¡Estamos Bien, Puerto Rico!
Young Adults and the Impacts of Compounding Disasters
Publication Date: 2022
Over the past four years, residents of Puerto Rico have experienced three major compound disasters, known locally as the “Dire Trio:” Hurricane Maria in September 2017, earthquakes in late 2019 and early 2020, and the ongoing COVID-19 pandemic of 2020-21. This study focuses on college students and recent college graduates in Puerto Rico and how the Dire Trio affected their mental health and well-being. More specifically, we explored the disasters’ effects on their physical and mental health, family and community stability, future plans, and resilience. Young adults can be particularly vulnerable to long-term negative outcomes following disasters, because these events so often interrupt critical periods in their life-course, such as finishing their education and entering the workforce. But young people also have other capacities that can make them resilient and important contributors to community recovery. It is particularly important to understand this group in Puerto Rico, as the archipelago struggles to rebuild its economy and communities, because the future of the island will be shaped significantly by the decisions young people make in the coming years. To understand this group’s post-disaster challenges, capacities, and hopes, we collaborated with Mentes Puertorriqueñas en Acción (MPA), a youth civic engagement organization based in Puerto Rico, to conduct a web-based survey and in-depth interviews with college students and recent college graduates. The surveys and interviews revealed that the young adults expressed attachment and commitment to their homeland despite psychological and economic stressors. However, they suffered direct impacts from the natural disasters, such as loss of electricity, water, homes, and livelihoods, as well as longer-term challenges at home and in their communities.
The archipelago of Puerto Rico is an unincorporated territory of the United States with neither the status of an independent nation nor a state. During the past four years, Puerto Rico has experienced compounding disasters beginning with the landfall of Hurricane Maria in September 2017. While many of the archipelago’s residents were still recovering from the hurricane in late 2019 and early 2020, Puerto Rico suffered a series of earthquakes, mainly affecting the southwestern portion of the main island. Within two months of the earthquakes, Puerto Rico and the rest of the world experienced the public health crisis of the COVID-19 pandemic. These events took place against a backdrop of a long-term economic and financial crisis that began in Puerto Rico in 2006. The economic fragility of the country has been severely worsened by widespread neglect on the part of the U.S. federal government and corrupt officials within the Puerto Rican government and international aid community (Atiles Osoria, 2021). With limited public resources or poorly functioning institutions, Puerto Ricans were severely hampered in their efforts to prepare for and respond to these events, provide support for the recovery, and mitigate future disasters.
A growing body of literature has sought to understand the mental health implications of disaster exposure among Puerto Ricans, particularly in the aftermath of Hurricane Maria in 2017. Studies have shown that for as long as six months after the hurricane, sizable portions of the Puerto Rican population, including those displaced to the continental United States, suffered from major depression, generalized anxiety disorder, posttraumatic stress disorder, suicidality, and neurocognitive disorder (Scaramutti et al., 20191). These conditions were more commonly found among those who were low-income and had pre-existing comorbidities such as mental health disorders, cardiovascular disease, diabetes, neurological diseases, and pulmonary diseases (Carl et al., 20202; Ferré et al., 20193; Jiménez Chávez et al., 20204; Macias et al., 2020; Ramphal, 20185; Scaramutti et al., 2019).
Researchers have also examined the mental health outcomes of Puerto Rican children, adolescents, and young adults who came of age in the context of past natural disasters and socioeconomic hardship. For instance, some studies found that exposure to Hurricane Georges in 1998 among youth was associated with major depressive episodes, ataques de nervios (attack of nerves), and long-term internalizing psychopathology, moderated by variables related to family and peer social environments (Diaz, 19996; Felix et al., 20117; Felix et al., 20138; Rubens et al., 20149). Though studies are more limited, there is also evidence that many Puerto Rican children experienced posttraumatic stress disorder due to a variety of immediate and prolonged stressors associated with exposure to Hurricane Maria, including damage to their own and neighbors’ homes; friends and family leaving the island; food and water shortages; lack of electricity; and perception of their own lives at risk (Orengo-Aguayo et al., 201910). Limited research, however, has explored how cumulative exposure to recent environmental stressors—including Hurricanes Maria and Irma, earthquakes in the southwest corner of the big island, and the COVID-19 pandemic—influence the psychological wellbeing of Puerto Rican young adults between the ages of 21 and 33.
