From generation to generation
The primary challenge facing Milwaukee is not one of the usual suspects — education, crime, even the availability of jobs. Instead, it is an epidemic of trauma passed from one generation to another, one neighborhood to the next.
When Joseph and Eva Rogers moved to Milwaukee from Arkansas in 1969, there was no better city for African-American workers to find employment.
Neither had made it past grade school, but Joe found a job on the bottle line at Graf Beverages, known for root beer, and Eva worked at a rag factory. They were part of what turned out to be the last chapter of the Great Migration, in which 6 million Southern laborers moved north for a better life, and reshaped the nation.
Their daughter Belinda remembers the city at its industrial zenith. For the first time, she says, “I saw African-Americans owning homes and businesses.”
She married at 18 and had three children by age 22. Her Louisiana-born husband worked at A.O. Smith, the biggest employer in the city, with 10,000 workers in cathedral-sized factories welding the undercarriage of just about every American-made car.
Then a global economic upheaval hit Milwaukee’s industrial core, and engine-makers, machine shops, tanneries, even heralded breweries shut down in rapid-fire succession. Belinda’s husband endured periodic layoffs, retraining in new machinist skills to keep getting called back.
At one point, he came home and predicted: One day, these factories are not going to be here.
Belinda Pittman wanted to help pay bills, but her husband insisted she stay home. Increasingly, they quarreled. In 1984, she left a marriage she says had become abusive, and headed with their three kids to what was then known as the Sojourner Truth House for battered women.
Similar narratives were unfolding across Milwaukee’s blue-collar neighborhoods. As jobs disappeared, so did many of the dreams that came with them. And just as during the Great Depression, people and their families began to break.
A half century later, a Journal Sentinel analysis of previously unmined data reveals that many have never healed.
Instead, poverty, joblessness and the social ills that accompany them deepened progressively within Milwaukee’s urban center, rippled across its 200-plus census tracts, and moved into its suburbs like a slow-motion shock wave. Few other American cities fell as far, as fast
and as forcefully.
Today, the old A.O. Smith complex is long gone.
Less than three miles away, Belinda PittmanMcGee, now 63, runs Nia Imani Family Inc., which she founded 22 years ago to provide transitional housing for homeless women and their children. The agency serves some 35 women and 85 children annually in an old two-story apartment house on N. 25th St. Families stay up to two years, learning to “rescript” their lives.
Pittman-McGee has seen firsthand what an emerging network of public health and neuroscience researchers, community-minded foundations and law enforcement officials now believe: The primary challenge facing Milwaukee and similar high-poverty cities is not one of the usual suspects — education, crime, even the availability of jobs — although all those play a role.
Instead, it is an epidemic of trauma passed from one generation to another, one neighborhood to the next.
The perpetuation of trauma has been documented in the families of those who survived the Holocaust, Hiroshima, the Vietnam War and Cambodian genocide. Studies have now turned up the same phenomena in families entrenched in poverty, violence and neglect.
In Milwaukee, the nation’s third most impoverished big city, trauma researchers contend the seeds of distress were planted years ago when the current generation of adults were children. They say new seeds are being planted right now.
That revelation is beginning to shift how Milwaukee and other cities respond to social and economic decline. It also is prompting researchers to explore why some who are exposed to childhood trauma emerge undefeated — and whether their resilience can be coaxed out of others and even scaled to entire neighborhoods
“The larger social issues that are generational in nature will only be solved if people can reduce the toxic levels of stress in their own lives, and we all work together to reduce it in communities,” says Susan Dreyfus, chief executive of the Alliance for Strong Families and Communities, a national group based in Milwaukee.
Abuse, neglect and chronic anxiety literally change the architecture of a child’s brain, she says. “It’s a public health crisis.”
It’s also an economic one.
“A lot of families in the inner city have been so devastated economically that some of these families are numb,” says Christine Dunning, professor emeritus at the University of WisconsinMilwaukee and a pioneer in the burgeoning field of global trauma studies. “They don’t have the wherewithal to give attention to their child; they are so frozen and withdrawn and dissociative.”
It wasn’t until the 1980s that the American Psychiatric Association included the term post-traumatic stress disorder in its diagnostic manual, almost solely in response to mental health problems among Vietnam War veterans. Before that, the symptoms had gone by different names — “soldier’s heart” after the Civil War; “shell shock” in World War I; “battle fatigue” and “combat stress” in World War II.
Today, the understanding of trauma and PTSD has moved beyond the battlefield. The terms are becoming part of the everyday vocabulary in social agencies and juvenile courts in Milwaukee and similar urban centers. Beyond that, scientists are investigating how prolonged exposure to panic and stress early in life can upset hormones and neurotransmitters. An emerging new medical field called epigenetics is exploring how chronic stress builds up toxins within the body and potentially can even mutate genetic codes, which are passed down in the DNA to children.
“The impact on children is significant,” says Yael Danieli, a psychologist who published The International Handbook of Multigenerational Legacies of Trauma. The generational cycle of trauma, she says, is avoided only when a resilient person or successful intervention breaks the cycle.
