The U.N.’s Economic Commission for Latin America and the Caribbean (ECLAC) held a virtual meeting to discuss the economic consequences of chronic diseases in the Caribbean. Puerto Rico was one of the locations covered.
“The high prevalence of non-communicable diseases in the Caribbean – such as high blood pressure, diabetes and cancer – is exacerbating the impact of the COVID-19 pandemic and hindering the subregion’s progress towards achieving sustainable development due to their multiple health, economic and social consequences,” said Alicia Bárcena, Executive Secretary of ECLAC.
In Puerto Rico, more than half of all deaths are caused by chronic diseases of this kind. In 2010, deaths from heart diseases, cancer, diabetes, Alzheimer’s disease, and stroke accounted for more than 57% of all deaths.
Chronic diseases also contribute to disability. Fully one third of Puerto Rican adults have diabetes, and more than 18% have arthritis. 17% report having asthma at some point in their adult lives.
The high rate of chronic disease in Puerto Rico is exacerbated by poverty, but it also has economic consequences.
Poverty is strongly associated with high rates of chronic disease in Puerto Rico. Recent research found that the rates of chronic diseases in general were significantly higher in households with incomes of $15,000 per year or less than in more affluent households with incomes of $50,000 or more.
Poor nutrition associated with poverty is a contributing factor to these non-communicable diseases. In addition, tobacco use and lack of physical activity are associated with chronic diseases. These diseases increase vulnerability to COVID-19 as well.
The economic consequences of these health care issues include reduced workforce participation and increased healthcare costs.
Chronic diseases result in disabilities which keep people out of the workforce. According to the CDC, 21% of adults in Puerto Rico have serious mobility limitations,
While the question of disability benefits is currently being considered by the Supreme Court, at present people living in Puerto Rico are not eligible for Supplemental Security Income. Many recipients of SSI are elderly, but others are unable to work because of long-term disabilities. In the States, they receive federal financial assistance which is not available in Puerto Rico.
Since Puerto Rico’s access to federal health care funds is also limited, the high levels of chronic disease create financial burdens for the territory. More than half of Puerto Rico residents are eligible for Medicaid, though the federal Medicaid funds provided to the territory do not come close to covering the costs of healthcare for eligible residents.
A Puerto Rico Chronic Disease Action Plan published in 2014 focused on collecting data, developing chronic disease self-management education and intervention plans in community settings, and working to increase access to nutritious food and healthful activity.
The ECLAC Plan for self-sufficiency in health matters sees strengthening the healthcare industry as a way to improve the economic position of Puerto Rico and its neighbors while also improving health outcomes. It involves increasing manufacturing capacity in the region, creating a network of clinical trials, and developing primary health care locally.
“To procure a resilient post-pandemic recovery, Caribbean countries need a healthy and productive workforce,” said Bárcena.
At the same time, the ECLAC plan acknowledges that “The ultimate goal of regional self-sufficiency in health matters will require substantial investment in resources in the medium and long terms.”