I Didn’t Ask for Any of This: (White) Privilege,the American (Dream) Family,and Health Care

Proem

The epigraph, written by Matthew Stewart as part of his Atlantic Monthly cover story in 2018, titled “The Birth of a New Aristocracy,” reframed the debate over the class politics and privilege in the United States, moving from an abstract indictment of “the 1%”—that fairly unreachable and, with good reason, easily loathed and caricatured fraction of the American public which displays an individual income of more than US$300,000 per annum and/or a net worth of more than US$10 million according to the most recent Annual Social and Economic Supplement survey data—to one of the comfortably secure top 10%: those with individual incomes of US$115,000 per annum and/or a net worth of just over US$1 million. Mixing a discussion of mythic meritocracy, fantasies of “the American Dream,” and examples of Whiteness and class privilege/politics, Stewart’s overarching theme indicts the “consolidation of wealth” and the “passing of privilege along at the expense of other people’s children,” or what economists might exculpate as the result of “intergenerational earnings elasticity” (Stewart, 2018, para. 17), which, plainly translated, means that in our current context children are likely to end up right where they came into the world.

Although Jordan Weissmann (2018) points out that the lifestyles of those in that top-10 percentile can be wildly different in that many are retirees, and someone making US$400,000 is likely to have different lived experiences from an individual or couple making less than half that, what is evident is that the odds of any class mobility in the contemporary United States is shockingly low. Read further, Weissmann suggests that “the American upper class is bigger than just the top 1 percent” (para. 22) and that while Stewart’s argument may be too simplistic it is worthwhile investigating what is going on among this swath of the population while wealth continues to consolidate toward the top tier. Paraphrasing Stewart, it has become politically and professionally expedient for me—a member of the tenured and secured professoriate—to claim the righteous mantel of “the 99%” as I cast critical analyses toward neoliberal economic policy and political rationality—but might refrain from insisting my family is from the middle-class (e.g., DeLuca & Andrews, 2016), because we simply aren’t.

In what follows, I pick up one strand of the new aristocracy debate—parenting and parenthood—reading it over and against my own (and by extension my partner’s) concessions, complications, and privileges of subjective performances of Whiteness. Specifically, I focus on the intersections of parenting and health/care that have forced us to come to terms with neoliberalism—though in ways different than you may think. And I say this as an ardent academic critic of neoliberalism, whose work include such detailed analysis of the historical present as can be seen through my recent book (King-White, 2018), and several journal articles on the topic (e.g., King-White, 2010, 2013, 2018, King-White, Clevenger & Beissel, 2021; King-White, DeLuca & Batts, 2016).

More to the point, I seek to explicate my experiences as a married, cisgendered father to three children prior to and during the COVID-19 pandemic. I do so to muddle the challenges that come with living “with privilege” while trying to maintain a critical outlook on the contemporary socio-political landscape—all balanced against an idealized if not rationalized “what is best” for my/our family conflict through two separate, yet related, vignettes centered on our experiences in the American health care and youth sport industries. To do so, I moor my understandings of the contemporary condition of fatherhood, parenting, and raising children in a traditional nuclear family (e.g., Fletcher, 2020) by blending theoretical lenses offered by academic understandings of neoliberalism, Whiteness, and social class as a member of “the new American aristocracy.” I do so not so much to be “let off the hook” for what others may critique as wielding our various privileged positions in society to unfair ends (which is probably true), but rather to contextualize how problematic it can be to marry our political outlooks with the way(s) we are raising our children—sometimes in conditions not of our choosing.

White Kids With White Kids

Our children were born when my wife (Meghan) was 29, 31, and 33, while I was 31, 33, and 34. She had her MA in speech language pathology, and I had my PhD well in hand, and were both ensconced in our careers. Simply put, we were relatively “on our way” in our professional lives. She was able to use banked leave time while I was able to wield the privilege of not having to carry our children and the physiological and psychological burden that comes with it. For me, it probably allowed for some time to further develop professionally. For us, it also meant pressing forward with our socio-political outlook, while also watching our bank accounts grow as “true neoliberal success stories.”

