Book Review: Dying of Whiteness: How the Politics of Racial Resentment Is Killing America’s Heartland by Jonathan M. Metzl

Book Review:
Dying of Whiteness: How the Politics of Racial Resentment Is Killing America’s Heartland by Jonathan M. Metzl

by Karyn Pomerantz, August 2019

Dying of Whiteness examines how racism hurts white working class people. Metzl counters the common ideology of white privilege, which posits that white people benefit from racism in terms of social status, safety, education, and housing. While racism devastates non-white communities, it also hurts ordinary white people. Metzl’s analysis doesn’t explicitly frame these inequities as different levels of exploitation caused by capitalism, but he demonstrates how racism enriches the rich, prompts people to support policies against their best interests, and divides people to keep the working class weak (see other blog pieces on white privilege).

Metzl rejects the claim that whites benefit from racist policies. He argues that white supremacy damages the health and well-being of white working and middle class people even as they adopt racist beliefs and embrace Trump. He takes readers on a tour of three Midwestern states, Missouri, Tennessee, and Kansas, to illustrate the effects of gun violence, tax cuts, and the rejection of the Affordable Care Act (ACA) and Medicaid.

Using data from state and federal databases and interviews with people affected, Metzl documents increased mortality and lowered life expectancy among white residents. He illustrates how racist ideology and practices create and sustain the belief that government aid is a handout accorded to non-whites, invoking the image of the “welfare queen” and needy immigrants.

During the 17th Century as slavery developed, the rich landowners separated black, white and native people to quell resistance. African people were enslaved, natives exterminated, and whites given policing jobs on the plantations despite their initial attempts to maintain multiracial relationships. The government paid white people a wage and reassured them that they were better than enslaved people. This lie persists as white conservatives have vigorously defended their status over centuries (“at least we are not slaves”). Even then, white laborers suffered unemployment due to the ability of the employers to use free labor. White anger targeted black workers, not the planters. A similar dynamic played out during the Great Migration in the first half of the 20th Century when six million southern black residents resettled in northern and western cities, provoking vicious attacks by white racists, including burning down entire neighborhoods in Tulsa and instigating a race war in Chicago.

How Racism Kills Whites


Metzl visits Missouri to assess the effects of gun ownership on mortality. Missouri does not regulate gun purchases or use, such as background screening or safety practices. From 2008 to 2013, shootings and killings with guns by whites were ten times higher than other groups. Suicides and domestic violence assaults exceeded the rates of homicides among black residents. Metzl interviews relatives of children who shot themselves to death. He contends that gun ownership makes the suicides (among men) more successful. Yet he does not explore the reasons for these deaths, what public health identifies as “diseases of desperation.” High rates of unemployment, substance use, hopelessness also drive this despair. Guns may facilitate these deaths but they don’t cause them .

Guns are associated with racism. During slavery, white men used arms to patrol the plantations and kill rebellious enslaved men and women. During Reconstruction, the KKK organized to take away guns from black Civil War veterans. Armed KKK groups attacked black families in terrifying night raids. The Second Amendment granting the right to bear arms is not applied equally to blacks and whites. In more recent times, whites can openly carry guns while blacks have been killed for legally carrying them. Metzl’s interviewees in St. Louis, where the Ferguson rebellion occurred, admitted to owning guns to protect themselves against the demonstrators. Militant black leaders, such as Malcolm X, Robert Williams, and the Black Panther Party, advocated guns for self defense. Metzl raises the question of whose lives are worth protecting.

Guns are also associated with masculinity and power. The Bushmaster Firearms company that sells assault weapons disseminated ads based on appeals to masculinity, the Man Card campaign. It pitches its message that manly men own guns: “To become a card-carrying man, visitors of will have to prove they’re a man by answering a series of manhood questions. Upon successful completion, they will be issued a temporary Man Card to proudly display to friends and family” (

Health Care

Metzl moves on to Tennessee to examine the reasons people rejected the ACA and Medicaid expansion. He found that they opposed government sponsored health care as a handout associated with services for black and immigrant people.
One resident of a low income housing project suffering from advanced liver disease told him:

“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.”

Before the 1960s hospitals in the north and south were segregated with drastic differences in access to and quality of medical treatment. Hospital administrators separated black and white patients, crowding black patients into wards regardless of their health status and needs. Men with TB shared space with women in labor, and black physicians were not allowed to admit their patients. (See the documentary, Power to Heal at

After the passage of Medicare, black physicians and civil rights groups demanded that the Johnson Administration desegregate the hospitals. The government made Medicare coverage dependent on desegregation. Hospitals that did not change their racist practices did not receive Medicare reimbursement. The civil rights division of Health, Education, and Welfare (HEW), now HHS, sent 1000s of lawyers and volunteers to verify desegregation by inspecting the physical spaces, not just hospital reports.

Medicaid provided health care for poor people who met income criteria. The ACA subsidized health insurance, legislated funding for prevention and public health, extended the age of dependents to use their parents’ health insurance, and allowed states to offer Medicaid to more people.

