In the span of a few short years, the residents of Puerto Rico endured a series of devastating storms—including Hurricanes Irma, Maria, and Fiona—and were faced with hundreds of earthquakes. Then, the COVID-19 pandemic struck, stressing the island's health care infrastructure when it was already compromised. "Puerto Rico has experienced multiple, compounding disasters in recent years.
It's been a recipe for health care challenges, to say the least," said Anna-Michelle McSorley, a postdoctoral associate at the NYU School of Global Public Health and the NYU Center for Anti-racism, Social Justice & Public Health. In an article published in the American Journal of Public Health , McSorley and her colleagues describe how federal policies treat the "often-forgotten US territory of Puerto Rico" differently than the 50 states. As a result, these policies exacerbate existing health disparities in the territory.
The researchers focus on three key policy differences that put the health of Puerto Ricans at a disadvantage: unequal disaster response from the Federal Emergency Management Agency (FEMA), the lack of parity in Medicaid funding, and Puerto Rico's limited political power. "Our lens needs to gaze upstream—which is so much of what we do in public health—to say, 'This is where the policy is failing. This is where it's creating a barrier, and that is ultimately what's leading to the consequences that we see,'" said McSorley, the lead author of the study, who will join the fa.