Dying of Whiteness is a recently published book by Jonathan Metzl. Metzl is a psychiatrist and a sociologist who directs the Center for Medicine, Health and Society at Vanderbilt University in Nashville, Tennessee. The book has received a good deal of attention in the mainstream media but, unfortunately, that attention has often oversimplified many of the book’s very unique findings and arguments. Metzl evidences a great deal of considerateness when he talks about white people and his provocative analysis of the ways in which their whiteness is killing them bears no resemblance to the all but ever present chatter about white privilege by the talking heads on CNN and MSNBC, the columnists of the liberal newspapers or the faddish intellectuals of the elite universities.
His argument is based on field research (consisting of observations and interviews), media accounts of the changes over time in state laws and policies, substantial works of history and statistical evidence (often from epidemiological databases) of the impact of those changes on people’s lives. The focal points of his investigations are Franklin, Tennessee; Olathe, Kansas and Cape Girardeau, Missouri. (Metzl grew up in Kansas City and is therefore familiar with that part of the country as well as Tennessee, where he now lives).
I believe that Metzl’s argument can be summarized as follows. Voters endorsing politicians whose policies seem likely to hurt them is nothing new; the South and Midwest have long histories of leaders that enact laws that disadvantage their constituents but who nonetheless keep voting for them. However, on the ground realities of people’s views are far more complicated than the media representations of them.
Nonetheless, he argues for the “toxic effects” of what he refers to as “dogma”: dogma consisting of beliefs about governmental assistance being evil; the rightness of a racial hierarchy; and the terrible problem of lavish handouts to minority communities. He ascribes a great deal of power and effectiveness to the role of politicians in key states setting a right-wing agenda for the crystallization of the current dogma. He suggests that the new right-wing agenda was tried out in states and then made national. When it comes to Tea Party politics, he once again acknowledges its complex origins but insists that notions of white supremacy were central (citing, by way of example, posters at anti-ACA rallies depicting Obama as an African witch doctor with a feather headdress and a bone though his nose).
As an example of the power of dogma, he tells the story of Trevor, a Tennessee man dying of liver disease, who lives 40 miles from Kentucky where he could get the care that he needs, but instead lives (and dies) in Tennessee which refuses to adopt Medicaid expansion under Obamacare. Trevor insists that he wants no more government in our lives and no tax dollars for Mexicans or welfare queens. What Trevor is choosing is no easy death–Metzl provides excruciating details about the progression of liver disease. He suggests that Trevor’s views are not just the result of his own thoughts. Instead, they are his politics.
Metzl argues that a perception of pervasive white victimhood has led people to accept the probability of dying for a cause. But it’s not the death of a kamikaze; instead, it’s often slow, excruciating and invisible. While he wants to argue that notions of whiteness threaten white well-being, he acknowledges that the negative effects of bad social policies affected non-white communities much more severely.
When it comes to Trump, he points out the invisible sacrifices of lower-class whites whose self-sabotage comes at a mortal cost to health and longevity and, in a powerful phrase, highlights the cruel irony of “platforms of American greatness embodied in forms of demise.” He believes that the continued support for damaging policies, even after the negative effects became apparent, were grounded in the lasting power of the narratives of victimhood and domination, which embodied symbolic or moral meanings that made conversations more difficult.
As a result, voting against “their own biological interests as well as their own economic priorities” was a reflection of the depths of their commitments on policy matters. (This distinction between “biological interests” and “economic priorities” is a helpful one).
He convincingly insists that he has no intention to expose anyone as duped or misinformed. He notes that many white workers live lives of quiet desperation—more mad at their white bosses than anyone else. And Southern forms of whiteness do not exist in “another country”—instead, they are an “exaggeration of systems of privilege that surround North and South, liberal, progressive and conservative….”
As he conducted his research, he kept thinking that the drive for self-preservation might trump political ideology but he discovered that the deep convictions that people held made it ever more difficult for them to imagine alternate realities or to empathize with other groups; for them, compromise was treason.
As mentioned above, his field research focused on three states where white people seemed willing to die for whiteness. Here’s what happened in each state:
- Missouri passed laws to permit concealed carry at schools, annulled local restrictions, allowed just about anyone over the age of 18 to have a gun—all policies grounded in an exploitation of racial tensions and the need for white citizen protection.
- Tennessee decided to block the Affordable Care Act and opposed Medicaid expansion.