Interestingly, though my wife and I have been together for over 20 years and married for 14, our upbringings were decidedly different. To clarify, I grew up as the oldest in a family of 8 (two more sisters came after I was in college and graduate school to run the total to 10) in rural upstate New York. My parents saved and purchased land from a farmer, and we lived in a trailer. They slowly built their own home in a desirable school district and were fiscally able to provide for the family, with the help of state support like welfare and Women, Infants, and Children (WIC), on an annual income that never topped US$39,000 per year. Our economic struggles became more apparent when my father’s machine shop company, which built parts for trains and the local military base, moved its headquarters to Germany. We relocated about 2 hours south to another rural area just outside of Binghamton, New York, where my parents rented a two-bedroom ranch in another desirable school district but struggled to make ends meet. College was not a requirement in my family, but all six who were college eligible have earned a bachelor’s degree, three have their master’s, and I have a PhD (the seventh just began her freshman year at the local community college that nearly all of us attended). Aside from my heavily subsidized private school experience at Ithaca College, the rest attended two of New York’s respected state institutions (Oswego and Cortland). My parents would sacrifice for us in as many ways as they could to stretch dollars in order for their children to have “good” life experiences—from coupon cutting to car and most home repairs themselves—but I was always lured by the neoliberal promise of “more” (though what that was or is has never actually been clear to me).

Conversely, Meghan, currently a speech pathologist at a local elementary school, whom I met during our time at Ithaca College, grew up in a decidedly upper-class family. When we first started dating her father had just become the CPA for John Hancock and would later retire as the Vice President at MFS Investment management in Boston. Her extended family includes engineers, medical professionals, and folks with summer and winter homes; an uncle was even a VP for MGM/United Artists, President of 20th Century Fox, and, at one point, President of Playboy Enterprises. Indeed, a first memory of visiting my future in-laws was punctuated by “Uncle Jimmy” being cajoled by my future mother-in-law to “waive to her” from his courtside seats, a few down from Brad Pitt, during a 2002 NBA Finals game between the Los Angeles Lakers and New Jersey Nets. A different social structure from my own I could not imagine.

My working-class sensibilities often clashed with Meghan’s familial norms leaving me constantly challenged by what Edward Said would term exile.

Said’s (2000) conceptualization of the expression suggests a state of “restlessness, movement, constantly being unsettled, and unsettling others. You cannot go back to some earlier and perhaps more stable condition of being at home; and, alas, you can never fully arrive, be at one with your new home or situation” (p. 373). Throughout the development of the larger study and this article in particular, it is this conceptualization that I return to over and again. For my desire, in some ways, to be upwardly mobile required making life decisions to “fit in” with people and places that I found absolutely disagreeable (e.g., Anon., forthcoming). By faking it enough for long enough and progressing through graduate school I became a member that fit into her family’s habitus. Thus, it could be said that Meghan and I are the end products, among myriad outcomes, that can come from segregated schooling and opportunity, social class solidification, as well as access to networks for social mobility.

Noted in the aforementioned is the fact that people are having children later, have developed professionally, and along with it tend to be more liberal. More liberal parents in a neoliberal environment brought about a number of issues whereby this population struggles to “live their politics” in a world where they have been socialized to achieve “success” through conservative-leaning rewards for hyper-competitiveness, radical individualism, and their ability to contribute to the corporate bottom line. Many who realize these “successes” do so while also failing to acknowledge their relative levels of identity privilege be it class, race, gender, sexuality, and/or ability. In the words of former NBA player cum psychologist and best-selling author, John Amaechi (2020),

white privilege, and indeed all privilege, is actually more about the absence of inconvenience, the absence of an impediment or challenge, and as such when you have it you really don’t notice it, but when it’s absent, it affects everything you do.

One area of our lives as parents that this has come into sharp relief is within the American health care system prior to and during the COVID-19 pandemic.

