A Comprehensive Hazard and Vulnerability Assessment of Puerto Rico's Public Health, Medical and Mental/Behavioral Health Systems

Background: Conducting a comprehensive Hazard Vulnerability Assessment (HVA) is critical to identify potential disasters that could impact the demand for public health, medical, and mental/behavioral services, and the ability to provide these services to the population. Since each hazard is different, associated risks must be analyzed to prioritize preparedness, mitigation, response and recovery activities.

Objectives: Describe potential hazards, vulnerabilities and risks faced by Puerto Rico’s public health, medical, and mental/behavioral health systems.

Methods: The Hazard Risk Assessment Instrument (HRAI) developed by UCLA (2006), translated into Spanish, was used to determine the occurrence of five hazards with the highest probability score. Key public health, medical, mental/behavioral health and subject matter experts were interviewed to obtain their input and assistance in identifying Puerto Rico island-wide hazards. Puerto Rico’s vulnerability was assessed according to the severity of the impact of the hazards on four indicators: human impact, interruption of healthcare services, com­munity impact, and impact on public health agency infrastructure. Results: Epidemics/pandemics, floods, hurricanes, earthquakes, and tsunamis were identified as potential threats that could severely impact Puerto Rico’s public health, medical, and mental/behavioral health systems.

Conclusion: The disasters assessed have the potential to immediately overwhelm the Puerto Rico’s public health resources exposing deficiencies at various levels of the disaster preparedness, response and mitigation phases. It is important that national emergency plans are based on a comprehensive hazard vulnerability assessment; this will allow proper planning which in turn provide a good distribution of resources in case of a disaster.