In a practice ahead of its time, Pittman-McGee for more than two decades has required every Nia Imani resident to fill out a detailed questionnaire — including a full page on PTSD symptoms. The results reveal that four of every five homeless women were sexually molested as girls, and about as many had parents with alcohol problems, drug addictions and jail terms.
“It came from the family before that family, and the family before that,” she says. “It’s gotten worse.”
At Lad Lake, a welfare agency that handles a steady stream of children from Milwaukee, Donelle Hauser runs residential programs for sex trafficking victims — young people coerced or conned into the sex trade. After they begin their recovery, many are eventually able to talk about what happened to them, and to initiate a conversation with their birth mothers.
“In more than 50% of the cases,” Hauser says, “they learn that their mother was commercially sexually exploited, too.”
“The kids become the parents,” says Gabriel McGaughey, director of child well-being at Children’s Hospital of Wisconsin. “They grow up and have kids and the cycle can repeat itself.”
Measuring trauma
The most common measure of nonmilitary trauma is a short survey of “adverse childhood experiences,” known around the world as the ACE test. The index consists of simple but intrusive yes-or-no questions: When you were growing up, did a parent or adult in the house beat you? Beat each other? Did any of them verbally or sexually abuse you? Emotionally ignore you? Were any of them alcoholics? Drug users? Incarcerated? Mentally ill?
Compared to someone with zero “yes” answers, a person with four or more is six times more likely to struggle with depression; seven times more likely to grow up alcoholic; 10 times more likely to inject street drugs; and 12 times more likely to attempt suicide. They’re far less likely to hold a job and more likely to end up homeless.
Children with high scores tend to enter adulthood without the normal ability to manage stress, navigate relationships or practice delayed gratification. Further, those with an ACE score of four or higher are twice as likely to have heart disease, twice as likely to be diagnosed with cancer. They’re more likely to miscarry or give premature birth, and more vulnerable to diabetes, strokes and liver disease. For those who score six or higher, life expectancy drops 20 years.
“If I grow up in a chaotic situation, I don’t know how to be calm,” Pittman-McGee says, describing a person with a high ACE score. “I know how to be chaotic.”
In the United States, from 2009 through 2015, 32 states and the District of Columbia carried out ACE surveys, according to the U.S. Centers for Disease Control and Prevention. Nearly 30 nations conducted ACE surveys, according to the World Health Organization in Switzerland.
The results: No social class, ethnicity or geography spares its children.
“This is a human phenomenon, which is global,” says Robert Anda, a public health physician who co-created the survey.
Just as universally, ACE scores spike in environments of concentrated poverty, widespread economic uncertainty and high unemployment. Surveys carried out across Milwaukee lay bare entire neighborhoods where scores of four or higher are more the norm than the exception.
One survey of AfricanAmericans and Latinos in the city, conducted by the Black Health Coalition of Wisconsin, found that more than one in three carried a four-plus ACE score.
Separately, statewide ACE surveys showed that nearly two-thirds of Wisconsinites who grew up with an incarcerated adult have at least three additional ACEs — landing them in the four-plus category in a state with the highest rate of black incarceration in the country.
Lad Lake uses ACE tests to screen children before admitting them for residential treatment. The percentage scoring four or higher: 70. The percentage with none: 0.
“Trauma is to mental health as smoking is to cancer,” says Steven Sharfstein, past president of the American Psychiatric Association.
After the fiery riots last summer in the city’s Sherman Park neighborhood, Franklin Cumberbatch, project manager at Bader Philanthropies, could see the toll on children’s faces.
“I’ve looked into their eyes,” Cumberbatch says. “They have no feelings. They are numb.”
Trying to forget
Larry Davis scores a nine out of 10 on the ACE test.
His grandmother moved to Milwaukee from North Carolina in the 1960s, chasing the same opportunities that lured Belinda PittmanMcGee’s parents.
A single woman from a sharecropping family with her daughter in tow, Davis’ grandmother found work at enginemaker Briggs & Stratton. The first years were good; her daughter attended Catholic school and learned ballet.
But as time went on, Davis’ grandmother began taking on extra shifts as a hedge against losing her job. Extra shifts meant more time away from home. Her daughter became pregnant as a teenager.
Davis was the fourth child. His mother developed a drug dependency and was unable to provide proper care.
Today, Davis, 27, is finishing up a master’s degree in public health policy. He’s already studied with some of the city’s top ACE researchers, and has In reporting “A Time to Heal,” the Journal Sentinel collected data on multiple Adverse Childhood Experience studies in the city of Milwaukee, as well as studies done across Wisconsin, in numerous other states, at the national level and in other countries.
More than 100 people were interviewed for their knowledge of trauma research, behavioral science, public health, urban sociology, economics, law enforcement, community development and welfare.
