Journal
JOURNAL OF IMMIGRANT AND MINORITY HEALTH
Volume 25, Issue 2, Pages 247-254Publisher
SPRINGER
DOI: 10.1007/s10903-022-01391-z
Keywords
Puerto Rico; natural disaster; community health assessments; displacement
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The study compares key health indicators among residents of Puerto Rico pre-and post-Hurricane Maria, finding changes in health insurance coverage and disease rates. The analysis highlights the importance of long-term follow-up to determine the impact of the hurricane and design appropriate public health programs.
Hurricane Maria is regarded as one of the worst natural disasters in United States history as it devasted Puerto Rico (PR) in September 2017. This study compared population-based key health indicators among PR residents pre-and post-Hurricane Maria. We examined Behavioral Risk Factor Surveillance System (BRFSS) PR data from five survey years, including pre-and post-Hurricane Maria: 2015 (N = 4556), 2016 (N = 5765), 2017 (N = 4462), 2018 (N = 4814), and 2019 (N = 4958). The sample consisted of non-institutionalized adults aged >= 18 years with access to a landline or a cellular telephone. Using logistic regression we compared health care utilization, health behaviors, and outcomes pre-and post-Hurricane Maria. Models adjusted for age, sex, race, education, employment, income, and marital status (2017 = referent). Compared to 2017, post-hurricane participants were more likely to have a college degree or higher, be currently employed, and not married/partnered. Post-hurricane, participants were less likely to have health insurance coverage (2018 AOR, 95% CI: 0.75, 0.58-0.97) and had lower rates of diabetes (2018 AOR: 0.82, 0.70-0.96). The odds of being overweight/obese were lower pre-hurricane compared to 2017 (2015 AOR, 95% CI: 0.88, 0.79-0.97). There was no statistically significant difference in health behaviors across survey years. Results may suggest that PR residents with lower socioeconomic status and/or chronic illness were more likely to emigrate, resulting in a compositional change in the population post-hurricane. This analysis highlights the need for long-term follow-up of PR residents to better determine the impact of Hurricane Maria, and adequately design public health programs to address healthcare needs, access, and outcomes.
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