A recent study has uncovered troubling health disparities between people living in Puerto Rico, Guam, and the U.S. Virgin Islands compared to their counterparts in the mainland United States, with residents in these territories reporting significantly worse overall physical health.
Led by Anna-Michelle McSorley, an assistant professor of allied health sciences at UConn Waterbury, the study was published in the Journal of the American Medical Association. McSorley and her co-author utilized the Behavioral Risk Factor Surveillance System (BRFSS), a unique data collection system that includes information from these U.S. territories, to highlight key health-related quality of life indicators.
McSorley emphasized the importance of utilizing such data, stating, “That is something that is pretty unique. 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.”
This groundbreaking research sheds light on the often-overlooked health issues faced by residents of U.S. territories. In previous studies, McSorley and her colleagues noted that territories are frequently excluded from federal data systems due to several reasons. For instance, territories often must apply for federal funding for local data collection, which may not always align with the methodological standards set by the Centers for Disease Control and Prevention.
As a result, these regions frequently miss out on essential funding and resources, leaving a gap in their representation in health-related data. The latest findings reveal significant disparities in health outcomes, particularly highlighting that 16.1% of individuals in the states reported fair or poor general health, compared to 17.7% in Guam, 18.6% in the U.S. Virgin Islands, and a strikingly high 27.8% in Puerto Rico.
“From the data that I saw, it was pretty remarkable to note that Puerto Rico had the most disparities when compared to the 50 states,” McSorley noted.
Interestingly, while physical health disparities were stark, mental health outcomes showed a different trend, with similar levels of poor mental health reported across both territories and the states. Puerto Rico experienced 12.8% reporting poor mental health, followed closely by 12.4% in Guam, 11.7% in the U.S. Virgin Islands, and 14.9% in the mainland states.
“There actually wasn’t this stark disparity,” McSorley explained. “There were quite poor mental health outcomes when looking at all three territories compared to the United States, which was also pretty alarming, and it indicates that there’s a need to really increase attention to mental health at a population level for the United States overall.”
These findings underscore the urgent need for focused initiatives to improve mental health services, particularly in the territories. McSorley announced plans to build on her work concerning the 988 mental health crisis hotline, aiming to extend its impact beyond the states to include the territories. “Finding that the pattern of poor mental health is high for each of the jurisdictions that I looked at provides further evidence for the need to dig into that area,” she stated.
McSorley has dedicated years to addressing data equity issues concerning U.S. territories, and this current research is part of her initiative to bolster the inclusion of territories in federal data systems. “This is a baseline-level attempt to insert these data into the literature because they’re often missing,” she remarked.
If data is absent, it hampers the ability to portray the health characteristics of these populations accurately.
As a member of the Data Capacity Subgroup for the Association of State and Territorial Health Officials, McSorley plans to share her findings with health officials in the territories and aims to contribute further to reports that advance territorial data equity.
In light of recent cutbacks in federal databases under the current administration, the timing of this study’s release is critical. McSorley pointed out that, as of now, the BRFSS has not been removed, underscoring the importance of capturing these findings while they can still be documented.
“It’s really important to be able to add this to the literature at this time to describe some of the findings that are present within systems that traditionally have been publicly available, and we’re not certain for how much longer they might be,” she added.
Conducted at UConn Waterbury, this research aligns with CAHNR’s Strategic Vision areas that focus on enhancing health and promoting diversity, equity, inclusion, and justice. As awareness of these disparities grows, McSorley’s work highlights the crucial need for ongoing attention to health inequities within U.S. territories.
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