The Drive Out Racism and Invigorating Equity (D.R.I.V.E.) Study was led by an interdisciplinary team of researchers from the Medical College of Wisconsin, University of Wisconsin-Milwaukee, Marquette University, and the Social Development Commission (SDC), the largest community action agency in Wisconsin, committed to empowering people with the resources to move beyond poverty.
The D.R.I.V.E. study was conducted to determine which structural and individual level factors associated with experiencing discrimination lead to poor mental and physical health. The project is highly innovative in that it was the first to explore relationships among structural, neighborhood, and individual level factors that influence health and resilience in the same model, in some of the most vulnerable neighborhoods in Wisconsin. Moreover this was the seminal study of the SDC's Institute on Poverty and Systemic Racism (IPSR) in collaboration with the MCW, UWM, and MU academic partners. Structural racism/discrimination (SRD) encompasses the societal structures and policies that reduce access to resources and opportunities for historically marginalized communities.
While it is recognized that SRD is a fundamental determinant of health disparities, the relationships among the many community-level factors that influence the impact of SRD on health and wellness and how these factors intersect with individual experiences are poorly understood. Milwaukee County is the most racially diverse and segregated metropolitan areas in the United States and the first to recognize SRD as a public health issue. Health inequity in Milwaukee disproportionately affects Black community members, significantly impacting the health of the whole state.
Participants reported experiencing discrimination, on average, 254 times per year, nearly everyday. Some participants even reported experiencing discrimination over 5x every day. When considering the different types of discrimination, people said they experienced roughly 4.5 of the 9 situations of discrimination asked on the survey in their lifetime.
The level of racial discrimination reported by Black Americans in the D.R.I.V.E study is very high and may increase risk for poor health. The ongoing vast experiences of racism shared by D.R.I.V.E. participants amplifies the need to address this prevalent issue in Milwaukee.
D.R.I.V.E. participants described various experiences of violence they directly had experienced or witnessed. On average, residents described experiencing 5 different types of violence in their lifetime and nearly 15 violent incidents. Everyone endorsed at least one experience of violence, and at most participants reported 90 experiences.
No matter the source, violence can carry a significant toll on people’s mental and physical health. Many factors can increase a person’s risk of experiencing violence, and not everyone faces these risks equally. Unfair systems can create crowded or deteriorating neighborhoods and keep people in poverty, which can lead to more violence in our communities.
An alarming 85% of people in the D.R.I.V.E. study had abnormal blood pressure readings. Seventy-five percent of the participants fell into either hypertension stage 1, stage 2, or hypertensive crisis.
Elevated uncontrolled blood pressure is a significant marker of health and if untreated, can lead to cardiovascular damage, including heart attack and stroke. These findings demonstrate one way that experiencing poverty and discrimination can impact health.
28% of D.R.I.V.E. participants reported symptoms that would likely meet diagnosis for posttraumatic stress disorder (PTSD). This rate is much higher than the estimated 6-8% of U.S. adults with PTSD. Even in veteran samples, lifetime prevalence is estimated to be 3-29%. Though PTSD is diagnosed after experiencing one traumatic event, the symptoms measured in this study were not evaluated after a specific traumatic event.
The high rates reported by participants indicate continual exposure to trauma in participant’s lives that may not be tied to one specific event. For instance, the high and chronic exposure to both violence and discrimination may serve as traumatic events leading to elevated symptoms.
