ISE Faculty Ramirez-Rios and Wallace receive research award from Natural Hazards Center

The project entitled, “Exploring How Transportation Access to Healthcare Impacts Social Vulnerability in Puerto Rico,” was selected for funding to explore the transportation-related healthcare access conditions that affect the social vulnerability of Puerto Rican communities.

The purpose of this research is to understand how the transportation of people to healthcare facilities and services in Puerto Rican communities following a natural disaster is related to their social vulnerability. These considerations include the available capacity of roads and highways, hospitals and other medical facilities, and the availability of medicine, medical equipment, and medical care personnel. By understanding the transportation-related factors that impact social vulnerability, this study could provide sound recommendations that will impact public health among communities in Puerto Rico.

In preparation for a disaster, optimal access to healthcare is imperative. Yet, when a community is hard hit by natural disasters, such as in Puerto Rico, their options reduce substantially. The latter is because disasters cause infrastructure damage, make resources like fuel, electricity, and potable water extremely limited, and put the population at risk. Public health strategies—including the allocation of external aid, distribution of medicine, and evacuation decisions—heavily rely on the quality and capacity of transportation networks. Thus, transportation plays a key role in the public health response.

This research employs a mixed-methods approach to study the transportation access to healthcare in Puerto Rico. Through a quantitative analysis of publicly available data, this study seeks to understand how the lack of access to healthcare affects social vulnerability. In addition, fieldwork data collected from in-depth interviews with key stakeholders and focus groups with the community enables the research team to propose potential public health strategies that tackle the most urgent needs of socially vulnerable groups in response to a disaster.

As part of the fieldwork, the team will conduct a series of focus groups with members of the community in two locations. One location will be a remote, hard to access, community (i.e., Vieques or Utuado). The second one is a community near an urban area, where its residents have higher access to healthcare (i.e., Manatí). During this activity, participants will be invited to share their personal experiences after a disaster event (i.e., Hurricane Maria), if and how they were affected by the lack of access to a health facility or service and ways they confronted those situations. They will also be presented with hypothetical scenarios of a disaster that caused a health emergency and will be asked about their reactions to decisions made by public health officials. The latter will provide the team with how certain public health strategies are better received by the community, and which strategies are clearly unacceptable. These strategies include transportation of people from their homes to a nearby shelter that offers medical attention, the delivery of emergency medical care directly to the communities (e.g., use of mobile clinics), the evacuation of people out of the island, road clearance and other infrastructure access repairs.