The Puerto Rican and Cuban public health systems: a comparison

This article compares the Puerto Rican and Cuban public health and mental health systems and the respective health profiles, emphasizing the role of psychosocial stressors. The Cuban health system was found to be better organized and more capable of providing equitable health care and encouraging community participation in health care delivery. However, the Puerto Rican public health system is in crisis and in the process of turning over the administration of its facilities to the private medical sector. Although both countries share health profiles similar to those of developed nations, differences in morbidity and mortality patterns, and the seemingly epidemic incidence of mental disorders in Puerto Rico suggest dissimilarities between their respective psychosocial stressors. Differences in the quality of public health care and in the health profiles seem mostly attributable to the divergent political and economic organization and priorities of both countries.