Resilience of environment, infrastructure, communities, and governance in Puerto Rico after Hurricane Maria and the need for community empowerment to develop decentralized, nature-based solutions to sustainability.

Collapse of electric and water infrastructure throughout Puerto Rico with Hurricane Maria is well documented but assessment of interactions among environment, infrastructure, and society is lacking. A classification system is developed to assess the resilience of each component based on principles of ecosystem responses to long-term and unexpected environmental change. All infrastructure sectors have experienced long-term decline because of a patch and stabilize approach that excludes strengthen and innovate. Maria was the tipping point for system collapse. The weakest sector, however, is governance and an inability to change direction from traditional centralized, engineered approaches incapable of meeting current or projected changes in resource availability and societal needs. The two most resilient sectors are environment and human communities. Their strong interrelationship is key to developing decentralized, nature-based solutions to address immediate and projected threats to resiliency and sustainability of communities in Puerto Rico. Still in its infancy, community ownership of the water-energy-food Nexus shows a great promise for island.

Contextualizing the COVID-19 Era in Puerto Rico: Compounding Disasters and Parallel Pandemics.

OBJECTIVES: The COVID-19 outbreak has worsened the ongoing economic crisis in Puerto Rico by creating "parallel pandemics" that exacerbate socioeconomic and health inequalities experienced by its most vulnerable residents. Unfortunately, conditions on the island have been largely overlooked by national media outlets and the mainland U.S. population. Thus, this research report aims to draw attention to the disparate burden multiple and compounding disasters have on older island-dwelling Puerto Rican adults' health and well-being. METHODS: We characterize the lived experiences of the older population in Puerto Rico by incorporating data from multiple sources and contextualizing the effects of compounding disasters, the fiscal pandemic, and health care challenges to provide a more nuanced portrait of existing compounding factors that negatively affect the health and well-being of older adults in the era of COVID-19. RESULTS: We highlight 2 main factors that exacerbate pre-pandemic inequities experienced by the older adult population amid the COVID-19 pandemic in Puerto Rico: (a) the impact of multiple and compounding disasters; and (b) health care challenges. DISCUSSION: The human suffering of the Puerto Rican population is compounded by the consequences of fiscal austerity, increasing levels of income and wealth inequality, the debt crisis, significant emigration, and a dysfunctional health care system. Future governmental actions are required to lessen the burden of parallel pandemics on older adults in Puerto Rico.

Life Expectancies With Depression by Age of Migration and Gender Among Older Mexican Americans.

BACKGROUND AND OBJECTIVES: Prior studies examining depression among older Mexican Americans suggest both women and immigrants are at higher risk of depressive symptomatology than males and U.S.-born Mexican Americans. We use data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly to examine whether life expectancy with depression and without depression varies by nativity, age of migration, and gender. RESEARCH DESIGN AND METHODS: Sullivan-based life tables were used to estimate depression life expectancies among Mexican Americans aged 65 years and older residing in the Southwestern United States. Depression is based on the 20-item Center for Epidemiological Studies Depression scale (CES-D). The CES-D is a continuous scale (0-60) with higher values indicating worse mental health. We dichotomize depression as a score of 16 or greater. RESULTS: Immigrant women, particularly those who migrated in late-life (after age 50) are at a significant disadvantage in the number of years after age 65 lived with depression and the ratio of years spent without depression relative to U.S.-born women. Among men, only late-life immigrants were disadvantaged in the number of years spent with depression. Early- and mid-life immigrant males did not differ from U.S.-born males. DISCUSSION AND IMPLICATIONS: Our results highlight the heterogeneity among older Mexican Americans in life expectancies with depression. These findings illustrate the importance of considering age of migration as a high-risk factor for depression among Mexican-origin immigrants. Including this risk factor as a part of depression screening is a key step for timely interventions in preventing disability and comorbidities associated with untreated depression.

Cultural mechanisms in the exchange of social support among Puerto Ricans after a natural disaster.

In this study, I uncovered the dynamics involved in the exchange (or lack) of social support among a group of Puerto Ricans who experienced a natural disaster. I coded and analyzed 12 semistructured qualitative interviews. My analysis of the interviews revealed that a reported high degree of need was not associated with any type of help seeking from the respondents' social support networks. Relevant issues that arose in explaining the lack of social support exchanges were level of comfort in help seeking and cultural issues. My findings point to the importance of culture in shaping patterns of help-seeking behavior in the aftermath of a disaster. Two of the most salient cultural explanations as to why disaster victims were reluctant to ask for help from family and friends were the issues of confianza (trust) and pena (embarrassment). I discuss the results with reference to how they might help in planning and establishing programs to maximize help seeking among Latinos/as in an emergency situation.

Family Cohesion and its Relationship to Psychological Distress among Latino Groups.

This paper presents analyses of a representative sample of US Latinos (N=2540) to investigate whether family cohesion moderates the effects of cultural conflict on psychological distress. The results for the aggregated Latino group suggests a significant association between family cohesion and lower psychological distress and the combination of strong family cohesion with presence of family cultural conflict was associated with higher psychological distress. However, this association differed by Latino groups. We found no association for Puerto Ricans, Cuban results were similar to the aggregate group, family cultural conflict in Mexicans was associated with higher psychological distress, while family cohesion in Other Latinos was associated with higher psychological distress. Implications of these findings are discussed to unravel the differences in family dynamics across Latino subethnic groups.

Contextualizing the experience of young Latino adults: acculturation, social support and depression.

Using a sample of 850 South Florida Latinos from the Miami-Dade county area, this study analyzes the effects of acculturation on the mental health of Latinos by testing whether family support mediates or moderates this relationship. For Latinos social support, particularly family support, is of special interest since it serves an important buffering function in mental health because of the importance of family values in this group. All of these research inquiries are investigated in a context where Latinos represented the majority of the population. Findings suggest a significant relationship between acculturation and depression that was mediated by family social support. Moderating effects were not discovered. The study discusses the importance of social context in analyzing the acculturation-mental health relationship and finds a strong association between gender, education and mental health.