This study is guided by Abramson et al.’s (201011) Socio-ecological Model of Recovery which posits that an individual’s post-disaster recovery cannot be measured by a single indicator alone, but, rather, is the product of multiple interacting factors. These factors include housing stability, economic stability, social role adaptation, physical health, and mental health (Abramson et al., 2010). Mental health and wellness are critical indicators of an individual’s post-disaster trajectory and long-term outcomes. Exposure to disasters has been shown throughout the literature to be associated with a variety of psychological issues, including posttraumatic stress disorder, anxiety, depression, substance abuse, grief, and suicidal ideation (Bonanno et al., 201012; Norris et al., 200213; North & Pfefferbaum, 201314; Goldmann & Galea, 201415). Individuals in a disaster-exposed community exhibit one of four potential post-disaster trajectories of functioning: (1) chronic dysfunction; (2) recovery, defined as “initial elevations in symptoms and distress soon after the target event that only gradually decreases, over the ensuing months”; (3) delayed elevations in symptoms; and (4) resilience, defined as a “relatively stable trajectory of healthy adjustment” (Bonanno, 200416; Bonanno et al., 2010 p.11). Most people follow the resilience trajectory, but a significant number suffer more negative outcomes, especially when their family, community, and other social contexts lack the resources needed to foster resilience (Bonanno, 2004). According to Abramson and colleagues’ (201517) Resilience Activation Framework, resilience is not an individual characteristic, but rather a product of human, economic, social, and political capital at the community and individual level that act as buffers against adverse post-disaster mental health outcomes.
Research Questions and Design
This mixed-methods study was guided by the following research question: How have 2017 Hurricanes Maria and Irma, the 2019 and 2020 earthquakes, and the ongoing COVID-19 pandemic (the “Dire Trio”) affected the mental health and well-being of Puerto Rican college students and recent graduates who have lived through all three disasters? More specifically, we explored the disasters effects on these young college students’ physical and mental health, family and community stability, future plans, and resilience.
We used a concurrent mixed methods design that consisted of a web-based survey and interviews during August 2021. This approach minimizes the weaknesses and maximizes the strengths of each of the research methods used in the study (Johnson and Onwuegbuzie 2004; Tashakkori and Teddlie 1998). Given COVID-19 restrictions, all data collection took place virtually. The survey was conducted using a web-based Qualtrics platform and in-depth interviews were carried out over a HIPAA-compliant Zoom meeting.
Research Partner and Site
Our collaborator, Mentes Puertorriqueñas en Acción (MPA), is a non-profit based in San Juan with the mission of building a community of change agents who make Puerto Rico their life project. MPA engages college students and young professionals in civic action programs that focus on social awareness, networking, and service projects. Most recently, MPA participants were involved in community mobilization recovery efforts and capacity-building activities for nonprofits throughout the archipelago. MPA participants live throughout Puerto Rico, including Vieques. MPA’s reach for 2020-2021 included youth from 29 municipalities distributed mainly in the San Juan metropolitan area, the north, and west of Puerto Rico.
Our collaboration with MPA began in 2018, when Hayward, one of the principal investigators of the study, partnered with the organization to develop an NIH rapid response grant in the aftermath of Hurricane Maria. Although this funding was not awarded, Hayward went on to collaborate with the MPA’s executive director at that time on a small study exploring the aftermath of the disaster on local communities as well as another grant application to engage young adults in post-disaster recovery before the pandemic (Hayward et al., 201918).
In the spirit of a community-centered project, MPA was involved throughout the research process. We collaborated with MPA to draft the grant proposal and the survey for data collection. Specifically, we included survey questions about areas of importance to the organization’s programming such as recent civic engagement, plans for the summer, and impact of pandemic on career or professional development opportunities. Given MPA’s connection to college students and recent graduates throughout the archipelago, they also led the recruitment of the participants via their social media outlets, with a reach of over 10,000 and mailing list of over a 1,000 subscribers. Additionally, MPA reviewed all final protocols to ensure that our materials were culturally responsive and appropriate to the Puerto Rican context.