Health Care and (White) Privilege in America

Managing the American health care system has and will continue to be a challenge to say the least (e.g., Clifford, 2000; Gawande, 2009; Herzlinger, 2006; Mintzberg, 1993; Porter & Teisberg, 2006). The system has long been celebrated within the United States for its ability to produce advances in treatments for a variety of medical issues (Vogenberg & Santilli, 2018), while simultaneously being viewed fairly and unfairly as being controlled by corporate profiteering (King-White, 2017, 2019). In sum, the COVID-19 pandemic has been instructive in shining a bright light on the systemic inequities in the American health care system. As Giardina and I have outlined elsewhere (forthcoming) racial minorities, the working class, women, and kids have all experienced the brunt of the economic, social, caregiving, and mental health harm the virus has inflicted on society.

Disparities in population’s access to and reception of quality health care do not begin and end with COVID-19. Indeed, these differences are witnessed and experienced across numerous sites, and have been researched at length elsewhere (Williams, 2007). Scholars often seek out ways to reach these disadvantaged populations to provide methods to inform and care for those who do not receive such care in a system so entangled in late capitalist sensibilities. Such activist work is difficult for numerous reasons, but namely systemic change requires convincing the privileged to recognize and voluntarily relinquish (some) benefits while reaching and encouraging those in need to accept support. In and of themselves, these are difficult tasks thanks, in part, to the roiling undercurrent in America that runs counter to most forms of social collectivity.

Although race is inextricably bound to iniquitous health care coverage, and some of that difference can certainly simply be reduced to the racist way(s) providers choose to treat people from different populations, another part of that difference can be attributed to the social class divide in America. For instance, Viswanath and Ackerson (2011) found that those who identify as “White” and middle to upper class seek out health information more avidly than other populations, and that this is a consistent predictor for actually engaging in the American health care system to address medical issues. They further argue that “[health information seeking] is a highly valued skill in the current consumer-driven health approach where people are expected to participate in decisions about their health, and information is a necessary resource in making those decisions” (para. 3). These are but a few of the many ways that health care disparities are realized in the United States, and there is little in the way of movement toward equity in this regard.

Specifically, adequately addressing these issues would likely require convincing an American populace that views Universal Health Care as some sort of socialist bogeyman to come to the consensus that perhaps it would be a desirable course of action. In the (post)Trump-era where it seems even the simplest of national health care behaviors, like wearing a mask or getting vaccinated, has become a political statement rather than common sense, this is easier said than done. It has become clear that for a significant portion of the U.S. population such a move would be an impingement on their “rights as an American” even if it would serve to their own and others better health. Given this as context, it does not seem likely that such a shift is likely to happen.

Borrowing from extensive work on utilizing narrative as a form of inquiry with which to better understand contemporary socio-political questions (Denison, 2016; Markula & Denison, 2005; Pringle, 2001; Sparkes, 1996), I aim to make linkages between politics, socialization, and ourselves. Following Markula and Denison (2005) locating our struggles with (White) privilege and parenting is required:

Is not to hang our heart out on a sleeve but to enable the reader to share or to learn from how personal experiences are lived. Through such personal stories the social construction of experience becomes more tangible and assumes a sense of the “real.” (p. 171)

As someone who sees and desires the overarching benefits to a national health system through some form of collective care and access and opportunity to physical culture to support it, this also leads to quite a challenging present. Namely what to do as liberal-minded people while being parents in the neoliberal moment—particularly when it comes to our relationship with the capitalist health care and physical cultural system. I will attempt to do so by providing two autoethnographic narratives linked with an interlude detailing our experiences with health care as parents and locating them within the contemporary socio-political conjuncture (see Grossberg, 2021) in the following.

Vignette 1 Raising a Child With a Chronic Health Condition in the New American Aristocracy

Parenting three White children living “normal” (in an upper-class home, with two working parents) lives means that we have spent considerable time working with the contemporary American health care system. Indeed, our 9-year-old daughter, Meredith, an active “spitfire,” has had an emergency room (ER) visit resulting in stitches on her face after colliding headlong into exposed metal at daycare at 3 years old (she apologized to the director of the facility “for running” when I picked her up), while our son, Colin (11), was stitched up after he cut himself with a knife at 6 years old upon unilaterally deciding that supervision with such culinary equipment was not required. The spurting blood from his thumb on our living room wall would have seemed to demonstrate otherwise. The youngest, Evelyn (7), has, thus far, navigated a life that has not required such a visit.

