A new study found that people living in Puerto Rico, Guam, and the U.S. Virgin Islands reported worse overall physical health than those living in the states.
This research, led by Anna-Michelle McSorley, assistant professor of allied health sciences at UConn Waterbury, was recently published in JAMA Network Open.
McSorley and her co-author were able to conduct this study because, unlike many federal data collection systems, the Behavioral Risk Factor Surveillance System (BRFSS) includes data from three U.S. territories—Puerto Rico, Guam, and the Virgin Islands.
“That is something that is pretty unique,” McSorley says. “That was the motivation for this paper. I found a data system in which [these populations are] represented, and I have the opportunity to tell a story about some key health-related quality of life indicators for those particular regions of the United States.”
In a previous Viewpoint article, McSorley and co-authors found that territories are often not included in federal data systems for several reasons. In some instances, a state or territory must apply to the federal government for funding to conduct the work at the local level. The work must align with the methodological standards set by the Centers for Disease Control and Prevention. However, territories are not always eligible for these grants, and even when they are, it is not always clear if they can apply.
McSorley identified significant disparities in the percentage of people living in the territories who reported having fair/poor general health compared to the states. In the states, this percentage is 16.1%, compared to 17.7% in Guam, 18.6% in the U.S. Virgin Islands, and 20.9% in Puerto Rico.
In the U.S. Virgin Islands, the percentage was 11.7%, and in Puerto Rico, it was 12.8%. McSorley noted that Puerto Rico showed the most disparities compared to the 50 states. Despite this, both the territories and states had similar levels of people reporting poor mental health outcomes. McSorley plans to extend her work on the 988 mental health crisis hotline in the states to include the territories, given the high prevalence of poor mental health in all jurisdictions she examined. Her efforts aim to address the lack of data inclusion for U.S. territories in federal data collection systems. She will share her findings with territorial health officials and continue advocating for territorial data equity, especially as federal databases are being removed under the current administration.