This study complements and extends the findings from a 2020 survey conducted by MPA. In 2020, MPA surveyed their college student program participants to assess the social, economic, and educational impacts of the COVID-19 mandated quarantine and lockdowns. The survey data from this study provides updated information about the impact on youth of the ongoing COVID-19 pandemic. The interview data provides richly detailed testimonies, or testimonios, about the experiences of Puerto Rican college students and recent college graduates.
The research team consists of a diverse and multi-disciplinary group of both emerging and established scholars across the disciplines of education, sociology, social work, psychology, and public health. The team includes several Latina researchers that identify as first-generation college-degree earners, Disaporican Boricuas, two white women, and the director of MPA, who is a native and lifelong resident of Puerto Rico.
The Co-PI conducted the majority of the interviews in Spanish. As a Disaporican Boricua, her lived experiences, as Collins (2000, p.251) posits, are a “criterion for meaning.” That is, her identity as a Puerto Rican with strong cultural and familial ties to Puerto Rico provided a unique perspective in the collection and analysis of data through a culturally responsive lens to this research (Zuberi & Bonilla-Silva, 2008).
The research team addressed reciprocity from the development of our proposal through our research design and procedures. Reciprocity, broadly, refers to mutual benefit to both researchers and study participants. We compensated each interviewee with a monetary incentive for their time. Further, we prioritized and spent all grant funds in Puerto Rico, which included a stipend to our partner organization, and contracted transcription and translation services with a Puerto Rican professional based in Puerto Rico.
Other Ethical Considerations
There are ethical concerns inherent in post-disaster research, particularly with vulnerable populations. One concern is for potential trauma reactions when asking interview participants to recount their experience during the earthquakes, hurricanes, or COVID-19. To address this concern, the research team was cognizant of potential trauma. One of the lead researchers completed the CONVERGE training modules on ethical considerations in post-disaster research and conducting emotionally charged research and all members of the research team have completed human subjects training which includes research with vulnerable populations. Although no participants shared trauma reactions, we were prepared to work with MPA to make referrals to local community-based mental health providers. Our participants were very open to sharing their anxiety and other mental health reactions after the natural disasters and during the pandemic. However, none of the participants indicated that they were distressed during the interviews. In fact, some participants said that talking about their shared experience with others helped them process feelings of stress and anxiety.
Recruitment and Consent Procedures
Following procedures and guidelines approved by Stony Brook University’s IRB, prospective participants were sent a link to an electronic survey that was available in both English and Spanish. The Qualtrics survey link included a copy of the consent form, in both Spanish and English, and the measures described below in the quantitative methods section. At the end of the survey, all participants were invited to participate in a follow-up interview. Participants who were interested in an interview provided their contact information to express their interest. The research team then contacted them to schedule the interview for a mutually convenient time. Verbal consent was obtained from each participant before each of the virtual interviews. Interviewees were provided with an incentive of $50.00 for their participation.
Out of the 68 study participants that completed the survey, 26 conveyed their interest in being interviewed in the last question of the survey. The bilingual lead researcher reached out to all of the prospective interviewees via email during the two-week period after the closing of the survey. The email, written in Spanish, indicated the purpose of the study and the interview, anticipated length, information about compensation, and logistical information such that it would take place virtually on a HIPAA secured Zoom platform at a mutually convenient time.
The study sample consisted of a total of 68 young adults who completed the survey and a subsample of 10 who participated in interviews. Eligible participants met the following inclusion criteria: (a) identified as a resident of Puerto Rico; (b) current or recent college student; (c) lived in Puerto Rico for the past four years or more; and (d) willing to participate in the research study. We focused on current and recent college students because this is the population that MPA exclusively works with in their programming. Out of the total sample, 46 young adults indicated their gender, with 61% who identified as female, 30% as male, and nine percent as non-binary/gender fluid. They were between the ages of 20 and 33, with a mean age of 24. The young adults were from across the main island of Puerto Rico, including Ponce (South), Moca (West), and Caguas (East), and the majority resided in the metropolitan San Juan area, which includes San Juan, Bayamón, Carolina, and Guaynabo.
The on-line survey was available to potential participants in both English and Spanish. The Spanish translation was conducted by a native Puerto Rican professional based in Puerto Rico. The survey consisted of two standardized scales, closed-ended items, and an open-ended item.