However, our more complicated and long-standing relationship with the health care industry has been around food allergies. To clarify, at a very young age, it was apparent that Colin was having trouble consuming normal food. He vomited after trying things like dairy, eggs, wheat, soy, most fish, and meats while my wife continued to breastfeed him. At his 12-month checkup, Colin was labeled as “failure to thrive” (a designation that is hard not to equate, as a good neoliberal might, with failure to parent), and thus began our journey with pediatric health care. It was clear to our doctor that Colin was allergic to certain foods, and we needed to go to specialists who would prod, prick, and test the young boy to figure out what foods were safe for him to consume. Broome, Lutz, and Cook (2015) found that parenting with food allergies can be extremely challenging “from the initial diagnosis, the parenting role is challenged by a multitude of emotional, practical, and social aspects of childhood food allergy” (p. 539). Further, “[We] experienced a threat to [our] parenting and questioned our competency” (p. 539). For two people who were used to figuring things out, this was a frustrating, anxiety riddled, and depressing time.

Making matters worse was the fact that the specialists were also concerned that he had more than the traditional immunoglobulin E (IgE) reaction to foods that lead to hives or worse, and that he may also suffer from eosinophilic esophagitis (EoE) a chronic condition where an individual’s food allergies actually manifest themselves in high white blood cells and strictures in the throat which makes it even more difficult to eat. To test for EoE, it is necessary for the patient to be anesthetized and have a camera inserted into the esophagus to see what is going on inside. Typically, the process takes 15 minutes, and the patient is discharged within a few hours. At 14 months old, we agreed with the doctors to conduct this procedure. Unfortunately, Colin did not respond well and needed to be intubated and held overnight in the hospital. Also, the tests returned positive for EoE. For the next 2 years, he mainly consumed fruits, vegetables, rice, chicken, and Elecare (an elemental formula designed to replace food)—something actually designated in the state of Maryland as medical equipment.

Trying to help a child gain weight to get off the “failure to thrive” designation proved quite difficult given the restrictions we had to deal with his EoE. In addition, Colin vomited often, sometimes 4 to 6 days per week, and particularly in the middle of the night. Countless times the young child would awaken us by coughing and throwing up nearly all the elemental formula we were instructed to encourage him to consume before bed. The number of times I would get up in the middle of the night, find him covered in warm, sweet, metallic smelling vomit, needing to wash him, his sheets, calm him, and get him back to sleep while trying not to wake my pregnant and working—then post-partum and breastfeeding for the new baby—wife numbered in the hundreds (that is not a typo).

Colin would be intubated again after another procedure and the doctors informed us that he needed to have his tonsils removed so that they could continue with these operations and begin food challenges. As the family cook and primary person who takes our sick children to the doctor, I must add that we were only able to move forward with the food challenges when I, alone, made the following executive decision: At a checkup with his EoE specialist the doctor stated “here’s the deal 98% of patients diagnosed with EoE never grow out of it, but do get better with the use of steroids. Do you want to take the chance that he’s the 2% or move forward with steroids?” A lifetime choice with a 15-minute decision window, and Meghan couldn’t be reached on the phone. I knew Meghan probably wanted to gamble but chose to take the odds instead and started him on the steroid. Since that decision was made Colin has participated in a number of “food challenges” with an allergist—actually passing quite a few of them over time. In fact, after a shocking challenge passage of tree nuts and pistachio in late-2021 he is now only avoiding peanuts and peas. However, we will never know if he could have outgrown his EoE without the help of medicine.

Currently, Colin continues to go to a pediatric EoE clinic twice a year and takes on occasional food challenges. He even ate his first ice cream cone on his eighth birthday with no reaction. Many who have had experience in the American health care arena will recognize that this has not come cheaply. Luckily for us throughout all of this we had pretty strong insurance coverage from my university. With this support, these things cost us around US$3,000 annually in co-pays, and without insurance the cost of his procedures, pediatric care, and elemental formula would have easily crossed into the low-mid six figures. Furthermore, elemental formula is only covered through insurance by 19 states, many of which have complex rules that need to be followed to receive said coverage (see: https://apfed.org/advocacy/state-insurance-mandates-for-elemental-formula/ ).

