"So why are white Americans in downwardly mobile areas feeling a despair that appears to be driving stark increases in substance abuse and suicide? In my own reporting in Vance’s home ground of southwestern Ohio and ancestral territory of eastern Kentucky, I have encountered racial anxiety and antagonism, for sure. But far more striking is the general aura of decline that hangs over towns in which medical-supply stores and pawn shops dominate decrepit main streets, and Victorians stand crumbling, unoccupied. Talk with those still sticking it out, the body-shop worker and the dollar-store clerk and the unemployed miner, and the fatalism is clear: Things were much better in an earlier time, and no future awaits in places that have been left behind by polished people in gleaming cities. The most painful comparison is not with supposedly ascendant minorities—it’s with the fortunes of one’s own parents or, by now, grandparents. The demoralizing effect of decay enveloping the place you live cannot be underestimated. And the bitterness—the 'primal scorn'—that Donald Trump has tapped into among white Americans in struggling areas is aimed not just at those of foreign extraction. It is directed toward fellow countrymen who have become foreigners of a different sort, looking down on the natives, if they bother to look at all."