- Under the regime of the hard to believe right-winger, Sam Brownback, Kansas began starving its public schools.
All of these measures had serious adverse effects. Prior to the emergence of the Tea Party and other right-wing projects, the three states had relatively moderate approaches to gun ownership, health insurance and public schooling and, in Metzl’s opinion, had achieved significant progress.
He insists that the problem is not a disorder in people’s brains or attitudes and will not be addressed by sensitization trainings or changing minds; it’s about larger politics and policies. The pathogens producing higher death rates were policies and ideologies; asking people to die for their whiteness was a diagnosable, quantifiable and increasingly mortal preexisting condition.
Metzl is also aware of the problems associated with medicine; he acknowledges that sometimes the best thing to do is to avoid seeing a doctor; he knows that “liberal” initiatives result in poor health. He argues that liberal disdain for working class whites is a way to mask their own ways of promoting inequality.
At the end, he makes a very idealistic plea for cooperation rather than supremacy as a way to go forward. He also returns to his theme that far more than being duped is involved in what white people do. He argues that a better awareness of the paradoxical tension between promises of greatness and practices of self-sabotage might enable us to confront the ideologies of whiteness head-on rather than by proxy. He closes by simply saying that whiteness fails to defend white folks.
In the rest of this review, I will be focusing on Missouri and neglecting the other two state studies because I believe that the gun suicide story in Missouri is the most compelling one and it’s the one I understand best. But the other two sections on Tennessee and Kansas deserve attention and I urge people to read the whole book.
Voting to Kill Ourselves
Metzl begins his analysis of gun violence and whiteness in Missouri with an account of a suicide survivors’ support group meeting in Cape Girardeau (referred to by most locals as Cape), a small city on the Mississippi River 115 miles southeast of St. Louis. According to Billie, one of the group’s co-leaders and the person who had invited Metzl to attend, over ninety percent of the participants are there because of suicide by gun. Pain, empathy and guilt (about not having seen the suicide coming) pervade the conversation.
Missouri has a “long history of gun use for hunting, warfare and dueling.” But until the early 90s, it also had very strong handgun controls, especially regarding background checks for gun permits. Over the course of about twenty years, the state legislature upended that pattern and passed law after law making gun ownership and use easier. In 2014, the state adopted an amendment to its constitution which proclaimed citizens’ “unalienable right” to own guns for the “purpose of defense of one’s person, family, home and property.” Then in 2016, the legislature passed “the guns everywhere bill”, effectively ending all restrictions, earning the state an accolade from Guns and Ammo magazine as the “top state for gun owners”.
If the goal had been to enhance individuals’ capacity for self-protection, it was a fatal miscalculation. Metzl tells what happened: “Between 2008 and 2014, the gun homicide rate rose to 47 percent higher than the national average. Rates of gun death by suicide, partner violence, and accidental shooting soared as well. In 2014, gun deaths topped deaths by motor vehicle accident for the first time in the state. News outlets referred to Missouri as the ‘Shoot Me State’.”
The more or less horrifying statistics and the intense personal loss inflicted by the death of someone close have not made a dent in white people’s extreme commitment to guns. Metzl records that when he first flew into the Cape Girardeau airport at the end of 2016, just about everyone at the airport was wearing camouflage. When he asked his cab driver about guns and camouflage, the driver responded: “I’m sure it might seem strange coming in from the outside, but for us it’s what we’ve grown up with. Freedom. Liberty. Patriotism. That’s why we just voted Trump. No way we were going to let ‘Crooked Hillary’ take those things away from us.”
The commitment of Cape Girardeau’s residents to those values is clearly able to “trump” just about any other considerations. In one of the most wrenching passages in his book, Metzl recounts what Rick and June, two of the support group’s participants, had to say about their son’s death:
“There’s nothing prepares you for being first on the scene, finding your son after he shot itself,” he begins. “That memory’s seared into my mind and always will be. It was like … he’d exploded. It was just … everywhere.”
Rick later tells me more about his son, Kyle, who he describes as a sensitive soul trapped inside the body of a linebacker. Kyle was good with his hands and found work restoring old cars at a local body shop. Like many young people in southern Missouri, Kyle also struggled with opiate addiction but seemed to have kicked the habit, only to fall into heavy drinking.
Rick reveals only a small part of the story to the group but his words have a profound effect on everyone. He then falls silent, and June speaks up, “We are grieving parents,” she says. “But Rick has another level of trauma that I can’t even imagine what he’s going through, having found Kyle’s body. How can you prepare for that? How can you ever forget it?