Watching a child struggle with such a difficult chronic health condition did come at a cost to my family and, specifically me, beyond the fiscal outlay—mental health. Compounding Colin’s issues and consumptive choices around food was the fact that he was also diagnosed with a significant learning disability. The anxiety around the fiscal challenges posed by navigating his food were multifaceted and when this became coupled with trying to set up structures to support his learning disability I developed clinical depression and attendant alcohol use disorder (AUD). So much so, that I needed to seek serious professional help—perhaps at just the right time as COVID-19 was just around the corner.

Vignette 2 Raising Three Elementary School Aged Children During COVID While Dealing With a Mental Health Crisis

By the spring of 2020, I was, in some ways, well positioned to parent during the COVID shutdowns in terms of “free” time. Yet, for someone working through a (mental) health condition and trying (to date successfully) to avoid consuming alcohol, this was not an ideal situation. Numerous studies have demonstrated that despite initial decreases in alcohol use, the long-term effects were such that alcohol consumption increased in the population during the extended lockdowns (Colbert et al., 2020; Scarmozzino & Visioli, 2020; Sidor & Rzymski, 2020; Sun et al., 2020). Being stuck inside with three kids and my wife all day with no end in sight while trying to “recover” from anxiety, depression, and alcohol use disorder (AUD) was psychologically daunting. There was no privacy or freedom, and it was replaced with school scheduling, preparation, and clean-up of breakfast, lunch, dinner and snack, and after school activities at a time when outdoor physical activities would be closed down by the state of Maryland from March to early May.

Instead of consuming alcohol at night to drown out the feelings of sadness and worry, for our kids it was replaced with following news stories about Trump’s incessant string of COVID gaffes, sifting through reams of (mis)information as the Centers for Disease Control and Prevention (CDC), local and national news, campus, governmental, community leaders, friends, family, and neighbors helped shape everyday life. Conflicting reports and ideas about whether or not to stay inside, if a vaccine could be developed quickly, what it meant for health care workers, and beyond shaped everyday life. Case in point, one day in late March 2020 my children and I were taking a ride to pick up a lunch that the state had provided to local schoolchildren and listened to Celine Gounder, an infectious disease expert and eventual member of Joe Biden’s short-lived COVID transition team, break down crying on live radio (https://www.espn.com/radio/play/_/id/28926689) as she expressed the very real fear about losing friends and colleagues to the disease simply because America was so unprepared. By the time we returned home, every single one of us in the car had silently put their masks on.

Although this was challenging beyond being stuck inside coupled with the sadness that the social benefits of social life and youth sport for our kids were radically altered during that time period (see also: Anon., forthcoming), we were also very fortunate that we were able to avoid many of the issues that befell other, less fortunate, families. While I was away from work until early April 2020, it was fairly easy for me to act as tech support and supervisor for the kids, and for Meghan to perform her duties online. The local public schools had provided us with Google chromebooks, and since both of us were still drawing salaries, it was relatively easy to cover the cost of reliable internet coverage. When Meghan’s computer was destroyed by a ransomware attack, she simply used the one provided to me from the University as she waited for a replacement.

During the early portion of this deeply insular period, where again both of us were drawing a salary, we were able to maintain our typical standard of living. Yes, there were a few health scares. For instance,

All of these were covered by minimal co-pays and access to quality health care coverage.

This has largely been the rhythm of COVID-life with our family, deeply insular periods, followed by some (relatively minor) crisis solved through access to capital (be it social, cultural, or economic).More to the point, since Meghan and I both worked in an online capacity, had access to outdoor physical activity (King-White & Giardina, forthcoming), shifted grocery shopping to an online meal delivery service, and the kids were educated online from March 2020 to February/March 2021 almost any contact we had with others were risks we took voluntarily. When the adult vaccines became available in America, we were inoculated in the first and second waves, respectively (Meghan January/February and myself February/March), had early access to a third shot in August/September, and all three kids were able to do so within the first few weeks of its availability in November. All this being written, when the omicron variant roared through the United States, and, despite our strict adherence to filtered masks wearing in public, we all were stricken with COVID and recovered while on winter break. Yet again, we were fortunate to have had no one get really sick with the disease or long COVID.