March 2019, Week 2


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 		 [In this interview, author Jonathan M. Metzl, a physician and
social scientist, talks about traveling through Trump country to find
that the politics of "white racial resentment" is poisoning and
sickening GOP voters as well as our politics.] [https://portside.org/]




 Tana Ganeva 
 February 21, 2019
Raw Story

	* [https://portside.org/node/19560/printable/print]

 _ In this interview, author Jonathan M. Metzl, a physician and social
scientist, talks about traveling through Trump country to find that
the politics of "white racial resentment" is poisoning and sickening
GOP voters as well as our politics. _ 






ISBN-13: 9781541644960

Early in his book, “_Dying of Whiteness: How the Politics of Racial
Resentment Is Killing America’s Heartland
physician and social scientist Jonathan M. Metzl introduces a
Tennessee man named Trevor. Trevor is 41 and dying of liver disease.
He lives in a low-income housing facility and he doesn’t have health

“Had Trevor lived a simple thirty-nine minute drive away in
neighboring Kentucky, he might have topped the list of candidates for
expensive medications called polymerase inhibitors, a life-saving
liver transplant, or other forms of treatment and support,” Metzl
writes. But Tennessee officials repeatedly blocked efforts to expand
Medicaid under the Affordable Care Act.

But Trevor is not mad at the state’s elected officials. “Ain’t
no way I would ever support Obamacare or sign up for it,” he tells
Metzl. “I would rather die.” When Metzl prods him about why he’d
choose death over affordable health care, Trevor’s answer is
telling. “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

Over the course of almost a decade, Metzl crunched mortality
statistics and spoke with people in the South and Midwest. He sought
to find out how—and why—many low-and-mid income white Americans
embrace values and back politicians who institute policies that are
literally killing them, from lack of health care to gun de-regulations
to shoddy infrastructure. Metzl shows that from a public health
perspective, the dogma propagated by Republicans is literally toxic to
a majority of their constituents.

He also traces the history of how right-wing groups have promised to
restore some ideal of white American “greatness”—usually at the
expense of racial and ethnic minorities. _That_ political trick
reached its ultimate fulfillment in the election of Donald Trump and
his slogan, “Make America Great Again.”

Let’s go back to Trevor. What killed him?

“At the most basic level, he died of the toxic effects of liver
damage caused by hepatitis C,” Metzl writes. “When the liver
becomes inflamed, it fails to filter toxins from the blood and loses
the ability to produce vital compounds such as bile and albumin.
Without treatment, death comes by systemic deterioration. Jaundice
gives way to ascites, which then gives way to hepatic encephalopathy
and coma. It’s an exceedingly slow, painful way to go out.”

But Metzl reveals another culprit: the toxic effects of dogma absorbed
by many white people that might lead them to accept a painful death
over giving up their place in a hierarchy that puts them above blacks,
Mexicans, immigrants, other nonwhite people and “the poor.”

_Raw Story _spoke with Metzl, who is Director of the Center for
Medicine, Health, and Society, at Vanderbilt University in Nashville,
Tennessee, about the politics of racial resentment, conservative
backlash, the rise of President Donald Trump and the idea of dying of

Tana Ganeva: You open your book with a question that it seems every
pundit has litigated since the dawn of time (or 2015). Why white
working class Trump supporters would support Donald Trump. Broadly
put, what is the conclusion you came to?

Prof. Jonathan Metzl: The book is really about the effects of a lot of
the policies that Trump supports, right? The scope of the book looks
at three core Trump administration issues, and the history of those
issues, going back about 10 years before the Trump administration. So
I open the book talking about health care reform and why certain
states would go ahead with rejecting Medicaid expansion, when the
health of populations in those states was failing so badly.

I also looked at guns in America, particularly in red states that
support very open gun policies even when populations are suffering
very bad health effects in terms of gun injury and death. In the third
part of the book, I look at massive cuts to infrastructure, led by
purple states. And really, I tried to understand why it is that people
would support cuts to services that they use, like roads and bridges.

So those are three very different examples, but in the book I try to
tie them all together for a couple of reasons.

First, because they all became central components of the Trump
administration, but also there were ten to twenty year histories
behind these polices before Trump, so I saw how Trump took those
stories and manipulated them.

I show how even though many of these policies were couched around the
promise of making particularly white populations great again, by
addressing a sense of lost greatness or anxiety about the world
spinning away from them — I looked at a lot of data and talked to a
lot of people and at the on-the-ground level, the health of _many_
populations suffers, but most of the negative health effects are
suffered by working -class populations who are the core of Trump’s

And three, there’s something similar about these three examples, in
that they all tie to not just promises in a broad sense of “what
America used to be” but they often have invisible undertones of
racial anxiety or a racial hierarchy. And it’s all hard to see but I
feel like the politicians who are supporting these issues … and the
Trump administration in particular really tapped into the anxieties
about falling whiteness. These deep racial tensions were embedded in
issues like health care and guns.

Let’s take health care. When they tried to “impose” health care
reform in the South during the 1950s, and before that in the Truman
era, there was profound anxiety because hospital wards were being
desegregated. So there a kind of racial history of resistance to
health care reform, that the anti-ACA people were tapping into.

