I mostly skimmed this, not because it is bad or poorly written, but because I already "knew" the book's thesis and the conclusions the book details. Most of the book is the research and supporting data for its conclusions (basically that many of the policies Republicans/Trumpies propound are "bad" for their supporters, who fail to recognize this). I didn't feel the need to go into all this (again) that deeply at this point. However, from what I read, as well as what I skimmed, it is well-written and well-researched, with lots of anecdotal evidence and interviews as well.

In its opening pages, the book gives us the example of Trevor in Tennessee, who is dying of severe liver disease. Trevor states he would "rather die than sign up for Obamacare," because "no way I want my tax dollars paying for Mexicans or welfare queens." (And in fact Trevor died shortly after the interview). Trevor is an example of how the politics of Trump is actually killing his supports--physically, not just economically.

The book supports its thesis by taking a deep dive in three areas:

1. Missouri and the loosening of gun laws there. Since the gun laws were relaxed more white males have died from guns (often through suicide) than any so-called protection they provide.

2. The Tragedy of Tennessee. Tennessee's rejection of the expansion of Medicaid and Obamacare has had severe consequences on healthcare there.

3. Brownback's massive tax cuts in Kansas. These tax cuts have backfired, and led to substantial deficits (rather than prosperity), with resulting cost-cutting with severe declines in things such as educational quality.

Recommended if you want to know more about this issue.

3 stars ( )

I wasn’t sure what to expect from just reading the description. The author does an excellent job of explaining his findings. He gets a tad dry with numbers in part of the book, and I’m saying that as a complete numbers nerd. I know from experience you can make data if not interesting, at least not snooze inducing. But other than that very small part of the book, the author has a good voice and presents his observations in a very readable book ( )

Jonathan Metzl is a professor of psychiatry at Vanderbilt University Medical School. In his medical and psychiatry he has seen many white southern Americans living dangerously unhealthy and shortened lives. Metzl lives in Tennessee and grew up in Kansas City where Missouri and Kansas border and share cities with the same name. He looked how white people in the states of Tennessee, Missouri and Kansas voted for political candidates who made their lives worse instead of better and continued to support those politicians despite their misery and suffering. The author looked at health care in Tennessee, gun laws in Missouri and school funding in Kansas. He interviewed many of the subjects of this book both in focus group and individually. The common theme that came out of it was one of white people trying to hold on to the privileges of being the dominant racial group even though it was hurting them. As one man in Tennessee said he would rather die than see "Mexicans and welfare queens" get the Affordable Health Care Act coverage. He did not want his tax money to support people he didn't like. What tax money I asked myself. He couldn't work, he was getting SSI benefits and he certainly paid no Federal Income Tax. Similar issues came up in Missouri about guns and in Kansas about schools. Is hanging on to racism holding all people back from better lives? Is racism the reason politicians like Brownback and even Trump can gain power and make our states and whole country worse instead of better. Certainly looks that way to me. Thanks go from me to Dr. Metzl for a well done book. Warning: whatever you think about these issues reading Dr. Metzl's book will not make you feel good. ( )

Overall a good book but it focused more on the philosophy and culture of a set of Americans who have been convinced to oppose their own best interests through racial animus and left out the most important reason: why? Cui Bono, who benefits?

Such views would have as much political cachet as beliefs in ancient aliens if no one wished to exploit, exacerbate, and ride them into office.

These people are tricked into supporting politicians promising to address these concerns they have been convinced to adopt, what else do those politicians then do in office and whose interests are met by what else they do?

Powerful financial interests fund the policy institutes creating the slogans and talking points and fear campaigns and fund the think tanks that generate the studies saying whatever their donors want to hear, they support the candidates that campaign on it, they benefit from what the candidates do once they are in office thanks to the misdirection.

Only in the Kansas section in looking at the tax cuts that cut funding to schools is this even acknowledged, but the who and why and broader goals because it goes far beyond mere tax cuts is left out.

Apparently many people need to be persuaded that doing the right thing is in their interest. Being anti-racist needs to be sold to White people as being inherently in *our* best interests as well, because simply benefiting people of color is not enough. While decades of evidence that trickle down policies do not benefit those (of any skin color) at the bottom rungs of capitalism, bottom-up policies seem to defy gravity in their trickle up effects. Unfortunately, many of those (White folks) at the bottom rungs cling to trickle down policies so that they can hold on to a few of their greatest privileges: those afforded them due to the color of their white skin, and the fact that they were born in the United States.

At any rate, this book quantifies the effects of austerity, White supremacy, and neo-liberalism and their exceedingly negative effects on White lives. (This is to say nothing of the lives of immigrants, people of color, and others, who have been living in a country both inherently and overtly hostile to their lives.)

Things I liked about this book: just about everything. Except, of course, for the fact that I'm living in this dystopian United States (albeit in a somewhat blue state).

Things I didn't like about this book: the author's claim that individuals in support of White supremacist policies "aren't racist" (not being an overtly racist person doesn't make one not racist, and if you don't believe this, you need to read more Ibram X. Kendi), pretty much all of the graphs and charts in this book (showing a relationship between two data points and calling it a trend... yikes, plus all of the other things that can go wrong with graphs, were done wrong in this book). ( )