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Member Research and Reports

Member Research and Reports

GW Researchers Finds Puerto Rico, U.S. Virgin Islands Health Centers Treating Patients with Complex Needs

One year after Hurricanes Maria and Irma made landfall in Puerto Rico and the U.S. Virgin Islands (USVI), community health centers report a surge in patients and patients who are more likely to present with serious physical and mental health problems. Nearly three quarters of community health centers report a growing demand for services, with some reporting an increase of more than 10 percent in the number of people seeking care.

The research, based on a comprehensive survey of the islands’ health centers, was conducted by the Geiger Gibson/RCHN Community Health Foundation Research Collaborative, which conducts extensive research into community health centers and the populations they serve as part of the George Washington University Milken Institute School of Public Health’s (Milken Institute SPH) Geiger Gibson Program in Community Health Policy.

Nearly all health centers (86 percent) reported that patients are more likely to present with depression and anxiety, including post-traumatic stress disorder, compared to before the hurricanes. A substantial percentage also reported that patients were more likely to have poorly managed chronic conditions, respiratory conditions such as asthma, alcohol or other substance use disorders, and suicidal thoughts or attempts.

Most health centers report being able to maintain or increase essential staffing since the hurricanes, but ten percent or more report losing physicians, nurses, mental health staff, substance use disorders staff, dental staff, outreach workers, and other enabling services staff. Health centers were particularly likely to report care shortfalls with respect to dental care, offsite and mobile care, mental health care and substance abuse services.

The new report and survey also complement a study released in August by another team of researchers at Milken Institute SPH, which found an estimated 2,975 excess deaths in Puerto Rico in the six months following Hurricane Maria.

“This report underscores that although the early mortality studies, such as the one published by our school, provide absolutely critical understanding of the most extreme near-term consequences of the disaster, of vital importance will be ongoing epidemiologic and public health research that can measure changes in health over time,” said Ms. Sara Rosenbaum, JD, the Harold and Jane Hirsh Professor of Health Law and Policy at Milken Institute SPH, one of the authors of the report. “In this regard, the experiences of health centers in the wake of the storm offer invaluable insight into the nature of problems to come.”

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