Even though whites benefited from these health reforms, Metzl’s interviewees rejected them since they represented government intervention and handouts used by blacks and immigrants. They also opposed the ACA because President Obama instituted it. Opposition to the ACA included people with severe disabilities and diseases who desperately needed care, a literal example of racism killing poor whites by “political acts of self sabotage.”


Kansas, under Governor Brownback, severely cut taxes. Kansas schools had been valued for their quality teaching and high graduation rates. However, the massive cuts drastically changed the educational system. There were fewer teachers and schools, larger classes, and diminished graduation rates and college admissions.

Racism also marks the history of education beginning by outlawing literacy education for enslaved people. During Reconstruction black led governments created public schools for all children; many white families refused to send their kids to schools with black children, denying them a chance to learn. In Mississippi in 1964, Freedom Summer leaders from SNCC, a militant civil rights organization, hosted college students to teach freedom schools, combining political education with basic skills. Today, as education deteriorates for all public school students, black students in segregated neighborhoods have less experienced teachers, less access to books, larger classes, and higher drop-out rates due to a smaller tax base. (Schools are financed by local taxes; neighborhoods with more poverty have less tax money to allocate to schools). The Brown vs. the Board of Education of Topeka, Kansas in 1954 outlawed separate but equal education but allowed the states to take “all deliberate speed” that slowed implementation.
Metzl calculated that these conditions lowered life expectancy by 9 years. He postulates that it could be due to less exposure to health education or less income due to lower graduation and college rates.


Dying of Whiteness helps readers understand how people reject policies in their self interest. The contract that the early landowners made with white indentured servants, that they were better than enslaved free labor, persists. Rather than uniting with black and immigrant people who have the same interests, Trump supporters defend their own slightly better status by rejecting policies that they associate with non-whites. Metzl explains that this is not hatred of poor people but one imbued with racism:

“…racism matters most to health when its underlying resentments and anxieties shape larger politics and policies and then affect public health. I say this in part because many of the middle- and lower-income white Americans I met in my research were not expressly or even implicitly racist. Race did not even come up in many of our conversations. Yet racism remained an issue, not because of their attitudes but because they lived in states whose elected officials passed overly permissive gun policies, rejected health care reform, undercut social safety net programs, and a host of other actions. In these and other instances, racism and racial resentment functioned at structural levels and in ways that had far broader effects than the kinds of racism that functions in people’s minds.”

Racism is more than an ideology and a set of attitudes. Prejudices, however, lead to unhealthy policies. Metzl condemns the policies of gun ownership, health care, and tax cuts for enriching corporations while hurting the people who suffer from them. He blames white superiority for people rejecting health enhancing programs, dividing people who have common needs, and scapegoating immigrants and black people.


Metzl calls for multiracial unity by creating opportunities for collaboration and community building to win reforms. How to accomplish this is unclear, although he does not recommend building the Democratic Party or any other.
Furthermore, the data and interviews on gun violence do not address the underlying reasons for the rise of suicide. There is little to no discussion of the economic disaster in these midwestern states, such as joblessness, that lead to hopelessness, drug use, and social isolation.

Metzl identifies the employment status and occupations of his interviewees but does not stratify his data by characteristics that would reveal if there are any differences based on class.

While demonstrating how racism hurts white workers, divides people, and profits corporations, he does not condemn capitalism as the cause of increased morbidity and mortality due to suicides, lack of health care, and diminished budgets for education. Much of the book focuses on Trump related politics. While outside the scope of the book, more examples of the role of racism throughout US history in maintaining segregation and the power of a small ruling class would strengthen the book.

This is a very useful book to read and share among friends and book clubs.

PS Metzl has definitely garnered attention among supporters, journalists, and white nationalists. He gave a book talk at Politics and Prose during the summer of 2019 in Washington, DC. A small group of white racists entered the bookstore and interrupted his talk as the audience sat by passively although they totally outnumbered them.

One thought on “Book Review: Dying of Whiteness: How the Politics of Racial Resentment Is Killing America’s Heartland by Jonathan M. Metzl”

  1. Hello Ms. Pomerantz my name is Patrick Tape. I am a black odd jobs guy struggling in California. I liked your review on the book. It is interesting that the author wrote a through review about Kansas politics under Governor Brownback in regards to the decay of education and living standards of the state. My mother’s family is from Oklahoma and I can tell you that in regards to Oklahoma (OK) politics it runs almost verbatim like Kansas runs its state. Big Gas and Energy barons run OK state. I went back to visit OK a couple years back and I was horrified that substitute teachers in OK get paid only $60/day vs California pay being $125-$200/day. A lot of Kansan and Oklahoma Teachers are now emigrating to Texas for better pay. Despite Kansas and Oklahoma being a predominately white majority states, the white working class families in both states are working multiple jobs for poverty wages, while their white Corporate counterparts control those states and brainwash white workers into loving Koch Industries and other Big Oil corporations in those states.


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