3. Tobacco use
Smoking was reported to be lower among Hispanic women overall (13.8 percent) than among many other groups, especially African-Americans (21.9%) and Whites (23.5%). However, Puerto Rican women smoke at a rate of 21%. Only 5.8% of Hispanic women report smoking during pregnancy; the reported rate among Puerto Rican women during pregnancy is higher. However, smoking among young Hispanic women, including Puerto Rican women, is lower than for White or African-American young women.
Among women who smoke, Puerto Ricans were more likely to be heavy smokers than others (48.6% smoked more than 1/2 pack per day).
Overall, among Hispanic men, the smoking rate is 26%, as compared with 27% for White men. It is not clear whether the same rates apply for Puerto Rican men. Tobacco use is disproportionately promoted in minority and Hispanic neighborhoods, including Puerto Rican neighborhoods.
4. Substance abuse
A 1984 study of adolescent drinking in Puerto Rican communities suggested a lower rate of alcohol use and abuse in this population. However, problem drinking increased when adolescents left home. The same study found that problem drinking was substantial among mothers.
5. Responsible sexual behavior
In the continental U.S., Puerto Rican adolescents have a relatively high rate of pregnancy among unmarried mothers, higher than for other Hispanic groups or for white women. These women tended to be poorly educated, and to have limited access to early pre-natal care.
Puerto Ricans have been reported to be at greater risk of contracting AIDS through sexual contact and drug use than other Hispanic groups. In particular, transmission through drug use is quite high, with heterosexual sexual transmission also much higher than in other groups. Prevention strategies must focus on the values and beliefs of the group, and recognize their particular modes of transmission (e.g. the relative popularity of "shooting galleries").
6. Mental health
Among Puerto Rican children in the mainland U.S., rates of depression are reported to be low. This finding is in conflict with reports that in Puerto Rico, the rate of childhood depression is higher than in the U.S. (35% as compared with 9%). Overall, Latino adults report lower rates of psychological problems than the U.S. population overall, although rates of psychological problems among Puerto Ricans are somewhat higher than for other Latino groups. Problems included in the survey reporting these data included affective disorders, substance abuse, and anxiety disorders.
Latino children and youth may have somewhat higher rates of psychological and behavioral problems than the population generally. They have been reported to have relatively high rates of suicidal ideation and depression.
7. Injury and violence
Puerto Rican individuals have relatively high rates of death from poisoning, unintentional injuries, and motor vehicle accidents. They also have relatively high rates of injury from falls, fire, and homicide.
The problem of violence is pronounced among Latino adolescents. A report from Minnesota indicated that 19% of ninth graders had reported being threatened at school during the most recent year. 10% of Latino students reported missing school because of anxiety about violence.
8. Environmental quality
No data could be located to describe environmental quality issues for individuals of Puerto Rican descent. This group does have a disproportionately high rate of poverty, and poverty is associated with an array of environmental problems, for example, living in buildings near brownfields and near industries producing toxic wastes. In addition, the high rate of unintentional injury may be associated with living in buildings that are substandard in construction or maintenance. Because at least 40% of Puerto Rican children in the U.S. live in poverty, they are very likely to live in areas with poor environmental quality.
9. Immunization
Precise data about immunization rates were not identified. However, research and extant data bases make clear that poverty, poor access to health care, and single parent family structure all contribute to low rates of immunization. It seems possible that this is true for Puerto Rican infants, whose parents have the added dilemma of language barrier in many instances.
On the island of Puerto Rico, as elsewhere, efforts to provide access to immunizations have been instituted. Many of these, particularly those that are attentive to language and culture, seem to be relatively successful.
10. Access to health care
It is generally true that minority Americans have a more difficult time accessing healthcare than white citizens. This applies to Puerto Rican individuals as it does to most other minority groups.
In 1984, Puerto Ricans were reported as having the lowest rate of health insurance at 40% of the population. By 2000, the number had been reduced to 33%, still much higher than the 14% reported in the population of the U.S. overall. At least 25% of Puerto Ricans report failure to receive needed care within a 12 month period. Preventive care, such as pap smears, cholesterol testing, or blood pressure checks are particularly difficult for Puerto Rican individuals to obtain.
Latinos as a group tend to underutilize health services, especially mental health care. Barriers encountered include economics, language, and cultural factors. Individuals of Puerto Rican descent believe that their care would be better if the provider were also Puerto Rican.
