Colonialism as a Social Determinant of Health in Puerto Rico: Using the Socioecological Model to Examine How the Jones Act Impacted Health After Hurricane María

Introduction: Puerto Rico is a territory of the United States, making Puerto Ricans vulnerable to damaging colonial policy. The purpose of this article is to utilize the socioecological model (SEM) to evaluate how the Jones Act impacted Puerto Rico after Hurricane María, examining colonialist policy as a social determinant of health (SDOH) in Puerto Rico. Methods: Levels of the SEM used in this examination included: individual, institutional, community, policy, and context. Results: Evaluation of the Jones Act using the model demonstrated relationships between all socioecological levels. The Jones Act caused delays and increased prices for goods needed to rebuild community utility infrastructure, which led to extended closures of institutions like workplaces, schools, and hospitals, and ultimately contributed to increased acute and chronic physical and mental illness among Puerto Ricans. Discussion: This evaluation establishes that colonialist policy negatively impacts the health of Puerto Ricans, positioning colonialism as an SDOH.