Vanderbilt Magazine

Dying of Whiteness: How the politics of racial resentment is killing America’s heartland

The following story is adapted from Dying of Whiteness: How the Politics of Racial Resentment Is Killing America’s Heartland (2019, Basic Books) by Dr. Jonathan M. Metzl, the Frederick B. Rentschler II Professor of Medicine, Health and Society, professor of sociology, and professor of psychiatry and behavioral sciences. He also is director of Vanderbilt’s Center for Medicine, Health and Society.

photo of boarded-up building in a small town in decline
Copyright 2019 by Jonathan M. Metzl


On the night of Nov. 21, 2014, Becca Campbell, a 26-year-old woman from Florissant, Missouri, died of whiteness.

Campbell was a white, lower-middle-class, single mother of two who worked as a server at Tigín Irish Pub in downtown St. Louis. According to media and police reports, Campbell and her 33-year-old boyfriend had a few drinks at the pub after her shift ended. The pair then drove off in a 2006 Toyota Highlander.

November 2014 was a particularly fraught time in St. Louis. Earlier that year in nearby Ferguson, Darren Wilson, a 28-year-old white police officer, shot and killed an unarmed African American teenager named Michael Brown. The disputed circumstances of Brown’s death in August spurred protests that intensified through October and November as a grand jury met to decide whether to indict Wilson for manslaughter.

On Oct. 3, street protests in Ferguson grew so large that the town police department ceded its jurisdiction to the St. Louis County Police Department. On Oct. 6, largely white supporters of Wilson clashed with largely African American protesters outside a St. Louis Cardinals baseball game. Later that week, Ferguson protesters launched a week of resistance throughout greater St. Louis, marching to such gentrified locales as the Powell Symphony Hall. On Nov. 17, as images of unrest in the St. Louis area played on television screens across the country, Missouri Gov. Jay Nixon declared a state of emergency in Ferguson and signed an executive order activating the National Guard.

In this charged environment, Becca Campbell and her male friend left work and drove into the night. What happened next is in some respects a matter of dispute. Either he drove or she drove. Either the gun she pulled from her purse was one that she owned for several years or, as seems more likely, was one that she purchased several days prior. Either she bought the gun as protection for her children or for personal safety in anticipation of rioting after the grand jury verdict.

According to police reports and subsequent media accounts, Campbell waved the gun around her head while in the moving vehicle as if an urban desperado. While waving the gun, Campbell joked that she was getting “ready for Ferguson.” At that moment, with the couple’s attention transfixed on the orbiting pistol, their vehicle rear-ended the car in front of them. As the cars collided, Campbell’s hand did what hands tend to do in moments of impact: It clenched, including the finger on the trigger of the gun. Then the gun did what it was built to do in response to a clenched finger. It killed.

Becca Campbell died of a gunshot wound to the temple fired by her own hand from her own gun.

I thought frequently about Becca Campbell over the course of writing my book Dying of Whiteness. I did not know Campbell or interview her. What I learned about her case came from media reports. Yet for me, Campbell’s tragic story became emblematic of the larger narrative I’ve tracked in this book, regarding the kinds of mortal trade-offs white Americans make in order to defend an imagined sense of whiteness. It’s a narrative about how “whiteness” becomes a formation worth living and dying for, and how, in myriad ways and on multiple levels, white Americans bet their lives on particular sets of meanings associated with whiteness, even in the face of clear threats to mortality or to common sense. A central political script then emerges in ways that, in its worst moments, defines the boundaries of white America in relation to real or imagined others who want to take what it has or be what it is. The story of Becca Campbell—and indeed, of my book—asks us to consider what white Americans give up when they invest so heavily in remaining at the top of social hierarchies or, more often, in defending a notion of status or privilege that appears under attack. In many instances, we give up days and months and years of life, as well as skills that might lead to better, more nonhierarchical, and less lethal solutions to the anxieties brought about by living in an ever-more-integrated world.

The Becca Campbell story seemed important because it highlighted a central point of this book—namely, that the mortal risks of whiteness extend beyond questions of whether or not any one person holds any one set of biases or beliefs. Risk evolves from politics or policies that surround identities and give shape to interactions among people and communities.

I say this in large part because Campbell’s death became a kind of Rorschach test in which different people interpreted her intentions and actions in politically distinct ways. Media, the police, and Campbell’s family members engaged in a protracted and painful public debate about whether the shooting resulted from Campbell’s own, deep-seated racism and was motivated by animus toward black protesters or whether she rallied in support of the protests and wanted to see Ferguson police officer Darren Wilson behind bars. Left-leaning commentators on websites such as Huffington Post voiced sentiments such as “sounds like they were going to troll the streets of Ferguson with a gun looking for trouble” and “she was worried about black people,” while right-wing sites such as an outlet called Weaselzippers asserted that “Becca Campbell was [herself] a #Ferguson protester.” Campbell’s mother later claimed that Becca “got involved in Ferguson protests to fight for racial equality.”

