Health Disparities Research Framework Adaptation to Reflect Puerto Rico's Socio-Cultural Context

In this article we aim to briefly describe how Puerto Rico's living conditions influence adverse health outcomes at an individual, community and population level using the National Institute of Minority Health and Health Disparities (NIMHD) Research Framework that considers multiple factors and their intersecting influence. People living in Puerto Rico face significant levels of poverty, a deficient infrastructure, a fragile healthcare system and the continuing dismantling of the public education system as well as hazardous environmental exposures. The treatment of Puerto Ricans as second-class citizens due to the federal policies of the U.S. government and also the mismanagement of funds from local authorities impacts the prevalence of chronic health conditions and vulnerability to disasters such as hurricanes, earthquakes and pandemics. Puerto Rico's health disparities are rooted in historical, cultural, political and economic factors that have an impact on biology, interpersonal and environmental aspects. In order to significantly reduce health disparities, systemic change is needed at a local, national and federal level. Interventions must consider how social determinants impact the quality of life and seek to impact the intersections of different contexts that have an effect at an individual, interpersonal, communal and societal level. This can be achieved through evidence-based, culturally appropriate and community based as well as translational research approaches that seek to impact behavior and social economic factors.