[3][4][5] In his 2019 non-fiction book, which is based on several years of research undertaken in the 2010s in the South and Midwest states—Missouri, Tennessee and Kansas, physician and psychiatrist Jonathan Metzl reveals the unintended public health consequences of some right-wing backlash politics related to taxes, gun control, social safety nets, and healthcare on vulnerable white voters they had promised to help.

His methods which included field interviews with a wide range of everyday Americans, along with research and public-health data,[3] revealed that racial resentment among lower- and middle-class white Americans, who believe politicians can make their lives great again, led to the enactment of public policy changes related to gun control, the Affordable Care Act, severe cuts to social services and education in states such as Missouri, Tennessee and Kansas, that placed these voters at a heightened risk of death by suicide, gun violence, a decrease in life expectancy and an increase in school dropout rates.

Metzl, from the perspective of a "sociologist and psychiatrist...examines the ways policies of right-wing backlash (pro-gun laws, cuts to education, social services, and health care) affect the lives and life expectancies of these people.

"[8] The Star Tribune wrote, "As a physician and psychiatrist reared in the Midwest, Metzl has science and Heartland street cred on his side; as a public health instructor at Vanderbilt University School of Medicine, his clinical approach doesn't overshadow his skill as a wordsmith.

"[3] An April 27, 2019 book launch at the Politics and Prose bookstore in Northwest Washington, D.C., was briefly interrupted by a group of eight men and one woman, white nationalists, led by Patrick Casey, co-founder of the American Identity Movement (AIM) with a megaphone and a videographer.