Centro Journal ISSN: 1538-6279 [email protected] The City University of New York Estados Unidos Rivera, Fernando I.; Burgos, Giovani The Health Status of Puerto Ricans in Florida Centro Journal, vol. XXII, núm. 1, 2010, pp. 199-217 The City University of New York New York, Estados Unidos Available in: http://www.redalyc.org/articulo.oa?id=37721077009 How to cite Complete issue Scientific Information System More information about this article Network of Scientific Journals from Latin America, the Caribbean, Spain and Portugal Journal's homepage in redalyc.org Non-profit academic project, developed under the open access initiative CENTRO Journal Volume7 xx11 Number 1 s p r i n g 2010 The healTh STaTuS of PuerTo ricanS in florida Fe r n a n d o I. rI v e r a a n d GI o v a n I Bu r G o s * a b s t r a c t During the past two decades, Puerto Ricans have been moving to central Florida in large numbers in search of better opportunities. While there is some evidence that Puerto Ricans in central Florida enjoy higher levels of education than Puerto Ricans living in traditional settlement hubs, it remains unclear if these population shifts have also translated into health benefits. The first goal of this paper is to provide a brief overview of the literature on the health of Puerto Ricans in the United States. The literature shows that Puerto Ricans continue to experience worse health outcomes than other groups. The second goal is to establish a recent profile of Puerto Rican health in the U.S. and Florida. By using recently released data from the 2007 American Community Survey, we compared disability rates of Puerto Ricans across 72 counties with large Puerto Rican populations. Our results indicate that Puerto Ricans in Florida have a health advantage over many Puerto Ricans living elsewhere in the U.S. We conclude by discussing some of the social scientific implications of this study and by making some recommendations for future research in this highly understudied area of Puerto Rican disability. [Keywords: Puerto Rican, health, mental health, disability, Florida] * Both authors contributed equally and are listed in reverse alphabetical order. [ 199 ] on august 13, 2008, the headlines of the Miami Herald read: “Puerto Ricans: Recession Drives Educated Puerto Ricans to South Florida” (Robles 2008). Headlines like this suggest a specific type of Puerto Rican migration – one based on higher education. Indeed, a recent report on Puerto Ricans in Central Florida indicates that the educational level of Central Florida Puerto Ricans is higher than elsewhere in the United States and Puerto Rico (Duany and Matos-Rodríguez 2006). These patterns of higher education and incursion into professional occupations are particularly important to the health of Puerto Ricans in Florida. Previous studies suggest that socioeconomic indicators, such as education and social class, have been associated with better physical and mental health outcomes among all ethnic/racial groups (Aneshensel 1992; James, Van Hoewyk, Belli, Strogatz, Williams, and Raghunathan 2006; Robert 1999; Williams 2005), including Puerto Ricans (Rivera, Guarnaccia, Mulvaney-Day, Lin, Torres, and Alegría 2008). The goal of this paper is not to examine the relationship between SES and health among Puerto Ricans in Central Florida, but rather to determine whether Puerto Ricans living in Central Florida enjoy better health, as measured by six types of disability variables, than Puerto Ricans living in other U.S. counties with large Puerto Rican populations. Although the migration of Puerto Ricans to Central Florida dates back even before 1980 (Duany and Matos-Rodríguez 2006), this region continues to attract large numbers of Puerto Ricans from Puerto Rico and other states—particularly from the northeast region. For example, from 1990 to 2000 there was a 95.1 percent change in the Puerto Rican population in the state Florida with Orlando experiencing a 142 percent change and Tampa a 78 percent change (Falcón 2004). More recent estimates show that six out of the ten counties that experienced the largest growth in the Puerto Rican population between 2000 and 2006 were located in Central Florida (see Vélez and Burgos 2010). At this point, however, a dearth of empirical studies makes it difficult to assess whether this mass exodus of Puerto Ricans, one driven in part by the search for a better life, translates into better health for Central Florida Puerto Ricans. The sociological and epidemiological literature on health, however, suggests two conflicting possibilities. On the one hand, Puerto Ricans living in segregated neighborhoods are expected to have poor health (Lee and Ferraro 2007). Given their increasingly large numbers and concentration in Central Florida counties, it is possible that the health of the Puerto Rican population in Central Florida is not among the best in the U.S. On the other hand, increased education [ 200 ] levels should provide for