A new study has confirmed that residents of Puerto Rico on average are more likely to have poor health than people living in the states. In the states, the percentage of people reporting poor health is 16.1%, while 27.8% describe themselves as in poor health in Puerto Rico. While there are many factors in play and many ways to respond to this news, it is disingenuous to pretend that the territorial status is not part of the equation. We need to acknowledge the health benefits of statehood.

Prosperity

Every territory which has become a state was more prosperous after statehood than before. Some of the territories faced famine and war during their histories; none have had to deal with such crises during statehood. There is no reason to think that Puerto Rico will be different.

Prosperity has a strong connection with health. Puerto Rico has a poverty rate of 43%, compared with the U.S. rate of  11%. What’s more, Puerto Rico has a wider gap between the have and the have-nots than there states do. We should not pretend that this difference has no consequences. Some of the effects of greater prosperity on health:

  • Access to quality healthcare: Prosperous regions typically have more advanced and accessible healthcare systems.
  • Better living conditions: Economic stability allows people to afford safe housing, nutritious food, and other essentials that contribute to good health.
  • Education and awareness: Higher levels of education often correlate with greater health literacy and healthier lifestyle choices.
  • Reduced stress: Economic security can reduce stress levels, which has a positive impact on both mental and physical health.

Poverty, on the other hand, can lead to poorer outcomes:

  • Malnutrition: Lack of access to affordable, nutritious food can lead to deficiencies and related health issues.
  • Infectious diseases: Overcrowded living conditions, poor sanitation, and a lack of safe drinking water increase the risk of infectious diseases.
  • Chronic diseases: Poverty is associated with higher rates of chronic conditions like heart disease, diabetes, and asthma. We see this in Puerto Rico.
  • Mental health disorders: The stress and instability of poverty can contribute to depression, anxiety, and other mental health problems.
  • Substance abuse: Abuse of alcohol and drugs can be a coping mechanism for the stresses of poverty
  • Increased infant mortality: Poverty is a major risk factor for infant mortality and poor health outcomes for children.

Puerto Rico is in a better position on these metrics than its neighbors in Latin America and the Caribbean, but does not compare well with the states. The difference is economic, and that would change under statehood.

Inequities

Data is not collected equally in the territories and the states. This means that health information is not always considered in government decisions about Puerto Rico.

Territories can, under the U.S. Constitution, be treated differently from states. While states must be treated equally, Congress can give less to Puerto Rico — and usually does. Funding for healthcare, health-related grants, health services, training for medical professionals, infrastructure to support medical facilities are all affected by this problem.

Since Puerto Rico has no senators and no voting members of Congress, the Island has fewer people with the power to stand up for Puerto Rico when negotiations about resources take place in the federal government.

These are the realities of life in a territory. It is not something about Puerto Rico. It is something about the colonial relationship between the mainland and the Island. It’s time for this to end. Puerto Rico is ready for the rights and responsibilities of statehood. Reach out to your legislators and make sure they understand that their voters want statehood for Puerto Rico.

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