Her reporting exposed deep disparities in San Antonio’s health care system and spurred action

Laura Garcia was uniquely qualified to write about the injustices of San Antonio’s health care system. 

Growing up on the city’s south side, she had seen family members and school friends struggle with diabetes and other chronic illnesses. Garcia had recently been diagnosed with Type 2 diabetes herself. And she knew from experience the difficulty of accessing medical care in her largely Hispanic community compared with the city’s wealthier north side. Where you live in San Antonio, she understood, helps determine how healthy you are.

“It was really a story that I had always wanted to tell, and I didn’t see it being told, not in that way. Not in a way that it was from somebody who is from that part of town,” said Garcia, who was then covering health care for the San Antonio Express-News. “I thought I could say it in a more authentic way.”

With the support she received as a Center for Health Journalism 2021 National Fellow, Garcia produced a three-part series, “Access Denied,” that exposed deep inequities in the city’s health care system. The series was a wake-up call for local government officials and ultimately led to new investments aimed at improving access to care on the city’s south side.

One story, examining the unequal toll that COVID-19 had taken in San Antonio, found that the death rate in poorer Hispanic communities was double that of the county overall. One ZIP code on the south side had a death rate 16 times higher than a more affluent ZIP code on the north side. Vaccination rates on the south side were half those on the north side. 

Another story looked at the heavy concentration of medical facilities in the city’s north side, where patients are healthier and wealthier and where providers can collect higher reimbursement from insurance companies. Her analysis found that for every eight emergency rooms located on the north side of San Antonio, the south side had one.

It was really a story that I had always wanted to tell, and I didn’t see it being told, not in that way. Not in a way that it was from somebody who is from that part of town. I thought I could say it in a more authentic way.”

Laura Garcia, National Fellow

Following her series, the Bexar County commissioners approved a new initiative aimed at improving access to care on the city’s south side, including $2 million a year in new public health funding. The effort included the creation of a new public health director position, better coordination of the county’s health related services and a new network of health clinics to serve those long-neglected communities. 

At a meeting to announce the initiative, Bexar County manager David Smith put up two maps from Garcia’s series to illustrate the city’s stark health disparities. Together, they showed the correlation between higher rates of diabetes and higher death rates from COVID in communities on the city’s south side. 

“To me, these two maps are a sort of visual mission statement for this new department that I’m forming,” Smith said at the time. “It is to try and make these health care outcomes more evenly distributed throughout our community.” 

Garcia said that her fellowship was critical to the project’s impact. Indeed, she said it might have never gotten off the ground in her newsroom if she hadn’t been awarded a Center fellowship and received mentorship every step of the way. “It felt incredible to have the support that I could actually do this, that I should do this, that this was an important story.”

She credits her fellowship mentor, who worked with her over many months, for helping her capture the complexities of her subject and stay true to her own experience. That veteran journalist, James Causey, had written about similar issues among Black residents in his hometown of Milwaukee for the Milwaukee Journal Sentinel. 

“Sometimes when you see a journalist writing about people who are marginalized, they’re writing about a certain stereotype. It’s just easier to put them in this little box,” Garcia said. “For me, it was a lot more complicated, the issues are a lot more nuanced. (Causey) understood that from the get-go and helped me navigate how to tell this story in a more authentic way for my community.”

Garcia also used her reporting to engage the local community in an honest discussion about the city’s health care disparities and possible solutions. With six months of engagement mentoring and a grant from the Center, Garcia organized a community health fair that brought together leaders and representatives from a broad spectrum of the city’s hospital and clinics, nonprofits and community groups as well as ordinary people often excluded from the decision-making table.

Garcia saw a leadership role for her newspaper in being able to convene competing interests around an important public issue, a role that the paper eventually embraced. “I was doing things that we don't normally do at our outlet,” she said. “There were a lot of folks who (said), 'You can't do that,’ you know, and I (said), ‘We are doing this!’”

A month after the health fair, the county announced approval of two new hospitals with an estimated cost of $950 million, including the first new hospital on the city’s south side in many years. Hospital board members and administrators told Garcia that her reporting had contributed to the growing public sentiment that a hospital be built on the south side at the same time as the one they planned on the north side. 

Garcia has seen her career take off since her project. She was invited to speak about it at journalism conferences, where she met the editor of the Texas Tribune, a prestigious nonprofit news site covering politics and public policy whose mission is to promote civic engagement. Garcia is now an editor there.

“I wanted to bring my perspective to the Texas Tribune, as a Latina and as somebody who’s from the south side of San Antonio,” Garcia said. “I wanted to have a seat at the table when we’re deciding coverage and how we’re directing our resources. I wanted to make sure that these stories of south Texans are being told.”