This letter features reporting from "‘I Just Don’t Want To Die’: Black Pregnant Women Are Turning to Midwives for Personalized Care—And a Better Chance at Survival" by Karen Kasmauski and Louis Hansen, and from Perils of Pregnancy: Black Maternal Mortality by Herbert L. White and Kylie Marsh
Dear Mayor Nirenberg,
In a story published by the Virginia Center for Investigative Journalism, a truth society has been avoiding is finally being brought to light. Black maternal deaths in the United States are at appalling, and frankly disturbing, numbers. The sheer carelessness of health care professionals has been a leading factor for many Black women to seek medical attention from alternative medicinal practices, such as midwifery. There has been a recurring theme of hospitals not supporting, listening to, and advocating for their Black patients. This perpetuates the inequity of medical care for Black Americans.
My mother is a Board Certified Maternal Fetal Medicine Obstetrician and Gynecologist at the Children’s Hospital. She is also a Black woman. A Black woman who has both seen through her profession and experienced personally the differences in treatment for Black patients. I recognize I am fortunate enough to have the exposure and education, through her, to see the reality of how Black pregnant women are treated in the healthcare system. However, even so, I am still a young Black woman with the possibility of becoming another statistic. The causes of maternal deaths for Black women are not simply socioeconomic. Many athletes, celebrities, and even doctors, like my mom, have suffered and experienced complications and frustration with the implicit bias from the healthcare system.
According to the Centers of Disease Control and Prevention, in 2021, the maternal mortality rate for Black women was 69.9 deaths per 100,000 live births, which is 2.6 times the rate of white women. Many testimonials from Black mothers across the United States are published in a Pulitzer Center-supported series from The Charlotte Post, where many Black mothers express their heartache and disdain for the healthcare system as it continues to prioritize its white patients. Even with compliance, Black mothers are still suffering incredible losses due to systemic racism in the healthcare system.
Unfortunately, this issue is not limited to just maternal medicine, but infiltrates all medicine. Black communities have continued to face injustice in an area that is simply a human right: health. According to KFF, the non-profit journalism foundation, “[Black Americans’] life expectancy is nearly five years shorter compared to White people (72.8 years vs. 77.5 years).” These healthcare disparities are evident and consistent. I encourage you, Mayor Nirenberg, to take steps to allocate funds in support of programs that identify and address unconscious bias in medical workplaces. Invest in the quality of healthcare in Black communities, and introduce alternative medical practices to ease that transition.
Some similar programs that have been successful would be the Healthy People 2030 Initiative set by the United States Department of Health and Human Services. Healthy People 2030 primarily focuses on health literacy and monitors evidence across the U.S. to identify populations of people experiencing severe cases of healthcare inequality. They host seminars and training sessions for medical professionals to introduce tactics on recognizing and reducing bias in the workplace. They also partner with different states’ Departments of Health for larger impact. Beginning to integrate these programs into medical facilities across San Antonio could be a powerful first step to reaching healthcare goals.
I hope San Antonio can soon be an example of equitable healthcare. Change is possible if we have the courage to take action. Black communities have been afflicted by discrimination for too long and have suffered too much. I believe, together, we have the power to build a better, brighter, and healthier future. For all.
Sincerely,
Jasmine Melvin

Jasmine Melvin is an 11th-grader at the International School of the Americas in San Antonio, Texas. She is a 16-year-old scholar who lives with her mother, father, and younger brother. She is an enthusiast of all things that can make her more knowledgeable. She enjoys dance, reading, writing poetry, family time, and the New York Times Mini Crossword. She is passionate about bringing attention to racial prejudice and challenging the structures that maintain discrimination. Jasmine hopes to continue being a champion and activist for equality in society.
Read more winning entries from the 2024 Local Letters for Global Change contest!