The first set of questions was about respondents’ backgrounds, including standard demographic questions such as age, gender identity, university enrollment status, and residential location. Second, we included a question about the direct and indirect effects of the Dire Trio on respondents, their households, and families. Specifically, the question read, “Puerto Rico has been impacted by major natural disasters in the past 4 years, please indicate how you or your family was affected by each recent disaster,” with choices such as “my home was damaged;” “family member moved to the continental US;” and “reduced work hours or lost job.”
The survey also asked respondents about the impact of the pandemic on themselves as individuals and members of their family. These questions inquired about financial and employment status and any missed opportunities (e.g., internship, educational trip, conference, new employment). In addition, the survey also included an open-ended item to allow survey participants an opportunity to provide any additional information about their experiences: “Please add any additional comments or observations about how the recent natural disasters or the pandemic has impacted your economic or personal situation.”
To assess respondents’ mental health and resilience, we employed two popular scales: the Coping Orientation to Problems Experienced (COPE) Inventory and the Child and the Youth Resilience Measure-Revised (CYRM-R). Both the COPE and CYRM-R have been widely translated and validated across culturally and racially diverse populations (Jefferies et al., 201819; Khawaja, 200820; Miyazaki et al., 200821; Panter-Brick et al., 201822; Yusoff et al., 201023). Spanish versions of both measurement scales, included in the survey, have been previously translated and validated with Latinx populations (Astorga, Landero-Hernandez, González, 2010; Perczek et al., 200024). Each of these scales is described in more detail below.
Coping Orientation to Problems Experienced (COPE) Inventory. The COPE is a multidimensional coping inventory to assess the different ways in which people respond to stress (Carver et al., 199725). The inventory consists of 28 items and focuses on understanding the frequency with which people use different coping strategies in response to various stressors. Sample statements from the scale are: “I’ve been turning to work or other activities to take my mind off things” and “I’ve been concentrating my efforts on doing something about the situation I’m in.” The Likert scale ranges from “0 = I have not been doing this at all” to “3 = I have been doing this a lot.”
Child and Youth Resilience Measure (CYRM-R). The CYRM-R is a 17-item measure of resilience in children and young adults (Jefferies et al., 2018). The screening tool was designed to explore the individual, relational, communal, and cultural resources available to individuals that may support their resilience. Sample items include, “I feel supported by my friends” and “My parent(s)/caregiver(s) really look out for me.” Responses are scored using a five-point scale ranging from one (not at all) to five (a lot), where higher scores indicate greater resilience. The overall sum score is calculated to measure resilience.
Interview Sampling Design and Criteria
All survey participants were eligible to participate in an interview. The last question of the survey invited participants to provide their name and email to express their interest in being interviewed for the study. The statement specified that the interviews would last an hour and that we would provide a $50 incentive for participation.
The interview sample consisted of ten college students and recent graduates. The ten interview participants indicated their gender in the open-ended item, “How do you identify your gender?” as: “they” (one), “female” (five), and “male” (four). They were between the ages of 21 and 29, with a mean age of 25.
The in-depth, semi-structured interviews focused on gaining a deep understanding of the experiences of the college students and recent graduates living through natural disasters and the ongoing COVID-19 pandemic in Puerto Rico. Interviews lasted between 30 and 75 minutes and were conducted during August 2021. The primary interview questions were: “Tell me about yourself” and “Tell me about your experiences living in Puerto Rico during the past four years.”
The majority of the interviews were done in Spanish by the bilingual research team member who identifies as a Boricua from the Diaspora. While the participants were all fully bilingual, in Spanish and English, the majority requested a preference for the interviews to be in Spanish, their native language. The other interviews were conducted by various members of the research team. The interviews were recorded using a digital recorder and then transcribed and translated by a Puerto Rico-based professional.
Interview Data Analysis
We approached interviews using the critical lens of Testimonios. Testimonios refers to a narrative inquiry approach that is participatory by nature, empowering participants to expose injustice and examine their lived experiences within particular socio-political realities (Delgado Bernal et al., 201226; Blackmer & Curry Rodríguez, 201227). The English versions of the interview transcripts were coded deductively by a priori areas of inquiry, including mental health, coping mechanisms, and wellness. Simultaneously, transcripts were coded inductively to capture themes that arose outside of the prior inquiry areas.
