‘White privilege’ in American medicine

‘White privilege’ in American medicine

More than 27,000 Americans will likely die from a heroin or prescription painkiller overdose this year. While the victims will come from every walk of life, most of the media attention – and there has been a lot of it – has focused on what has been called the new face of heroin addiction: suburban, white, middle-class Americans. Their drug use is often depicted as surprising and puzzling, which marks a stark contrast to how addicts have been portrayed in the past. It is as if their (white) privilege makes them immune to succumbing to substance abuse.

One specific research paper got an enormous amount of attention last year: Princeton University economists Anne Case and Angus Deaton wrote in Proceedings of the National Academy of Sciences (PNAS) that “drug and alcohol poisonings, suicide, and chronic liver diseases and cirrhosis” were killing less-educated, late-middle-age working class whites to such an extent that the overall mortality rate for whites was rising for the first time after decades of decline. News articles about their findings employed anxiety-laden language and headlines (“The Dying of the Whites”) to suggest how alarming this trend was.

Hoping to make sense out of what appears to be two bizarre developments, Jeff Guo of The Washington Post has even suggested a possible “eerie correlation” between the climbing death rate of poor whites and Donald Trump’s success in the Republican presidential primaries.

Anxiety over white mortality is not new. In fact, media reports on Case and Deaton’s analysis reminded me of a book I had found some 20 years ago in the University of California, Berkeley’s main library. Written in 1929 by Esperanto enthusiast James Denson Sayers, Can the White Race Survive? warned against the mixing of the races (or else American civilization would cease to exist). While researching the eugenics movement in the United States, I had come across this type of racist rhetoric before; this book stood out, however, because someone who had handled it during its 65 years or so in the library had responded to the title on its cover by penciling in a tiny “no” directly after the large question mark. So while what is now threatening white Americans – drugs, suicide, and alcohol – appears to be new, the nervousness around extinction may have a longer history.