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Studying Psychiatric and Substance Use Disorders in Puerto Rico Before and After Hurricane Maria

Puerto Rico houses destroyed from storm

May 2, 2019

Alex Ortega, PhD, professor and chair of the department of Health Management and Policy in the Dornsife School of Public Health (DSPH), along with his team of DSPH and University of Puerto Rico investigators, was awarded a $3.2 million R01 grant by the National Institutes of Health (NIH) to study psychiatric and substance use disorders among island Puerto Ricans impacted by Hurricane Maria.

In September 2017, Hurricane Maria, a Category 4 hurricane, hit Puerto Rico and devastated the island. Residents were still recovering from Hurricane Irma, which hit two weeks prior. The storm resulted in major infrastructure damage and fatalities across the island. The total financial losses are estimated at $91.61 billion, which ranks in the top three costliest tropical cyclones. The official death toll is 2,975 though it is believed to be much higher.

It is projected that 44 percent of the island’s residents live in poverty, which increases the risk for poor mental health consequences in the event of a natural catastrophe. In addition to the island’s struggling economy, the unprecedented delayed institutional response and recovery efforts formed a highly stressful environment for residents.

Ortega and his team will conduct a follow-up survey of 3,062 Puerto Ricans, ages 18-64 years, living on the island, as well as those who moved to the United States mainland after the hurricane. The study participants were surveyed for psychiatric and substance use disorders one year before Maria hit the island, which will allow them to examine the longitudinal development and exacerbation of psychopathology before and after the disaster.

The study aims to estimate the change in prevalence of psychiatric and substance use disorders from before and after the hurricane; understand the mechanisms that lead to increased psychopathology, including institutional response and recovery efforts and post-disaster stressors; identify the personal, family and neighborhood factors that lead to resilience among those who did not have psychopathology post-Hurricane Maria; and understand the effects of institutional response and recovery efforts on psychopathology across the eight health regions that vary in geography and levels of hurricane impact.

Hurricane Maria was highly publicized because of the poor institutional response to the island’s recovery. The research, once complete, will contribute to the literature by not only examining the long-term associations between exposure to the hurricane and psychiatric disorders, but it will also examine how real and perceived institutional responses affect communities.