To create census-tract maps showing how the economies of Milwaukee and other cities have evolved since 1970 — the nation’s industrial peak — the Journal Sentinel used U.S. Census Bureau data provided by the Minnesota Population Center’s National Historical Geographic Information System.
Statistical advice was provided by Charles Franklin, professor of law and public policy at the Marquette University Law School and data experts at Milwaukee’s Hunger Task Force.
worked around the country as a youth counselor and child welfare advocate. He’s contributed thousands of hours of public service.
“I don’t think the American dream is the picket fence and the house anymore,” he says. “It’s changed. It’s building yourself from the ground up.”
He is sometimes invited to share his turnaround story.
He describes the night he spent at the Milwaukee Secure Detention Facility, having a conversation with God, asking for help. That came after being arrested for driving the car for a burglary, for which he calls himself an unwitting accomplice. Which came after a harsh Wisconsin winter sleeping in a car, drinking to fall asleep. Which came after dropping out of high school. Which came after bouncing around several middle schools. Which came after spending childhood weekends at emergency “respite care” homes where his foster mom dropped him off because she “had a social life to keep up.” All of which came after being removed by authorities from his mother at age 3.
In an interview, Davis grimaces when he’s prompted to go further in his story.
He finally mentions that, as a youngster, he needed to make his own
In Milwaukee, the nation’s third most impoverished big city, trauma researchers contend the seeds of distress were planted years ago when the current generation of adults were children. They say new seeds are being planted right now.
meals after school or go hungry. He recalls classmates labeling him “Foster,” and needling him for wearing ragged clothes and missing field trips because he couldn’t pay the fee. There were nights using candlelight because the electric bills hadn’t been paid.
And then Davis shuts down. “See,” he finally says, “I forced myself to forget this.”
Like former frontline soldiers who repress combat experiences, forgetting is a common survival strategy for trauma victims — sometimes as a psychologically healthy way to move forward with a new sense of identity and purpose. But that collective silence has become part of the problem as well, keeping trauma experiences hidden behind stigma, pain and shame. Danieli calls it “social denial.”
“Trauma is perhaps the most avoided, ignored, belittled, denied, misunderstood and untreated cause of human suffering,” says Peter Levine, an American psychologist and author.
Economic consequences
Until recently, the economic impact of trauma has been just as invisible.
The CDC estimates the economic burden resulting just from child abuse and neglect in the U.S. at $124 billion.
“ACEs are the leading determinant of public health spending,” and a major driver of incarceration and child welfare costs, says Jennifer Jones of the Alliance for Strong Families and Communities. She has overseen six statewide ACE surveys in Wisconsin since 2009, more than any other state has conducted.
Shifting priorities into preventive programs “would save on the deep-end cost” of incarceration, public medical care and mental health facilities, Jones says.
When Joe and Eva Rogers settled in, after uprooting from Arkansas, 43% of black Milwaukeeans drew paychecks as industrial laborers — assembly line workers, punch press operators, forklift drivers. No other city came close, not even Detroit.
Today, the city sets the national This year marks the 50th anniversary of Milwaukee’s open housing marches, which focused attention on a knot of persistent urban problems. This project is part of an ongoing series of stories, videos and other special features that will examine how far Milwaukee has come — and the work that remains to be done. extremes of distress. Milwaukee leads all 100 of the nation’s biggest metro areas in an index of concentrated poverty created by the Federal Reserve Bank of Cleveland. In the Annie E. Casey Foundation’s annual report on the well-being of children, which examines the nation’s 50 biggest cities, Milwaukee is the only large city to land in the bottom five in such key categories as: percentage of children in single-parent families; children in poverty; children in low-income families; and children in which the head of the household has no more than a high school degree or equivalent.
In a 2014 study on upward mobility in the 50 largest cities, Milwaukee had “lower rates of mobility than any developed country for which data are currently available.” The study was conducted by Raj Chetty, a Stanford University economics professor who grew up in the Milwaukee area.
“You’re kind of stuck in Milwaukee,” Chetty says. “And it’s hard to achieve the American dream.”
Given the scope of the city’s challenges, some are astonished that Milwaukee’s neighborhoods aren’t in even worse condition.
“You look at the communities and they should be a lot worse off, believe it or not, than people would think,” says Patricia McManus, president of the Black Health Coalition of Wisconsin. “I don’t think our communities get enough credit for resilience.”
One of the most common strategies to coax that resilience out of trauma victims is to help them create a different narrative for their own lives — a process called re-scripting. The objective is to map out a future that moves beyond the auto-repeat memories of the past.
Pittman-McGee takes that concept literally at Nia Imani, handing out writing assignments to residents.
“At times when I was sober, I was depressed and suicidal,” one woman recently wrote. “I was cutting myself with razors and glass to feel some kind of life.”
In careful print, the young mother continued, diary-style: “It may take me a couple more months or a couple more years, but forgetting everything is just not an option anymore. Death is not an option.
“When I look at my babies, all I can see is success for them. No matter how many setbacks I have and how many demons try to stop me, I will rise and that’s a promise to myself and my boys.”