“And don’t forget the funeral,” Rick adds.
“The funeral?” asks Billie.
“Where we come from, you say goodbye with an open casket. That’s how it’s done,” Rick answers. “Kyle was … gone. There was nothing left that looked like our son. I worked so hard with the undertakers, there was hardly anything left.” He begins to weep. “We got the left arm. In the end, we got the left arm.”
“They did a good job getting the left arm to a place where it looked like part of Kyle,” June says stoically. “We held … they, they covered what was left of the body, but we held an open casket showing the left arm. It felt like enough. We got to say goodbye to him.”
Another participant, Kelly who’s in her late twenties, says: “We’ve had four suicides in our family—no, wait, five if you count my cousin. All done by gun.” (29-30)
No one during the meeting mentions anything about guns as a cause of suicides. In response to a question from Metzl, Billie insists, “I don’t think that any of us blame the gun.” Instead, they focus on individual issues. As the meeting ends and people get ready to leave, another member, Kim, stops to tell him, “Thank you so much for coming and listening to us,” she says. “And just wanted you to know that what she said is right. We don’t blame the gun. It’s never the gun—it’s the person. Besides if they say it’s the gun’s fault—well they might come take away our guns, too.”
In light of the pervasive gun culture in southern Missouri, Metzl worried about how his question might have sounded: “… perhaps phrasing the question in the way I do and the fact of my being an outsider implies on some level that I ascribed culpability to the culture itself and to its inhabitants even though this is not my intention. Perhaps as someone who grew up without guns, it’s impossible for me to even ask this question in the right way.” He concludes that, in Missouri, guns are “connective tissue” and that they “are a part of us that helps us identify each other when we’re all dressed in camouflage ……” It’s quite striking that he uses “we” when he writes about this. I can’t emphasize enough the heart-felt respect that he conveys about the people he meets. That’s why Kim thanked him.
Because of his medical experience, Metzl is quite knowledgeable about risk and risk factors. He knows that research into suicide has resulted in the identification of risk factors and warning signs which, when made well known, have achieved measurable decreases in the incidence of suicide in various communities. (At the same time, suicide rates have climbed—suggesting that, whatever the personal causes involved in individual suicides, the social causes of those personal causes continue to become more significant). Nonetheless, the research findings are relied upon by suicide survivor groups and, indeed, were relied upon by the leaders of the Cape Girardeau group. But what the Cape group had available to it in their discussions was not enough–because there is very little research into the specific realities of gun suicide. The use of federal funds for research into gun violence is, all but uniquely, prohibited by legislation, passed during the first Clinton administration and continually re-approved since then. Its passage and re-approval are testimony to the lobbying power of the NRA and its allies. Since federal funds are the primary source for health and public health related research, the absence of funds results in a severe restriction in the number of studies and in very limited databases that could be used for analyses.
And it’s not as if gun suicides are a small problem. They are the “method of suicide that kills more Americans than all other intentional means combined, including hanging, poisoning, overdosing, jumping, suffocating, or cutting. The method that kills more Americans than all of the murderers, robbers, terrorists, and attackers put together as well.” (38)
Gun suicide is impulsive, as are other forms of suicide. But even more so—the time between decision and execution in gun suicides is very short. However, gun suicide is not only impulsive; it’s also effective. Most attempts at suicide by gun, unlike other methods, are successful. In many ways, the biggest risk factor in gun suicides is the gun. No loaded gun in the house could very well mean that a despondent young person would pass out drunk before he could do anything—after all, you only need to pull the trigger once.
He expresses some skepticism about the popular reliance on notions of white and masculinity crises in regard to suicide and sees them as ways of “making automatic assumptions without thinking them through.” In the case of the supposed crisis in masculinity, he’s quite sharp: “Such framing of crises is also often based more in an imagined sense of nostalgia than in any lived reality, inasmuch as many men fought to maintain what they held to be their natural authority even though every man was not a king, a boss, a plantation owner or a CEO. By definition, the majority of men needed to be underlings for the system to survive.” (53)
In a very interesting and convincing turn, Metzl then invokes history as a powerful explanatory framework for why guns came to have the meanings they do and why people might fight so hard against efforts to take away the historic privileges associated with gun ownership.
