For many whites, and especially for white men, a vote for Donald Trump was a cry of pain. Leave aside that most of Trump’s voters did not attend rallies, and that few live in the bizarre, twitterspheric world of the Alt-right. His successful wooing of white middle America, especially in the Mid-West, and of white less-educated men, helped him to win the Presidency.
Many of his supporters are in pain. Some might seem angry. But anger is just pain in disguise. The malaise of white middle America can be seen in trends for mortality, life expectancy, suicide and opioid use. Perhaps it is not surprising that the areas where people are turning to oxycodone are also the ones that turned to Trump. Trump out-performed Mitt Romney in counties with the highest levels of premature mortality, according to our own analysis. Data from the relationship in the six states that went from the Democrat column to the Republican one—Florida, Iowa, Michigan, Ohio, Pennsylvania and Wisconsin—shows this correlation (counties above the line are those where Trump did better than Romney):
There are of course a huge number of overlapping variables at play here, including education, income, employment and so on. But to the extent that the mortality figures express some genuine malaise, it looks like this was in some way related to Trump’s victory.
But what is the real cause of this middle-American malaise? Those on the political left think that the pain is caused by economic inequality, and that many of Trump’s supporters are simply misguided, having being misled. Bernie Sanders says that Trump’s “campaign rhetoric successfully tapped into a very real and justified anger.” To his mind, people are “tired of having chief executives make 300 times what they do, while 52 percent of all new income goes to the top 1 percent.” Well, maybe.
Meanwhile Jenny Beth Martin, president and co-founder of the Tea Party Patriots, says that Trump’s victory is a validation of their agenda: “Repeal…Obamacare, protect our borders, stop illegal immigration, restore fiscal sanity and get the government off our backs and out of our lives.” Well, maybe.
There is lots of work to be done to truly understand the complex picture that emerged on November 8. But it doesn’t look to me as if economics will take us very far in terms of understanding white pain, at least in any simple way. Scott Winship of the new thinktank Foundation for Research on Equal Opportunity delves into the numbers, and concludes that “there is little empirical support for the idea that ‘it was the economy, stupid’.” I agree. This was an identity vote more than an income vote. Many white men, especially those of modest education, feel as if they are being overtaken and left behind. “It’s relative status, stupid!”
Over the past decade, Professor Kathy Cramer has been conducting a series of in-depth interviews with people in rural Wisconsin (which went heavily for Trump), resulting in her book The Politics of Resentment. Cramer is sympathetic and open-minded. What she finds is that people have a backward-looking reference point.
“People are in the occupations their parents were in, they’re farmers and loggers,” she reports. “They say, it used to be the case that my dad could do this job and retire at a relatively decent age, and make a decent wage. We had a pretty good quality of life, the community was thriving. Now I’m doing what he did, but my life is really much more difficult.”
These men, and many women too, compare their lives to a world in which men like them—perhaps their own fathers—could get a decent-paying job, be considered the automatic “head of the household,” and always know, at some deep level, that they were superior to people with darker skin. All of those basic assumptions have been challenged. Without a decent education, decent wages are hard to get; that’s the way the labor market works now. Women have entered the labor market; many are prospering and so the gender gap in median wages has narrowed.
And of course we’ve had a black President since 2008. As James Baldwin warned almost half a century ago, “the danger, in the minds of most white Americans, is the loss of their identity…The black man has functioned in the white man’s world as a fixed star, as an immovable pillar: and as he moves out of his place, heaven and earth are shaken out of their foundations.”
But Trump cannot bring back the 1950s. Even if he succeeds in reducing trade competition—which is fairly unlikely—any impact on the lives of mid-Western whites will be small, and slow in coming. Women are not returning to the kitchen, or standing by their man just because they have to. Americans of color are going to continue to challenge the white presumption of superior status.
Policies to soften the transition are of course available: wage insurance, higher minimum wages, family leave, and so on. But note that none of these are high on Trump’s agenda. In the long run, the only cure is for whites, and especially white men, to change their expectation that high status, along with a decent-paying job, will be delivered to them merely by virtue of their race and gender.
Loss of relative status is painful, no doubt. But it is the inescapable price of equality. Trump has no cure. Nobody does. In the meantime, he has provided some temporary psychological relief. But it won’t last. Trump is a temporary painkiller; the political equivalent of the opiates sweeping small town America. As J.D. Vance, author of Hillbilly Elegy, warned back in July, the Trump hit will wear off. “So long as people rely on that quick high, so long as wolves point their fingers at everyone but themselves, the nation delays a necessary reckoning,” he wrote in The Atlantic. “There is no self-reflection in the midst of a false euphoria. Trump is cultural heroin. He makes some feel better for a bit. But he cannot fix what ails them, and one day they’ll realize it.”
When that day comes, what will happen? Perhaps those who voted for the past will realize that it cannot be conjured back up again, and embrace, or at least accept, the world as it is today. Perhaps some of those who voted for him will turn to a more progressive populism. Perhaps, and most worrying of all, when the pain returns they will turn to an even stronger drug than the one he offered.
 Data compiled by Social Explorer, County Heath Rankings and Roadmaps, and the CDC (for mortality data), and the Guardian, Townhall.com, and Tony McGovern (for elections data). Premature, age-adjusted mortality rates are calculated by weighting deaths by the age at which they occurred, to create a total “years of potential life lost” for each county; younger deaths mean more years of potential life lost; totals are then divided by population to create the rate.
 Michigan had not formally announced at the time of this writing, but looks likely to go to President Trump.
[On the politics of climate impacts in the U.S.] The political alignment around climate impacts is almost the exact opposite of the political alignment around emissions control.
[On the geographic distribution of climate impacts in the U.S.] The damages to the Republican-electing congressional districts is almost double what it is for the Democratic-voting districts.
[On Brookings research on climate impacts and human health] When you look at the out years, all of these factors have an impact on what people care about, but the really dominant effect is mortality. Literally, there’ll be climate change killing people.