The overarching theme of my research is the interruption of cycles of trauma. Within that umbrella, I have studied child sexual abuse, the child welfare system as a traumatic experience, and currently I am using the theoretical framework of historical trauma to explore high asthma prevalence among Puerto Ricans. Historical trauma has not yet been applied to Puerto Ricans in the literature, and as such, serves as the first goal of my dissertation study. The second goal of the project is to understand the experience of asthma for those who lived through the 2017 hurricanes in Puerto Rico, and subsequently migrated to the States through the lens of historical trauma.
Puerto Ricans have the highest prevalence rates of asthma in the United States compared to every other racial/ethnic group. What is known about prevalence rates, risk and protective factors, and epidemiology is understood at a population level and many questions remain. Puerto Ricans are a heterogeneous group with multiple aspects playing a role in their identity and experience including place of birth (i.e., Puerto Rico or the US), age of migration for those not born in the US, level of assimilation, and socioeconomic status. My dissertation, Puerto Ricans and asthma: Looking through the lens of historical trauma has two main goals. First is to expand the theoretical framework of historical trauma by applying it to the Puerto Rican experience. Second is to explore associations between the government’s response to the devastation of Puerto Rico by Hurricanes Irma and Maria, participants’ subsequent migration to the U.S. and asthma outcomes for this group.
The government’s response to the 2017 hurricanes in Puerto Rico was very different from its response to Hurricane Harvey in Texas a month prior. This drastic difference is directly connected to the Island’s continued colonial status and the separate and unequal treatment of the Island as compared to individual states. Asthma outcomes may be connected to these experiences in a number of ways, including: stress, inadequate access to medications or electricity following the hurricanes, feelings of land loss, and a new experience of marginalization following migration to the United States.
Moving forward, my research seeks to continue understanding the Puerto Rican asthma experience by using a within groups approach to answer the following questions:
- What effect did the government response to the hurricanes have on asthma symptoms for those who remained on the Island and those who lived in the States at that time? As my dissertation focuses on those who migrated following the hurricanes, these are the other two broad groups of Puerto Ricans I am interested in interviewing early in my career.
- Does age at migration affect asthma prevalence and/or asthma severity? If so, how? Some research shows that migrating at a young age is associated with similarly high asthma prevalence as being born in the U.S., but migrating as an adult is associated with lower prevalence rates.
- Does the specific location that Puerto Ricans migrate to in the United States play a role in asthma prevalence and/or asthma severity? Research with other Latinx groups have shown lower asthma rates for those who migrated to an ethnic enclave. Though Puerto Ricans were excluded from that study, it is possible that a similar pattern could exist.
- Are there differences in the asthma experience for Puerto Ricans in each of the U.S. areas with large communities (i.e., New York, Florida, California)? If so, has that changed over time and are there differences in risk/protective factors associated with each area? These questions consider whether Puerto Rican populations in different areas of the United States, each started under different conditions, have any relationship to asthma outcomes.
Future research will draw on social media as a recruitment tool to reach some of the sub-populations required to answer the above questions. Additionally, I will seek out the local Puerto Rican community and partner with them on community projects. Together, these two methods of recruitment and relationship-building allow me to reach a broader audience than either one does separately.