In late 17th Century America, white men were authorized to carry guns with the purpose of defeating black slave rebellions or attacks by Indians or pirates. At the same time, laws forbade slaves and Native Americans from having guns. Later on, at the moment of the founding of the nation, the Second Amendment enshrined the right of armed citizens as potential members of a militia. Only whites had such rights. Furthermore, Metzl cites researchers into what he calls “the hidden history of the Second Amendment” which found that “the militia remained the principal means of protecting the social order and preserving white control over an enormous black population.”
In the 19th Century, as the fear of slave revolts increased, the relationship between gun possession and black oppression became ever more explicit. Although Metzl doesn’t mention this, it may very well be the case that the only time when black men carried guns in the South was during the last period of the Civil War when Lincoln finally armed the slaves in his effort to win the war. Alas, the moment of armed black men, able to act in the cause of their own freedom did not last. It was ended in the infamous Hayes-Tilden Compromise which withdrew federal troops from the South and ended the Reconstruction era. Even during Reconstruction (1865-1877), whites began campaigns to take guns away from black people. He cites the historian Adam Winkler who had written:
“few people realize it, but the Ku Klux Klan began as a gun control organization” that aimed to confiscate any guns that free blacks may have obtained during and after the Civil War and thereby “achieve complete black disarmament.” (66)
The absence of weapons in the black community meant that it really had little defense against the denial of its rights for almost seventy years—until the eruption of the modern Civil Rights movement in the mid-50s. The Klan and other hostile groups never ceased their efforts to deny blacks the right to self-defense. Metzl notes the remarkable case of Robert Williams:
…. African-Americans who attempted to take up arms in self-defense against white supremacist intimidation met with violent resistance. Robert F. Williams, president of the Monroe, North Carolina, chapter of the NAACP in the 1950s and early 1960s, became a vocal proponent of ‘the right of Negroes to meet the violence of the Ku Klux Klan by armed self-defense.’ With no protection from law enforcement, Williams advised African-Americans to arm themselves as a group to defend their homes, their wives, their children because, as he contended, the Constitution bestowed the right to own a gun was in defense of a person’s home or property on all Americans. “If the United States Constitution cannot be enforced in the social jungle called Dixie,” he famously proclaimed, “then it is time that Negroes must defend themselves even if it is necessary to resort to violence.” Violent white protests ensued after the Freedom Ride passed through Monroe, and Williams and his family fled to Cuba after being pursued by the FBI on fabricated kidnapping charges. (67)
Later on in the Civil Rights era, the black Deacons for Defense more surreptitiously took up arms to defend activists from white violence. This is not a topic that Metzl addresses.
The contemporary character of gun ownership and gun rights began to take shape in the 70s and 80s when the NRA was transformed from a sporting and rifleman’s association into a progressively wealthier gun lobby. At the same time, the defense of gun rights, although still grounded in the Second Amendment, became more and more linked to rights of individual self-defense and less to the need for an armed militia. The NRA was greatly assisted in these efforts by the phenomenal growth of the gun industry. Guns in private hands increased by 70 million between 1994 and 2014. Metzl claims that in 2016, Americans had 255 million guns but I’ve seen estimates that place the total closer to 400 million. A 2015 survey found that white men were the majority of gun owners and the majority of ‘gun super-owners’—individuals who own between 8 and 140 guns.
Metzl connects the dots to explain the high rates of gun ownership among white men—it was a matter of continuing and defending several hundred years of the privilege of carrying guns and using them to intimidate black people. As an illustration of that sensibility in Missouri, Metzl writes that in 2014, white open- carry advocates paraded through the African-American areas of downtown St. Louis with their handguns, long guns and assault rifles. The contrast between the deferential treatment accorded to white men with guns and the all too frequent incidents of police shooting and killing black men with or without guns speaks volumes. Metzl challenges the frequently invoked use of “implicit bias” as an explanation for the profoundly unequal treatments: “… the implicit bias framework often overlooked different historical narratives embedded in American racial assumptions about guns. From before the birth of the nation, American laws, mores, and traditions coded armed white men as defenders and armed black men as threats. Not just the bodies were racialized; so were the guns as well.” (72)
The contemporary defense of gun rights of course takes place in the larger historical context of the last fifty years. Metzl cites the analysis of Leonard Steinhorn in a 2014 Huffington Post article titled: “White Men and Their Guns”:
According to Steinhorn, working class white men long benefited from racial and gender discrimination that gave them a monopoly over manufacturing and construction jobs. Starting in the 1960s, the civil rights and women’s movements brought increased competition into these marketplaces while at the same time wages and the availability of manufacturing jobs declined precipitously. These changes in the economic and social order left working- class white men feeling bypassed, humiliated and “victimized” by “usurpers” such as women and people of color. “So how do these white men restore the strength and prestige of their idealized past?” Steinhorn asks. “Through guns which instill fear particularly among the urban and educated elites who hold the levers of power and status in society today.” (74)
This yearning for restoration was encouraged and cultivated by gun manufacturers in advertisements in the NRA’s American Rifleman and other publications. These messages went well with the new emphasis of guns for self-defense–often on the basis of imaginary hostile racial encounters with blacks.
