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How the Politics of Racial Resentment Is Killing America’s Heartland by Jonathan M. Metzl

“Ain’t no way I would ever support Obamacare or sign up for it. I would rather die….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, a terminally ill White man in Nashville. (p. 3)

Jonathan Metzl leads us through three case studies in which he conducted extensive interviews and focus groups to shed light on three puzzles:

  • The first is why White men in Missouri are opposed to any kind of gun regulation even though White men commit suicide with guns at a rate far higher than any other demographic.
  • The second is why White men in Tennessee adamantly oppose Obamacare even when (as with Trevor, above) they are seriously ill and cannot effort medical care.
  • The third is why Whites in Kansas voted for a program of radical austerity sponsored by Governor Sam Brownback, even though it greatly weakened school quality.

Metzl is a professor of sociology and psychiatry at Vanderbilt, and directs the Vanderbilt Center for Medicine, Health and Society.

Unwillingness to support government programs that might help minorities or immigrants fed into Republican opposition to Obamacare,

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The basic theme is spelled out in the Introduction (p. 15):

…we make a wrong turn when we try to address racism mainly as a disorder of people’s brains of attitudes, or try to “fix’ the problem simply by attempting to sensitize people or change their minds….instead, racism matters most to health when its underlying resentments and anxieties shape larger politics and policies and then affect public health.

That is, racism is systemic in American society, even when individuals may not be conscious of racist thoughts or feelings. Thus in Missouri, the widespread conviction among Whites that the right to bear arms was both sacred and threatened fed into the enactment of laws such as open carry without restrictions above age 19. Those laws in turn fed a gun culture that emphasized protection of self and family against threatening dark-skinned others.


In Tennessee, similarly, unwillingness to support government programs that might help minorities or immigrants fed into Republican opposition to Obamacare, which in turn fed into adamant refusal to access a program that was designed to benefit everyone. The same basic pattern was found in the politics of austerity in education in Kansas.

It’s a grim picture, but Metzl does note that in Kansas and Kentucky (but not Tennessee or Missouri), coalitions of moderate Republicans and Democrats were able to win elections and roll back some of the most reactionary policies. In his Conclusion, he talks (not very convincingly) about somehow overcoming the polarization we now endure.

I come away with a better understanding of what we’re up against, but I have not changed a fundamental conviction: racism is built into the very origins of our society.

impeachment unavoidable

All our social relations are conditioned by it. We will never be rid of it. We can only (and must) struggle always against it. And now, that struggle starts with rolling back as much as we can of what Trump wrought.

John Peeler