Public policies rooted in racial resentment can carry grave consequences for health and well-being, according to new research by Vanderbilt psychiatrist and sociologist . His findings, based on seven years of fieldwork in Tennessee, Missouri and Kansas, can be found in his new book, .
Metzl is the Frederick B. Rentschler II Professor of Sociology and Medicine, Health and Society, and director of , which studies the social, political and community forces that impact health.
Metzl undertook the research for this book to understand how white Americans reconciled support for anti-tax, pro-gun policies in regions struggling with the impact of poor health care and education and high rates of gun death. He took a personal approach, focusing in three specific areas: Medicaid expansion in Tennessee, school funding in Kansas and gun laws in Missouri鈥攖hree states where he鈥檚 lived much of his life.
鈥淲hat was interesting was that, even as the negative health effects became more and more apparent, I found that it actually made people more adamant about supporting these positions, not less,鈥� Metzl said. 鈥淚 realized you really can鈥檛 understand this point of view until you understand the history of race in America.鈥�
What it means to be white
In his book, Metzl explains that today鈥檚 skepticism toward gun control and government programs has a long history in the segregated South and Midwest, where gun ownership, affordable health care and quality education were considered privileges that only whites deserved. Likewise, those attitudes reflected a view of whiteness that emphasized extreme self-reliance鈥攖he idea that individuals can and should be solely responsible for the health, safety and well-being of themselves and their loved ones.
According to Metzl, this view is linked to backlash following the U.S. Civil War and Federal interventions to end segregation. More recently, he said, these attitudes resurged following the election of President Barack Obama, paving the way for Metzl鈥檚 research.
The 鈥渕ortal trade-offs鈥� of racial resentment
Through focus groups and extensive in-depth interviews with working- and middle-class whites, Metzl found that anxieties about changing racial dynamics were significant predictors of support for pro-gun, anti-tax policies and rejection of government-sponsored health care programs. Support wasn鈥檛 necessarily motivated by explicit racism, he said, though he did encounter that, too鈥攁ll it took was an investment in this particular brand of 鈥渨hiteness.鈥� Furthermore, through statistical analyses of population and life expectancy, he found these attitudes carried significant health consequences not only for minorities and immigrants, but whites as well. 鈥淚n other words,鈥� Metzl said, 鈥渨hiteness itself has become a negative health indicator.鈥�
I realized you really can鈥檛 understand this point of view until you understand the history of race in America.
He found that, in Missouri, when gun laws were relaxed, white men became 2.38 times more likely than men of other races to die by firearm suicide. In Tennessee, he calculated that opposition to the Affordable Care Act led to health care gaps that cost every white resident of the state 14.1 days of life. And slashing school funding in Kansas greatly increased the number of white teens dropping out of high school, which correlates with nine years of lost life expectancy.
Yet there remained a significant portion of the population who acknowledged the personal harms of these positions, but felt it was more important to prevent groups they felt were undeserving from taking unfair advantage of them. 鈥淪o this sense of white identity and white identity politics was in some instances a more powerful driver than longevity or well-being for dictating how people behaved,鈥� said Metzl.
Seeking solutions for a healthier future
Why would voters support policies that make their lives sicker, harder and shorter? Metzl emphasized that his research does not suggest that these individuals are simply naive people who have been duped. In fact, many of the people he interviewed expressed far more nuanced views than were reflected in the region鈥檚 political discourse. Rather, he found it鈥檚 a symptom of how powerful and pervasive this hierarchical conception of whiteness is, and it shows how damaging backlash policies can be for everyone.
Metzl believes that neither major political party is going to have all the answers. 鈥淲hat I鈥檇 argue for instead is a progressive conservatism that emphasizes cooperation and common cause, and that actively promotes the well-being of all lower- and middle-income Americans,鈥� he said.
He hopes that his research will provide some ideas for a healthier way forward. 鈥淚f you look at the toll that racial tension and racial resentment is taking on this country鈥攖he toll on all of us,鈥� he said, 鈥渋t’s not a great mystery why addressing that would be better. Better for everybody.鈥