Factors that support public health infrastructure recovery in Puerto Rico and US Virgin Islands after Hurricanes Irma and Maria.

This paper describes the factors that support recovery of public health infrastructure (PHI), including conditions that facilitated or hindered recovery in United States (US) territories impacted by hurricanes Irma and Maria. A deductive approach was used to categorize data from five organizations that received crisis hurricane recovery (CHR) funds from the Centers for Disease Control and Prevention.* Spending was grouped into five infrastructure gaps: (1) human resources, (2) informatic upgrades, (3) equipment, (4) minor repairs, and (5) preventive maintenance. Unanticipated PHI costs, facilitators, and hinderances to PHI recovery were identified. Most (72 percent) of the $53,529,823 CHR funding was used to address infrastructure gaps in (1) human resources (56 percent), (2) informatics (16 percent), (3) equipment (13 percent), (4) minor repairs (10 percent), and (5) preventive maintenance (5 percent). Most of the requests (56 percent) to redirect funds were associated with unanticipated costs in initial work plans and budgets. The use of administrative partners, planning tools, dedicated staff, streamlined procedures, eg, contracts, and cost sharing facilitated PHI recovery. The most common hindrance to PHI recovery were delays in procurement and shipping. In summary, investments in dedicated funding to upgrade, repair, or replace critical structures and systems for infectious disease surveillance, laboratory capacity, vector control, environmental health inspections, and vaccine storage and administration in Puerto Rico and the US Virgin Islands after Hurricanes Irma and Maria contributed to their recovery capacity. These findings may inform funding and resource allocation considerations for PHI recovery in the US territories.

Descriptive profile of people with diabetes who use the Puerto Rico Quitline.

OBJECTIVE: To provide a descriptive profile of the people with diabetes (PWD) who received the services of the Puerto Rico Quitline (PRQ) during 2008, compared to non-diabetic people (NDP) to establish a significant statistical difference. METHODS: Using a cross-sectional study methodology, the Quitline database was analyzed. Ninety-four percent of the 1,137 people who received the services of the PRQ during 2008 and completed all the interviews were included in the analysis. Frequency distributions and means calculation were performed to describe the PWD. Chi-square tests, odds ratio, t test and 95% confidence intervals were calculated to identify statistically significant differences between the PWD and NDP. RESULTS: Nearly 11 percent (10.9%) of the people who received the services of the PRQ during 2008 and completed all the interviews reported a diabetes diagnosis. Health conditions were reported by 95.7% of PWD vs. 62.3% of NDP (P < .01). People with diabetes were more likely to have hypertension (P < .01), circulatory problems (P < .01), and respiratory infections (P = .02) than NDP. They also reported a higher mean number of smoking years than the NDP (P < .01), but the PWD were less likely to use menthol cigarettes Sthan NDP (P =.01). A physician's recommendation is the only reason for trying to quit smoking with a statically significant difference between the PWD and the NDP (P = .02). The mean number of alcoholic beverages consumed per day for the PWD was 8 and for the NDP it was 5 (P < .01). CONCLUSION: This study provides important evidence that can help increase the chances of success in the smoking cessation process in the PWD who access the services of the Quitline program.