May 23, 2022

Researchers at the Dornsife School of Public Health (DSPH) were awarded a National Institute on Minority Health and Health Disparities $3.2 million NIH R01 grant to study the Puerto Rico healthcare system before and after three major public health disasters.

Alex Ortega, PhD, professor of health management and policy at DSPH, is the principal investigator and is joined by researchers at DSPH as well as the University of Puerto Rico, Medical Sciences Campus.

Puerto Rico has significant health and health care inequities among its population, where 46 percent of the population is on Medicaid and 45 percent live below the poverty line. These inequities are exacerbated by a struggling healthcare delivery system that has been challenged over the past several years by natural disasters and infectious disease outbreaks, low Medicaid reimbursements, and an exodus of medical providers to the U.S. mainland.

This study provides a unique opportunity to understand the effects of the following three distinct major back-to-back public health disasters on Puerto Rico’s entire healthcare system of 50 general hospitals and 20 community health centers:

First, Hurricane Maria hit in September 2017 causing major devastation throughout the island. Communities lost access to essential services such as electricity, potable water, safe roads and bridges, and health care. Most of the island’s public and private health care facilities closed or had limited capacity for months.

Second, in December 2019, a series of more than 500 earthquakes of magnitude 2.0 or greater struck Puerto Rico causing more infrastructure damage to many struggling health facilities and leaving thousands homeless or living outside in their yards.

Third, Puerto Rico continues to deal with the COVID-19 pandemic and an increasing frequency and intensity of tropical disease outbreaks.

Researchers will look at the healthcare system’s preparedness, response, and recovery efforts and how the disasters have affected the resiliency, experiences, and utilization of the island’s health care system. They will also synthesize their findings to provide data driven recommendations for an effective and coordinated approach to mitigation, preparedness, response, and resiliency under conditions of increasing frequency and intensity of disasters on the island.