benefited from ACA coverage, the governor and legislature in his native Tennessee made it impossible for him to access the coverage it might have provided. “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.’” (p 3)
It is Trevor’s stated preference to die himself rather than allow people of color (namely LatinX or Black folks) receive any government-backed health insurance benefits that most neatly illustrate Metzl’s title and his thesis. In short, though Hepatitis C was killing Trevor, he was dying of racism, or, in Metzl’s language, he was dying of whiteness. To be honest, this story is all you really need to know about the thesis of this title. It is true that Metzl compellingly supports the thesis with a lot of data, but if you could only read one, I think Isabel Wilkerson’s Caste is a more interesting read about this phenomenon of choosing caste over your own well-being. What I do want to lift up, though, is what comes out of Metzl’s interviews of Black folks about the ACA.
Since Metzl and his team were specifically investigating racial attitudes toward the ACA, they conducted their focus groups in affinity spaces, with Metzl, who is white and Jewish, interviewing white participants in group settings and a Black team member conducting the interviews with Black participants. The similarities and difference among the focus groups of white men vs. Black men as reported in this book were striking to me. Metzl notes that “Men of both races generally linked their health to their own agency, as manifest through what they ate or what they did.” (p 145) But the two sets of focus groups diverged when “the conversations veered into the politics of health” (p 146).
When participants were asked what role the government should play in promoting health, the white respondents tended to answer something along the lines of “nothing” or “we don’t want socialism.” When pressed, white respondents expressed things like “And a lot of people use this Obamacare that use the state up when there’s a lot of people been sick, but there’s a lot people that’s not sick. They go to two or three doctors, you know, and just use the shit out of it, and then when somebody really needs it, they ain’t there for you to get it.” (p 149) This scarcity mindset quickly devolves into much less-veiled racist comments in Metzl’s telling: “‘Yeah,’ one of the men pulling an oxygen tank added, ‘there’s a lot of people that use welfare,* the welfare department and stuff that needs to get jobs, quit having children, and really get buckled down now. I mean, I’m not saying everybody; I’m just saying there’s people that have ten and twelve kids. There ought to be a cutoff point somewhere there.” (p 149)
The responses from the Black focus groups was decidedly different. Though, as Metzl points out, Black communities in this country have good reason to be skeptical of government “interventions” in their health care, Black respondents in this research, when asked “Who benefits from Obamacare?” were much more likely to answer “Everybody” than were the White respondents. This was true regardless of socioeconomic status. “Everybody. Society. The citizenship. For these men, health care was a utility shared by all, for the benefit of all. Where white men often defined government involvement as a risk or a debt, many black men saw a communal safety net as an investment. Expanded health care enabled well-being for highly practical, seemingly nonideological reasons: health care allowed more people to go to doctors and to do so before they became gravely ill, thus saving money and improving quality of life. This line of reasoning is often attributed to ivory-tower health economists who study the benefits of particular health policies through frameworks of economics or public health. In the African American groups, we found that many people on the ground felt the same.” (p 163)
Metzl’s research centers white people. I say this not as a critique but as a statement of fact. He was trying to understand both the data and the psychological “why” of some of the first losses in overall life expectancy that white folks have seen in generations. It is important work. I’m glad he did the interviews and the statistical analyses to put additional metrics behind what Wilkerson and other commentators have noticed. At the same time, this difference between the white and Black respondents to questions about Obamacare are what I found the most fascinating about this book. White folks, in general, approached the questions Metzl posed from a place of scarcity. Their comportment toward the question was one that assumed there isn’t enough--not enough safety (in the gun question) not enough health care, and in the third section of the book, not enough money/time/resources for education. (If you really want to dig deeper into that question and the ways racism affects it, you’ll have to read the book.) Black folks, at least on the health care question, were generally more likely to come at the questions with what was closer to an abundance mindset: health care is not a pie with finite pieces, but a rising tide that lifts all boats.
What stayed with me the most from this work was that divergence. It left me with more questions than answers: Is there something in Black American culture that engenders an abundance mindset, or is it that white American culture engenders scarcity? Or is it both? If neither data nor death nor grief can change hearts and minds, what can? As a white, Jewish woman, in what ways have I internalized the scarcity and the caste biases Metzl uncovers, and what can I do to counter them?
I am certain that uncovering them and holding them up to the light is an essential step in my work to reject the illogic of caste.
*I would note here that though I know that “welfare” in this country is predominantly used by white people, I also know that the man who made the statement Metzl quoted did not have white folks in mind when he made the comment.