Becca Campbell may or may not have acted because of her own beliefs about African Americans—we may never know her true intentions. And to be sure, any number of individual-level factors undoubtedly fueled the events that played out on Campbell’s final, fateful night. Campbell’s own finger rested on the trigger—a finger being a voluntary digit linked by striated muscle and controllable nerve to a voluntary part of the brain. The trigger released the firing mechanism of the gun Campbell chose to own. The events took place in Campbell’s own car.

photo of Jonathan Metzl teaching
Jonathan Metzl teaches a seminar for upper-level undergraduate students at The Rymer Gallery, a contemporary art gallery in downtown Nashville’s arts district. (Susan Urmy/Vanderbilt)

Yet what everyone seemed to overlook in their interpretation of Campbell’s death is the point I make throughout the book: We lose perspective when we explain racially charged encounters in the United States solely on the basis of what exists in people’s minds or on their individual actions. Doing so blocks recognition of the ways racial anxieties manifest themselves in laws, policies and infrastructure—in ways that carry negative implications for everyone. These latter forms of bias result not just from personal attitudes or choices but from the investments and disinvestments that we as a society vote on, implement, and live with in the day to day. In an increasingly polarized country, such structures silently shape larger American interactions surrounding race, as well as intimate encounters that impact how we live, work, think, feel and die.

For instance, any number of policies and political formations I describe in this book surrounded Campbell on that fateful night. Consider as one example the possibility that Campbell’s concerns about safety reflected not simply a concern about black protesters but also a sense that she was responsible for her own security—within a city that had long been divided by race and class in ways that created an often-untenable divide among communities. St. Louis is described as one of the most segregated cities in America, a city with a massive racial split in which high crime, poor health, and low economic mobility reside mainly on the black side of town and privilege and opulence on the white side. The tensions around this split heightened in the years leading up to Ferguson due to a series of draconian tax and budget cuts enacted by the increasingly conservative Missouri legislature. Among other effects, the cuts reduced the size of police forces throughout the state and slashed funding for victims’ advocacy programs, drug treatment centers, and a number of social services.

Reductions to police funding and infrastructure carried lethal implications for minority populations in places like Ferguson, where, to make up for lost revenues, police shifted from protective models of public engagement to oppressive and financially predatory ones. Department and government analyses later found that Missouri police were “being pushed into the role of revenue generators” when dealing with minority populations, leading to “aggressive actions that reflect and exacerbate racial bias.” In an entirely different register, cuts to police impacted white communities as well, inasmuch as a smaller police presence left many white communities feeling less protected. White Missouri residents voiced concern about slowed police response times and long delays for 911 calls. Reductions in hiring new police and training classes for officers led concerned citizens to hold urgent town hall meetings—at one, Tammy Dickinson, the U.S. attorney for the District of Western Missouri, called police budget cuts “crime-fighting kryptonite.”

After the accidental shooting, emergency workers rushed Campbell to a hospital, where she would be declared dead. If that ambulance jolted over potholes on the way, it was quite possibly a result of extensive cuts to infrastructure spending that negatively impacted maintenance and construction of Missouri’s roads and bridges. An infrastructure report card produced by the American Society of Civil Engineers graded Missouri roads with a C because of “significant funding shortfalls” that forced state administrators to funnel dollars into failing bridges and highways at the expense of city roads.

Even the hospital system that attended to Becca Campbell in her dying moments reflected policy decisions that worked against the well-being of lower- and middle-income white citizens of Missouri. St. Louis is a city that boasts an important history of medical innovation in trauma care, thanks in large part to pioneering work done at level-one medical facilities such as Washington University School of Medicine, Barnes–Jewish Hospital, and the Saint Louis University Hospital. The state’s rejection of Medicaid expansion under the Affordable Care Act led to “tough and uncertain times,” manifested by service cuts and massive layoffs at area hospitals and reductions to emergency services. To be sure, no intervention would have saved Becca Campbell, who arrived at the hospital with a bullet lodged deep in her brain. But the system that she entered in the waning moments of her life was also itself hemorrhaging vitality due in part to a host of self-inflicted legislative and economic wounds.

Then there was the gun. Even 10 years earlier, it would have been exceedingly difficult for a Missourian to purchase, conceal and transport a handgun due to state and federal regulations. However, in the years and months leading up to Campbell’s death, a steady stream of pro-gun laws made it easier for citizens to own firearms and carry them in public. Two months before Campbell’s death, Missouri lawmakers passed a law that allowed citizens to carry concealed handguns at schools, annulled most city and regional gun restrictions, and allowed just about anyone over the age of 19 and not in jail to carry a concealed weapon without a permit. Among Missouri’s pro-gun laws were so-called Castle Doctrine statutes that permitted gun owners to shoot perceived intruders in their homes, “free from legal prosecution for the consequences of the force used.” Gun sales spiked in St. Louis in anticipation of the Darren Wilson verdict, and particularly among “new, inexperienced gun owners.” In the months after Campbell died, legislation would extend Castle Doctrine protections to … a person’s car.

