Social vulnerability and the role of Puerto Rico’s healthcare workers after Hurricane Maria

Hurricane Maria was one of the most devastating storms in United States history. The tremendous force of the hurricane, along with the associated wind, rain, flooding, and critical infrastructure damage, caused incredible disruption to lives and livelihoods.

This study uses interview and observation data with healthcare workers across Puerto Rico to better understand what kind of impacts the hurricane had on people’s health, and who was most impacted. We sought to understand how healthcare workers responded to the crisis in order to reach communities in need.

The study highlights how and why people with chronic health conditions, those who were economically disadvantaged, rural populations, and older populations were particularly vulnerable to the health impacts of the storm and massive, extended disruptions to key infrastructure. It also explores how Puerto Rico’s colonial relationship to the United States, migration patterns, economic recession, and underfunding of health care services contributed to health vulnerabilities. Despite severely compromised health facilities and services across Puerto Rico, the healthcare workers that participated in the study accomplished incredible feats in their efforts to reach people in need. Flexibility in roles and local knowledge of communities were key for being able to conduct medical outreach and to know what kinds of services to provide.