Qualitative Assessment of Environmental Health Risk Perceptions and Community Challenges in a Puerto Rican Community: Change and Continuity in Response to Hurricanes Irma and María

Pérez-Ramos, José G.; McIntosh, Scott; Barrett, Emily S.; Vélez-Vega, Carmen M.; Dye, Timothy D.

doi:10.1080/08964289.2019.1700894

Cited by 5 publications

(5 citation statements)

References 48 publications

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“…As described in previous studies, Culebrenses expressed a feeling of being forgotten by the Puerto Rican government, which could partly explain why Culebrenses have a sense of pride and ownership with respect to Culebra [ 48 ]. As a result, Culebrenses could demonstrate a greater inherent consciousness of protecting natural resources, the environment, and fragile ecosystems, which are also the island’s main tourist attractions.…”

Section: Discussionmentioning

confidence: 99%

“…app was designed and developed as a community-oriented ICT to stimulate collective action to mitigate environmental health risks (eg, trash and mosquitoes). This study design involved direct input from community organizations and community members in Culebra, including women’s advocacy organizations, sports organizations, private businesses, health organizations, and schools, primarily through focus group and qualitative engagement processes, as previously described [ 48 ].…”

Section: Methodsmentioning

confidence: 99%

“…For addressing community environmental priorities, two additional sections were incorporated from previous study findings [ 48 , 49 , 58 ] to assess the use of technology, environmental challenges, community resolutions, and access to technology at home (eg, cell phones and the internet).…”

Section: Methodsmentioning

confidence: 99%

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Attitudes Toward the Environment and Use of Information and Communication Technologies to Address Environmental Health Risks in Marginalized Communities: Prospective Cohort Study

et al. 2021

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Background Information and communication technologies, including mobile health (mHealth), can help isolated communities address environmental health challenges. The Puerto Rican island of Culebra has faced multiple sociopolitical and economic factors that have distressed the island’s environment and health. Culebrenses are technologically engaged and have demonstrated a use of technology that transcends socioeconomic barriers. As a result, technological interventions could potentially help manage environmental risks on the island. Objective This study aims to test and evaluate the potential benefits of an mHealth tool, termed ¡mZAP! (Zonas, Acción y Protección), for engaging communities with environmental risks through technology. Methods Participants using ¡mZAP! (N=111) were surveyed. Bivariate analyses were used to examine associations of mHealth use with sociodemographics, technology use, an adapted environmental attitudes inventory, and the multidimensional health locus of control. Logistic regression was used to examine associations between attitudes toward environmental health risks and mHealth use. Results Higher positive attitudes toward the environment were significantly associated with the use of ¡mZAP! (odds ratio 5.3, 95% CI 1.6-17.0). Environmental attitudes were also associated with the multidimensional health locus of control powerful others subscale (P=.02), indicating that attitudes toward the environment become more negative as feelings controlled by others increase. Participants felt that the authorities would resolve the challenges (63/111, 56.7%). Conclusions Perceived lack of control could present barriers to collective actions to address salient environmental health challenges in communities. The ongoing dependency on government-based solutions to community problems is worrisome, especially after the hurricane experiences of 2017 (which may potentially continue to be an issue subsequent to the more recent 2020 earthquakes).

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Attitudes Toward the Environment and Use of Information and Communication Technologies to Address Environmental Health Risks in Marginalized Communities: Prospective Cohort Study

et al. 2021

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“…Despite the absence of an association, fishers on the small island of Culebra exhibited more cohesion than those operating in the other landing sites, which reflects how small groups are more likely to form ties than larger groups. Residents of Culebra are known for working within their close community ties to address perceived environmental challenges (Cubero, 2017;Peŕez-Ramos et al, 2020).…”

