Between 2008 and 2011, more than two dozen Detroit women died because of issues directly related to pregnancy or childbirth, reports The Detroit News. That maternal death rate is three times the national average, and the worst of major U.S. cities. Racial health disparities are squarely to blame, experts say.

Writes The Nation‘s Dani McClain:

The numbers make sense given the racial disparity in maternal mortality. Black women nationwide are at three to four times greater risk than white women. And since Detroit’s population is 83 percent African-American and more than four in ten of its residents live under the poverty line, it’s no wonder that the chance that pregnancy or childbirth will result in death is so high–higher than in Libya, Uruguay or Vietnam, the article reports.

Blame it on the prevalence of chronic health issues likely to put a new or birthing mother’s life at risk, namely diabetes, hypertension, obesity and heart disease. Black women are also twice as likely as white women to receive no prenatal care, or to receive it only in the third trimester.

Read more on new approaches to addressing racial health disparities from Colorlines’ Miriam Zoila Pérez.