Findings from the interviews with young adult Puerto Ricans revealed four primary themes: (a) the impacts of compounding disasters; (b) systems of support and wellness that participants employed during and following the disasters; (c) feelings of frustration at the economic and sociopolitical crises in Puerto Rico, and (d) a commitment to supporting their communities and the island in the future.
Theme 1: Impacts of Compounding Disasters
The young adults noted direct and indirect impacts on their lives from the “Dire Trio.” Many of their responses referenced physical and financial damage to their homes and livelihoods. Other impacts were especially salient to their attempts to come into their own as young adults, including interruptions to schooling, work, and independent living, and an increased need to support their families.
Pre-existing Medical Conditions. The young adults described feeling more vulnerable to the potential effects of the COVID-19 virus because of pre-existing medical problems such as ulcers, auto-immune disorders, depression, and anxiety. Stress, anxiety, lack of adequate nutrition, and access to health care exacerbated these conditions.
Moving Back Home. Almost all of the young adults talked about moving back in with their families during both the aftermath of Hurricane Maria and the pandemic, which impacted their lives in various ways. A 21-year-old female noted a lack of personal space and autonomy living with her mother after having been away at school. Another young woman noted that her college experience was interrupted twice, once with Hurricane Maria one month after starting college, and again in the spring of 2020 while attempting to study abroad. Also, moving home came with increased responsibilities and other stressors, such as encouraging family members to adhere to social distancing guidelines and scheduling vaccinations. Another 21-year-old woman indicated that she had to schedule vaccination appointments for most of her extended family because “to get an appointment in Walgreens, you need to know English.”
Interrupted Schooling. The young adults talked about interrupted schooling and inconsistencies, confusion, and an overload of work, especially during the shift to online learning during the pandemic. One student talked about the roller-coaster transition to virtual learning. She recalled,
It was hard for me to focus. It was stressful and I was frustrated all the time. You didn’t know when you were going to have a class. You didn’t know which platform you were going to use. We changed from Blackboard to another one and then another one. And for some reason, they gave us more assignments. They didn’t give us any time to accommodate or adjust to it. They just threw all these things on us. Changed my classes, changed my programs, changed my schedule, and all these things. As soon as you get used to something, they change it.
Continued and Secondary Trauma. While some of the young adults mentioned direct impacts on their and their families’ mental health, others recognized the continued trauma of having to bear witness to the stories of others in their own and other communities throughout Puerto Rico. For example, a recent college graduate talked about the continued traumatic stress he feels during the announcement of inclement weather. He said,
Something else that has impacted me during all these emergencies and these historic moments has been after Maria, right now there is an announcement of a storm, the first rain has just fallen and the body feels different, like you tense up and I think that memory will never go away, that fear of being without electricity, fear of total disconnection for weeks…I didn't hear from anyone for three weeks, other than my mom and my brother who were the ones I was spending everything with. That desperation comes back with any rain, any wind, any sound in the windows, I mean that same feeling of that day is still there, there is no way for it to go away. Sometimes I say, "Will the day come when I will hear the rain and I won't feel that?" That's something that I really find interesting in a way; how the memory and the body keeps all that trauma somehow and recognizes it and remembers it.
Another recent college graduate respondent expressed similar sentiments about her continued trauma experiences, particularly after the earthquakes. She said,
But getting sleep at night, you just don't sleep the same. And I swear I can be sitting at the table and it vibrates, I'm like, ‘Is it shaking?’ So horrible. Now everything, everything, everything, if the bed moves, ‘Is it shaking?’
A recent college graduate who worked in a position which brought him into contact with individuals seeking assistance after Hurricane Maria. This caused him secondary stress which was expressed as feelings of helplessness that came from documenting the needs of the community without being able to help them. He said,
I feel that that was equally or more stressful than being without resources immediately after the hurricane, because it's hearing from people that six months, nine months later, they still don't have resources, that the resources are there, that the funds are there and that they're not being handled well and that they're not getting the help simply because these big heads are not doing the job as they're supposed to. And I feel like maybe I got a little bit more burned out on that part, a little bit more emotional burnout.