better health outcomes (Muntaner, Borrell, Chung, Avison, McLeod, and Pescosolido 2007). Given that the levels of education for Puerto Ricans in central Florida are relatively high, the average health of the Puerto Rican population in central Florida should be among the best in the nation. We engage this paradox by comparing disability rates, as indicators of physical and mental health status, of Puerto Ricans in Florida counties to the disability rates of Puerto Ricans living in other U.S. counties. our focus is on studies that look specifically at puerto rican health, and those that compare puerto ricans to other groups, including latinos from other ethnic backgrounds. We begin by first providing a brief overview of the physical and mental health status of Puerto Ricans in the U.S., noting in particular the need to add to the existing but limited literature in this area. Our focus is on studies that look specifically at Puerto Rican health, and those that compare Puerto Ricans to other groups, including Latinos from other ethnic backgrounds. Second, we discuss studies on the health status of Puerto Ricans in Florida. Third, we empirically compare disability rates (as a health indicator) utilizing data from the 2007 American Community Survey on regions with significant numbers of Puerto Ricans (mainly in the Northeast and Midwest regions) to Puerto Ricans in Florida. We then conclude by suggesting new avenues for future research in this understudied area of Puerto Rican health. HealtH trends in tHe United states and Florida Until fairly recently, there have been few nationally representative data that would allow researchers to document and explain Latino ethnic differences (e.g., Puerto Rican, Mexican, Cuban) in physical and mental health (Heeringa, Wagner, Torres, Duan, Adams, and Berglund 2004). As a result, many researchers have had little choice but to lump Latinos into one monolithic group (i.e., “Latino” or “Hispanic”) and little recourse but to make broad generalizations on the health status of this population. Key problems associated with this lack of information is that researchers and policymakers continue to have a very difficult time documenting which ethnic groups are at high risk of developing health problems, explaining sub-group differences in health, and developing culturally sensitive interventions (Institute of Medicine 2004; U.S. Department of Health and Human Services 2001). These problems are compounded if we consider that the Latino population is expected to grow in the next few decades, that they are dispersing rapidly throughout the U.S., and that place [ 201 ] shapes the onset and trajectory of disease, wellness, and illness (Ahmed, Mohammed, and Williams 2007; Cisneros 2009; Curtis and Jones 1998; Fitzpatrick and LaGory 2003; Williams and Mohammed 2009). Although place matters and the Latino population continues to grow in both geographical scope and in sheer numbers, little is known about the health of Puerto Ricans in different parts of the country. At the very least, this is a very serious issue in light of the fact that the Puerto Rican population, in particular, is on the move and that both the Center for Disease Control and World Health Organization have made it a priority to monitor emerging diseases associated with migration patterns (Brownstein, Freifeld, and Madoff 2009; Madoff and Woodall 2005). Because we have little or no information on many health indicators of Puerto Ricans in different parts of the U.S., we hope that this article will stimulate more research in this area and further the collection of health data that is linked to place—not just for Puerto Ricans but also for Latinos of different backgrounds. although place matters and the latino population continues to grow in both geographical scope and in sheer numbers, little is known about the health of puerto ricans in different parts of the country. Fortunately, there are a few data sets that allow researchers to gauge the health status of some Latino ethnic groups, such as Puerto Ricans. In this section we briefly review findings on Puerto Rican health at the U.S. national level, paying particular attention to common and disabling chronic health conditions (e.g. diabetes, cardiovascular disease, asthma, and cancer) that are known to have a disparate impact on the Puerto Rican community. In addition, we briefly document some of the common risk factors (e.g. obesity, smoking and physical activity) associated with these chronic conditions. Physical Health in the United states The Hispanic Health and Nutrition Examination Study (H-HANES) has allowed researchers to analyze Latino sub-group differentials in health and is still one of the most commonly used national surveys with regard to Latino health (National Center for Health Statistics 1985). Findings from these data reveal the disparities in health experienced by the U.S. mainland Puerto Rican community in comparison to other Latino ethnic groups.