In Missouri, the desperate efforts to restore what white men believed had been lost mostly led to the loss of their own lives. What those white men thought was needed in the fight for gun rights was exactly not what was needed for the ability on the part of all too many white men to overcome their pain or anger or sense of abandonment when they were alone with their guns. Few white men appeared to be aware of the risks they were facing because of the “knowledge vacuum” produced by the ban on gun violence research. If people don’t actually have access to findings based on evidence, “risk becomes an abstraction onto which people project anxieties, biases, and fears.”
What makes matters worse is the manipulation of the absence of knowledge by politicians and lobbyists to produce deeply divided communities about “matters of life and death, and mundane daily routine– matters about which, if left to their own devices, people could probably forge consensus.” Such “polarization then leads to an often-absurd state of affairs. Calculations of risk produce ever-safer cars, medications, bike lanes, and building codes.” (84) But not safer guns or safer gun practices. There are gun suicide prevention programs, many of which are funded by gun companies. But the terms of the funding prohibit any mention of the risks posed by firearms.
But there’s more to it than that. What if risk emerged not just from the presence or absence of guns or policies? What if the guns and apologies rendered whiteness itself as a risk? Did being a white citizen of Missouri put a person at a higher risk of firearm suicide? Did that risk change after Missouri loosened its gun laws? In other words, was risk not merely individual and psychological but collective as well? Metzl concludes that the answer to these questions is yes. He makes a case for that conclusion by engaging in a substantial comparison of Missouri with Connecticut.
Missouri and Connecticut?
Why Connecticut? Metzl and his colleagues chose to compare Missouri with Connecticut because researchers at Johns Hopkins University’s Bloomberg School of Public Health had already compared patterns of gun violence in the two states. Those researchers picked the two states (which normally wouldn’t be seen as comparable) because, at the same time that Missouri was loosening its gun laws, Connecticut had tightened its laws.
Recall that for the better part of the 20th Century, Missouri had enforced a permit to purchase (PTP) law that required anyone wanting to purchase a handgun to apply in person at a local sheriff’s office. Potential buyers were interviewed and background checks were conducted for things such as: past convictions for violent crimes, being under a restraining order for domestic violence, or a heightened risk of suicide.
By comparison, Connecticut had a largely uneven history of gun control legislation during more or less the same time period. In 1995, however, the legislature passed PTP legislation requiring background checks and safety courses. In 1999, the state went much further when it authorized police to temporarily remove guns from individuals when there was “probable cause” that a person posed a risk to himself or others. Finally, after the Sandy Hook shootings in 2012, the state passed gun laws considered to be among the toughest in the country.
The researchers hoped to determine if the different patterns of legislation resulted in different ways people that lived and died. The group published two studies; the first in 2014 looked at homicide; the second in 2015 examined suicide. The second research paper involved the compilation of data on all recorded suicides in Connecticut and Missouri over 30 years. They statistically controlled for state level factors such as unemployment, poverty, demographics, and the presence or absence of strong mental health treatment systems.
Connecticut experienced a drop in its firearm suicide rate with the adoption of a PTP handgun law that was greater than nearly all of the 39 of the states that did not have such a law at that time and Missouri experienced an increase in its firearm suicide rate following the repeal of its PTP handgun law larger than all states the retained their PTP laws. The analysis ultimately estimated a 15.4% reduction in firearm suicide rates associated with the implementation of Connecticut’s PTP law and a 16.1% increase in firearm suicide rates associated with Missouri’s PTP repeal. They found no such trends in suicide methods other than by gun.
When the researchers reported their findings, they were very cautious about recommendations for steps that might be taken to reduce incidents of gun suicide. They also emphasized that their results needed to be taken as tentative ones since there was much that they could not know. Nonetheless, their findings were attacked by prominent gun advocates. Metzl notes that the criticisms were often times simply restatements of the concerns that the researchers themselves had expressed.
