José Celso Barbosa was the first Puerto Rican to graduate from medical school in the United States. He was also the father of the statehood movement. There is a connection, and it comes down to the social determinants of health (SDOH), a modern concept that applied just as clearly in Puerto Rico during Celso Barbosa’s time.
Social determinants of health
The modern idea of the social determinants of health includes five non-medical aspects of life that affect people’s health:
- Economic Stability
- Education Access and Quality
- Health Care Access and Quality
- Neighborhood and Built Environment
- Social and Community Context
Celsa Barbosa’s legacy
Celso Barbosa cared about economic stability for his patients and for the people of Puerto Rico. He established the first credit union in the Western hemisphere, “El Ahorro Colectivo”, in 1893. The worker’s cooperative was intended to help workers band together to provide financial services which otherwise were not available to them. He worked toward economic justice for Puerto Rico, and his commitment to statehood was part of that. He could see that, as a state, Puerto Rico would have economic capacity and control over its resources unavailable to the territory.
Education was also extremely important to Celso Barbosa. In addition to his medical practice, he taught anatomy, natural history, obstetrics and midwifery at Ateneo Científico y Literario and served as Undersecretary of Education for the territory. His political writings were also intended to educate readers on topics such as civil rights and political action, as well as statehood.
Health care access and quality was clearly close to his heart. Celso Barbosa persuaded employers to pay ahead for the future healthcare needs of their workers. This amounted to an early form of health insurance.
The good doctor established the Parque Dr. José Celso Barbosa and advocated for improved infrastructure for Puerto Rico, recognizing that connections with nature and community along with an improved standard of living can all make a difference to residents’ health. In Dr. Barbosa’s time, just as it is today, territories receive less support for infrastructure than states do — and that continues to be a good reason to choose statehood.
Social and community context was central to Celso Barbosa’s life. His personal experience of racism — including a rejection from the first medical school he applied to — made him passionate about advocacy for equality and justice across the board. He worked for universal suffrage,
He read and admired the works of Frederick Douglass, W.E.B. DuBois, and Booker T. Washington. In his life and work he championed equal rights and opportunities for all. “We want and we ask for equality,” he said. “Not colonialism or protection. Since the American Flag first waved over Puerto Rico, those have been the ideals that we have defended.”
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