Section: Place-based Communitiesmentioning

confidence: 99%

Social cohesion and self-governance arrangements among small-scale fisheries in Puerto Rico

et al. 2022

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In small-scale fisheries that suffer from weak formal governance, fishers use a variety of institutional strategies to self-govern. These self-governance arrangements may or may not be forms of collective action, yet they rely on informal institutions (such as norms of reciprocity) in generating social cohesion among users so that common rules can be agreed upon. Social network perspectives have been used to understand the cohesiveness of fishers operating with different gear types or in different communities, yet less is known about how social cohesion differs between fishers that operate through formal cooperative arrangements, such as fishing associations, and independent fishers who operate solely at the community level through informal cooperation. Using mixed methods, we compared the social cohesion of commercial fishers arising from information-sharing and work-support networks in four fishing communities of north-eastern Puerto Rico, as they coped with prolonged hurricane recovery and the COVID-19 pandemic. A series of exponential random graph models (ERGMs) were applied to untangle the drivers of cohesion emerging from fisher’s information-sharing patterns. Fisher’s communication was driven not just by operating at the same landing site or using the same primary gear type, but also by choosing to organize their fishing under the same self-governance arrangement. Specifically, fishers that were members of fishing associations mostly communicated among themselves, while independent fishers talked across arrangements, indicating the role of fishing associations in fostering social cohesion. However, associated fishers were less likely to receive information than independent fishers, suggesting the need for targeted communication strategies within each group. Moreover, independent fishers had more work support ties and a greater diversity of supporting actors across the supply chain, suggesting their need for higher levels of linking social capital. Multiple social factors explained whether fishers choose to be members of fishing associations or remain independent, including trust in leaders and agreement on membership rules. These findings highlight the importance of knowing the cohesiveness of cooperation networks among small-scale fishers.

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“…The spread of the SARS-COV-2 virus to Puerto Rico in early 2020 placed additional stress on failing social infrastructure and health institutions already dealing with the effects of compounding disasters-posthurricane pandemic life amidst ongoing earthquakes. 29,30,31 False Promises Despite Puerto Rico's intended role as a Cold War "showcase for democracy" 32,33,34 and US-style capitalism, the archipelago's more than 120 years as a US territory have significantly contributed to the contemporary health crisis, which is characterized by hospital closures, a mass exodus of health professionals, poor health outcomes, and the imposition of fiscal austerity measures to curb public spending on health care and education. 35 In response to the large public debt, and given that Puerto Rico is excluded from bankruptcy protections under chapter 9 of the US Code of Federal Regulations, Congress authorized the 2016 Puerto Rico Oversight, Management, and Economic Stability Act (PROMESA), 36 which called for the creation of a Financial Oversight and Management Board (FOMB) for Puerto Rico to oversee Puerto Rico's finances.…”

mentioning

confidence: 99%

How Is Colonialism a Sociostructural Determinant of Health in Puerto Rico?

Pérez-Ramos

Garriga-López

Rodríguez-Díaz

2022

AMA Journal of Ethics

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Puerto Rico is experiencing a public health crisis driven by effects and processes of US colonialism in the archipelago, such as the exclusionary application of federal health policy, an exodus of health care professionals, and the long-term effects of unequal distribution of health care funding in the unincorporated territories. Compound effects of multiple disasters, including Hurricane María, repeated earthquakes, and the COVID-19 pandemic, as well as relentless privatization and fragmentation of the health care system, have led to very poor health outcomes. Puerto Rico's case clearly shows the negative effects of colonialism on public health. This article specifies what decolonization requires from a public health standpoint to promote health equity. Public Health in Puerto RicoPuerto Rico has been experiencing a public health crisis since the 1990s, driven by limited resource allocation for preventive health care for residents of Puerto Rico, austerity policies in response to a massive debt crisis, and primary care privatization. 1,2,3 Compared to other jurisdictions in the United States, Puerto Rico has worse health outcomes, such as higher rates of preterm births, asthma, diabetes, cardiovascular disease, HIV/AIDS, gender-based violence, food insecurity, incarceration, and homelessness, among other outcomes. 4,5 Colonialism is literally killing Puerto Ricans.

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Qualitative Assessment of Environmental Health Risk Perceptions and Community Challenges in a Puerto Rican Community: Change and Continuity in Response to Hurricanes Irma and María

Cited by 5 publications

References 48 publications

Attitudes Toward the Environment and Use of Information and Communication Technologies to Address Environmental Health Risks in Marginalized Communities: Prospective Cohort Study

Attitudes Toward the Environment and Use of Information and Communication Technologies to Address Environmental Health Risks in Marginalized Communities: Prospective Cohort Study

Social cohesion and self-governance arrangements among small-scale fisheries in Puerto Rico

How Is Colonialism a Sociostructural Determinant of Health in Puerto Rico?

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