Metzl was himself critical of one aspect of the 2015 study. Race had functioned as a central component of the earlier 2014 homicide paper—“Homicide is the second leading cause of death for people age 15 to 34 years in the USA and the leading cause of death for black males in this age group,” was the very first sentence in the authors’ analysis. But the 2015 study did not focus on race.
Metzl believed that the change in the focus on race “subtly conveyed the notion that homicide was a race problem but suicide was a policy one. Intended or not, race meant black homicide in Missouri but not white suicide in Missouri, Connecticut and all of the states where white men made up the majority of self-inflicted gun deaths.” (90)
When the Metzl group began, they had to acknowledge that they could not always be completely confident about the numbers since it was likely that the number of suicides was under-reported because of the stigma against mental illness or concerns about life insurance reimbursements. But such undercounts would likely occur in both states.
They first looked at overall firearm suicide numbers in the two states and adjusted them by what is called the crude rate, obtained by dividing the total number of deaths among residents in a geographic area by the total population for the area in a time period and then multiplying the result by 100,000. This standardization of rates allowed them to compare the two places in spite of the fact that Missouri has about three million more people than Connecticut.
The years they looked at differed slightly from the years for the Hopkins studies. But the data for gun suicides between 1985 and 2015 followed the same trends as those for the years between 1980 and 2012. Crude gun suicide rates in Missouri generally declined until 2007 and then increased; by 2015, the state’s gun suicides rose to an all-time high of 10 per 100,000 people. Meanwhile, crude gun suicide rates in Connecticut went down slowly from the mid-1990s and eventually stabilized at rates between 2 and 3 per 100,000 in the last years of analysis.
In Missouri, white male suicide rates trended downward from the mid-90s until 2007 and then rose steadily until they hit their highest point in 2014 and 2015 at over 20 deaths for 100,000 white men. Meanwhile, suicide by persons of every other demographic group showed what is called random variability, spiking occasionally but otherwise demonstrating relatively lower levels and no consistent increases or decreases over time.
In Connecticut, white male suicides peaked at 9 for 100,000 people in 1994, and then jumped up and down for the next 20 years but followed an overall decreasing trend. Gun suicides by other groups of men fell considerably over the same period. Gun suicides by women, and particularly women of color, remained very low.
In 2015, white men were about 40% of Missouri’s population but were the victims of nearly 80% of gun suicides. White men committed gun suicide at rates that were higher than those for men from all other backgrounds combined—over 20% as compared to about 5%.
There were certainly factors other than gun policies which affected white male gun suicide rates in the two states. Missouri and Connecticut have different gun and hunting cultures, distinct mental health systems and quite different economies—there are a lot more farms in Missouri than in Connecticut. The studies cited above tried to take those factors into account. All things considered, Metzl writes: “But it is hard to dismiss the suggestion that different gun policies catalyzed different white male suicide rates between Connecticut and Missouri.” (101)
Metzl argues that most suicide risk analyses focus almost entirely on individual psychological factors. However, risk factor analyses for gun suicide should assess risk “based on who a person is, what they are, or where they live.” White men in Missouri were 2.60 times more likely to die by gun suicide than nonwhite men in Connecticut and 2.38 times more likely to die by gun suicide than nonwhite men in Missouri. “Put another way, the data hints at the possibility that white male gun suicide may be a side effect of both loose gun policies and conceptions of white masculinity, in addition to the effects of troubled individual minds.”
Metzl closes out what I consider to be his profound analysis:
My experience in Cape opened windows into the complex relationships between the people, the place, their histories, and their guns. Guns mark forms of family and privilege that the white Missourians with whom I’ve spoken cling to as an inheritance. Guns also represent trauma multipliers that turn passing moments of desperation into agonizing and permanent loss for individuals and communities. Joined together, guns come to embody, truly, double-edged swords, inasmuch as the same people and communities who benefit from imagined privileges represented by their guns also live closest to suicide enablers in moments of desperation.
A resolution of the gun suicide crisis demands a look beyond the guns.
 Metzl writes: “Much has been made about opioid addiction in rural America and its impact on white men. But the aggregate death rate for white males by unintentional drug poison in Missouri between
2008 and 2015 was 17.51 for 100,000 people, while the rate for self-inflicted gunshot was 17.82.”