None of this context detracts from the individual-level tragedy of Becca Campbell’s death. Two children lost their mother, a mother who herself was someone’s daughter.

The loss was as preventable as it was nonsensical. But in a broader sense, the death of Becca Campbell embodied the larger tensions and politics regarding what it means to be a white American, and particularly white and lower- or middle-income in a conservative state in the era of Ferguson, the Tea Party and Donald Trump.

Regardless of her intentions, then, Becca Campbell’s final actions suggest a woman whose decisions were buoyed by privileges, laws, policies and institutions that enabled her to buy a gun and ride around one of the most segregated cities in America. But when read through a larger perspective, it becomes clear that Becca Campbell paid dearly for these privileges—in fact, she paid with her life. By this latter reading, the same laws, policies and institutions that seemingly supported Campbell worked against her own existential self-interests. Fewer police officers drove the streets, and fewer medical personnel worked the hospitals. Roads pot-holed. Tax-cutting politics that bolstered upper-income white people and their property also yielded a growing unease among lower- and middle-income white people who didn’t quite have enough. The laws that allowed Campbell to purchase, conceal and carry a handgun with neither training nor a permit quite literally put self-inflicted death within her car and within her reach.

In the years following Campbell’s death, political decisions to slash taxes, defund health care reform, or spread guns became ever-more-vocally tied to promises to “restore” an imagined sense of lost white privilege. Yet, much as with the case with Campbell, when read through the lens of health, these decisions often boomeranged back at population levels to deliver the opposite.

Graphs showing rising morbidity and mortality, or illness and death, following these decisions complicate common assumptions about injury or death. We usually define mortality as linked to biology, genetics, fate, accident or illness. Or we think about death from unwanted intruders, pathogens that invade through the water or air. Yet the kinds of data I’ve tracked in Dying of Whiteness raise the specter that American human frailty is in part man-made, rendered all the more tenuous not by invasions of them, the immigrants or pathogens, but by political choices made by us, the white electorate.

Sometimes the risks that emerge from these political choices often come from direct effects, such as more shootings from more guns or fewer doctors in times of need. At other times the effects are far less obvious—such as when picking up a gun in the face of Ferguson protests seems the only option because the environment forecloses other ways of addressing societal problems or of imagining avenues for equitable societies in which guns and protests are not needed.

It is also important to note that policies that carry negative mortal consequences for everyday people are not the sole domain of any one political party or ideological persuasion. The situation in St. Louis, a city that upheld decades of segregation and injustice through a series of policies authored by both Democrats and Republicans, suggests one example of how seemingly “liberal” initiatives can also have disastrous consequences for the people they claim to help. The history of Missouri cities shows how liberal desegregation efforts can lead to worsening economic and racial segregation. More broadly, anthropologist Adam D. Kiš, in a book titled The Development Trap: How Big Thinking Fails the Poor, explains how grand attempts by organizations such as the World Bank to eradicate poverty can end up making life all the worse for people at the lower ends of the economic spectrum.

Yet liberal initiatives in the United States often fail because they try to do too much at once, such as trying to provide health care or education for wide swaths of the population, without addressing the underlying social or economic systems that produce poor health or low educational attainment in the first place. Liberals also frequently fail to explain adequately the everyday benefits of their initiatives for everyday people in ways that resonate or that address historically based tensions or concerns.

Meanwhile, the kinds of legislation that have become more prevalent under the Trump administration exact their negative health effects by cutting programs or services or by privileging the rights of particular subsets of Americans—such as gun owners or exceedingly wealthy persons—above those of everyone else. These latter approaches open the door to the types of racial anxiety, xenophobia and misguided nationalism amplified in the United States of late because they divisively suggest that minorities and immigrants are hoarding resources or that people need to protect themselves from one another.

It does not need to be this way. We know from American history that our communal, electoral power allows us to build vibrant social networks, safer communities, and better education systems—when we decide to do so. If impoverished structures lead to negative outcomes, then a renewed focus on restoring equitable structures and infrastructures will improve individual and communal health. In obvious and counterintuitive ways, fixing the electoral and economic structures that sustain structural racism and oppression will then better life, not just for racial and ethnic minority communities, but, indeed, for everyone. Beyond the clear benefits of better roads, wages, schools, hospitals or gun laws, a renewed focus on structure might also silently promote more healthy and self-reflective frameworks … of structural whiteness.