Guns, there’s another good example. Guns were in many Southern
states were only allowed for white Americans for a couple of
centuries. So, the point of the book is, we can’t understand why
white people act against their self-interest unless we understand the
histories and how these particular issues have racial meanings.

And the book traces these stories and reveals the costs. They make
people’s lives shorter, harder and sicker.

Tana Ganeva: So your research combines data analysis, such as
mortality rates, and then also just talking to people across these
Southern and mid-Western states. Did any of your findings challenge
your expectations?

Prof. Jonathan Metzl: Absolutely. Let me just say that the reason I
tell the story in multiple ways is I wanted to be clear that it’s
not just an individual story. In other words, I’m not saying that
individual people are racist, or that certain people are uninformed. I
found a great diversity of opinions among the people I spoke with,
about race, about education, about class, economics.

The main thing I try to do in the book is look at all these different
viewpoints. It helped me learn how the health risk to white Americans
and everyone else doesn’t come from individual bias. It’s a
structural story. The health risks come from living in a county or
state where Tea Party style politics dictated the policy instituted by
the government.

So that’s why I looked at so many different data sets … it’s not
just an individual story.

That being said, when I did talk to individual people I found
something quite remarkable across the political spectrum. I spoke to
very liberal people, very conservative people, I spoke with many
people of different racial and ethnic backgrounds, and I think if you
just went by Twitter, there’s a sense that we’re all fighting with
each other all the time. In three sentences or less it’s very easy
to simplify and hate each other.

But when I spoke to people on the ground, there really was a much
deeper longing than I expected, to find a middle ground. Even in the
most extreme places.

I would go to very pro-gun areas and very pro-gun meetings, and people
even there said, “Why can’t we have background checks?” I would
say that people were much more willing to compromise in person, than
if you just looked on Twitter.

Tana Ganeva: Yes, Twitter is hell. So, it’s great that you emphasize
the history of these narratives in your work, because sometimes it
feels like “Nothing ever happened before Donald Trump!” But you
started this work in 2013, and you observe that it’s been a common
strain in right-wing politics going back decades — the idea of a
return to some kind of white American “greatness” at the expense
of other people. Can you talk about the historical basis for these
stories that Donald Trump picked up and ran with?

Dr. Jonathan Metzl: Sure. History is important, because if you’re
just looking at Twitter or the news right now, it seems like we’re
living crisis to crisis. So it’s really hard to sit back and look at
this in terms of a historical current. But in terms of all these
issues, there are very important histories we need to know to
understand why we’re talking about them the way we are right now.

Of course, there are the long histories of overt and implicit white
backlash movements going back to everything from the Tea Party and the
Freedom Caucus, all the way back to John Birch Society, the KKK… the
idea that there are organizations that thrive on racial animosity is
not a surprise to anybody.

What I look at in particular is the role of hot button issues in those
agendas. So, guns are a perfect example. There were many organizations
in the South… from the KKK on down … where their main purpose was
to make sure that black Americans weren’t able to get guns or have
2nd Amendment protections. When black Americans arm themselves,
suddenly everyone is singing the praises of gun control. A lot of
these movements are fanned by fears of minorities taking away your
resources. It’s also the basis for the idea that people should
resist Medicare and health care expansion.

And I do think it’s important not to be ahistorical because I think
in answering the question “Why is it so hard to change people’s
minds?” There are like 200 years of history leading up to people’s
opinions right now. It’s not like, you’re pro-gun one day and
anti-gun another day.

Tana Ganeva: How was Trump able to seize these narratives?

Prof. Jonathan Metzl: Trump has masterfully spoken to tensions that
were already present in these low-income white populations. The
politics of white loss, nostalgia and resentment. Other figures had
done that before — the Tea Party, Freedom Caucus — but it was at a
local, state or regional level. Trump nationalized a lot of those
conversations. He was saying it to the entire country. That’s why he
was so jarring to a lot of people. Trump was singing this song on a
national level.

The other is, he’s just an incredibly good salesman tapping into a
lot of these things, making people feel like someone cares about their
interests at the national level, whether or not you agree with the
policies. That’s powerful. Trump didn’t treat the South like
flyover country. I think that’s why people were willing to stand by
him, no matter how many times he said some crazy thing.

Tana Ganeva: Describe “Dying of Whiteness” and why you chose to
frame your book this way?

Prof. Jonathan Metzl: First of all, the theme of the book is that
white working class Americans in the South and Midwest are suffering
as a result of policies that are put into place by politicians who
they support. And so the main thrust of the book is to track the
health effects of certain core GOP policies like blocking health care
reform, very pro-gun policies, anti- infrastructure policies and just
looking at the health of communities.

The main reason I argue that people are dying of whiteness is that the
GOP has built a base on this politics of racial resentment. In order
to do, it’s made the lives of supporters expendable. The GOP
doesn’t work unless their base makes a trade off that has very bad
health effects on them.

	* [https://portside.org/node/19560/printable/print]







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