On leaving: Coloniality and physician migration in Puerto Rico

Varas-Díaz, Nelson; Rodríguez-Mader, Sheilla; Padilla, Mark; Rivera-Bustelo, Kariela; Mercado-Ríos, Claudia; Rivera-Custodio, Joshua; Matiz-Reyes, Armando; Santiago-Santiago, Adrián; González-Font, Yoymar; Vertovec, John; Ramos-Pibernus, Alíxida; Grove, Kevin

doi:10.1016/j.socscimed.2023.115888

Cited by 5 publications

(2 citation statements)

References 25 publications

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“…According to the 2020 US Census, Puerto Rico’s population was estimated at 3.2 million people, with a median age of 42.4 years and a median household income of $21,967, significantly lower than the United States’ median household income of $61,521 ( 10 ). Preceding the pandemic, the enduring impact of environmental disasters on the island had already taken a toll on its economy, health, and security, triggering a substantial migration of Puerto Ricans to the mainland United States ( 11 – 18 ). In addition, the population in Puerto Rico has dwindled by an estimated 4.4% since 2017 ( 17 ).…”

Section: Contextmentioning

confidence: 99%

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The Puerto Rico community engagement alliance (PR-CEAL) against COVID-19 disparities: outreach and research engagement efforts in disproportionately affected communities

Pons-Calvo,

Pérez,

Canales-Birriel

et al. 2024

Front. Public Health

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In September 2020, the National Institutes of Health acted in response to the COVID-19 pandemic, recognizing the critical need to combat misinformation, particularly in communities disproportionately affected by the crisis. The Community Engagement Alliance (CEAL) emerged as an initiative dedicated to fostering reliable, science-based information, diversity, and inclusion; aiming to implement effective strategies to mitigate the spread of COVID-19 nationwide. One of the teams participating in this initiative is Puerto Rico-CEAL (PR-CEAL). Our whose goal was to raise awareness about the coronavirus disease and advance research, mainly focusing on vulnerable and underserved populations. This concept paper seeks to outline PR-CEAL’s infrastructure during its initial two cycles, providing insights into the research and community engagement activities designed to enhance prevention, counter misinformation, and foster awareness and uptake of COVID-19 vaccines. Ultimately, our objective is to reflect on the strengths and challenges encountered thus far as we endeavor to sustain this robust infrastructure, addressing ongoing public health issues with a forward-looking approach.

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Section: Contextmentioning

confidence: 99%

“…In addition, the population in Puerto Rico has dwindled by an estimated 4.4% since 2017 ( 17 ). This migration dynamic extended to healthcare professionals, with approximately 15% of medical specialists leaving in pursuit of enhanced resources and salaries in the US ( 16 , 18 ).…”

Section: Contextmentioning

confidence: 99%

The Puerto Rico community engagement alliance (PR-CEAL) against COVID-19 disparities: outreach and research engagement efforts in disproportionately affected communities

Pons-Calvo,

Pérez,

Canales-Birriel

et al. 2024

Front. Public Health

View full text Add to dashboard Cite

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Puerto Rican physician’s recommendations to mitigate medical migration from Puerto Rico to the mainland United States

Santiago-Santiago,

Rivera-Custodio,

Mercado-Ríos

et al. 2024

Health Policy OPEN

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“They think we wear loincloths”: Spatial stigma, coloniality, and physician migration in Puerto Rico

Padilla,

Varas‐Diaz,

Rodríguez‐Madera

et al. 2024

Med Anthropol Q

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Puerto Rico (PR) is facing an unprecedented healthcare crisis due to accelerating migration of physicians to the mainland United States (US), leaving residents with diminishing healthcare and excessively long provider wait times. While scholars and journalists have identified economic factors driving physician migration, our study analyzes the effects of spatial stigma within the broader context of coloniality as unexamined dimensions of physician loss. Drawing on 50 semi‐structured interviews with physicians throughout PR and the US, we identified how stigmatizing meanings are attached to PR, its people, and its biomedical system, often incorporating colonial notions of the island's presumed backwardness, lagging medical technology, and lack of cutting‐edge career opportunities. We conclude that in addition to economically motivated policies, efforts to curb physician migration should also address globally circulating ideas about PR, acknowledge their roots in coloniality, and valorize local responses to the crisis that are in danger of being lost to history.

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On leaving: Coloniality and physician migration in Puerto Rico

Cited by 5 publications

References 25 publications

The Puerto Rico community engagement alliance (PR-CEAL) against COVID-19 disparities: outreach and research engagement efforts in disproportionately affected communities

The Puerto Rico community engagement alliance (PR-CEAL) against COVID-19 disparities: outreach and research engagement efforts in disproportionately affected communities

Puerto Rican physician’s recommendations to mitigate medical migration from Puerto Rico to the mainland United States

“They think we wear loincloths”: Spatial stigma, coloniality, and physician migration in Puerto Rico

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