In Dying of Whiteness, Metzl argues that policies and politicians supported primarily by lower- and middle-class white Americans in the United States heartland significantly impact the health and well-being of all US residents. He argues that voters who generally support GOP tax cuts, healthcare strategies, and loosening gun restrictions do so because these issues are deeply tied to historical ideas of white superiority. Politicians thus draw upon white anxiety to garner support, promising “to make America great again—and, tacitly, white again” (5). However, in an attempt to remain atop the social hierarchy, white Americans are “putting their bodies on the line” (168) to create a system that harms societal well-being.

In Missouri, Tennessee, and Kansas, Metzl illustrates how policies that may not be overtly racist have significant racialized histories and connotations. Gun ownership, for example, was a “privilege” historically granted only to white men, making firearms deeply symbolic of white privilege, autonomy, and masculinity. Furthermore, many interviewees cited the need for protection from imagined “dark-skinned intruders” when they argued against gun restrictions. Likewise, in Tennessee, white men worried about “welfare queens and Mexicans” stealing resources as a reason to oppose the Affordable Care Act. The expansion of Medicaid threatened to create a “network” linking white men to minority groups and, therefore, undermining their authority and autonomy.