Theme 2: Social Support Systems and Wellness
Social networks and support systems of the Puerto Rican college students and recent graduates helped them deal with the compounded effects of the multiple disasters during the past several years and the pandemic. Friends, family, the relationships that they made through their association with MPA, our partner organization, and their religious faith provided companionship, comfort, and connections to valuable resources. A college student talked about how the visits from friends helped ease her anxiety after the hurricanes. She explained,
I want to add to my experience, that my friends, weirdly, even though they had no gas, and they live half an hour away or 45 minutes away, they still came to my house. We would play board games until it was late, and then they would leave. So, playing board games, playing Sudoku, and playing with puzzles, that’s basically how I relieved my anxiety, which is why I can say that I was also very, very lucky under the circumstances.
Similarly, another college student expressed how their friends supported them during the onset of the pandemic by being able to relate and by being present. They said,
[My friends] stuck around me and listened to me and put up with me while I was crying and frustrated. And they listened to my frustrations and protected me at other times. Telling my experiences and knowing that someone could relate helped.
Some of the young adults noted their family as their primary support system. During both the aftermath of Hurricane Maria and the COVID-19 pandemic, many of them had returned to their parents’ homes, from either living independently or with roommates. Family members reinforced values of familial and community interdependence and resilience throughout these times back home.
For example, a recent college graduate was grateful for time between him and his mother during the onset of the global pandemic in quarantine. He said, “I think it helped a lot that I was with my mom throughout it all, just between her and I. But being able to be with my mother… And when I look back on it, I think this was somewhat healthy, in a way, like sort of disconnecting from the world.
Another recent college graduate, who was living at home with his parents and grandparents, recalled how life lessons from family members helped him to “remain calm” during the wake of Hurricane Maria and the earthquakes. He said,
I was doing chores around the house and keeping myself busy. Understanding that it is something natural and we had no choice but to go through that process. For example, my grandparents were at my house for a while because we brought them from their house to ours to go through the process together and help them… I attribute it to the way I was raised and life experiences. Especially my father has also helped me to have a pretty resilient mindset in that sense of being able to handle these situations.
The connection that the college students and recent college graduates had with MPA, was also especially important to them throughout these difficult times. MPA served as a space for networking, solidarity, and emotional well-being. For instance, a recent college graduate, who has been involved with MPA since 2016, talked about how her connection to the organization and friends served as essential elements of her support system. She said,
Belonging to an organization like this (MPA) for young people who are constantly connecting, that you can say, "Look, I need this.” I got the housing through fellow members of the organization. I would say that my biggest help was through belonging to a student group like this and my friends in general outside of the organization, who were also a really significant support.
I don't think I've ever had a crisis, like the companionship of MPA is really something else. We have always supported each other in the process, whenever we felt alone, or closed in, we would call or write to each other; we even went to get vaccinated together. So that's how I think, I can tell you that, from Maria to here, it's been a constant creation of community among my friends and the people I work with that have really allowed me to go from one emergency to the next without feeling like the situation has collapsed, because you really feel the collective support.
Being able to talk about what was happening and express feelings of fear, shame, and frustration were also noted as being important. She continued,
MPA did an event called the consciousness café and it was a conversation where people just came in and talked about how they were feeling. I think it was a very healing and beautiful space in which I even connected with people that I hadn't seen for a long time, that...in some way were also looking for that space to express all the fear that comes with an earthquake and a pandemic, practically so fast...I think that this space was also one that helped me a lot to channel everything that we were going through and to share experiences among peers of my own age, so to speak, in my own context.
Community, via mutual aid in their immediate locales, as well as through more formal institutions such as the church, was also noted as a source of support. Several college students and recent college graduates noted that their faith was especially important as a space of comfort during both Hurricane and the COVID-19 pandemic. For instance, a college student expressed gratitude to her faith for the opportunity to be in spaces that allow her to serve others and be a part of our partner organization. She said,
I pray to God, that if he can't take the anxiety away, then he can use this to make the world a little bit better to help my neighbor. That's basically how I've been able to cope. I thank God, because I know that I'm called to serve and help my neighbor, and for being a part of an organization that focuses on civic and political participation from youth…I believe God has placed me in these spaces. That's why I believe in God, because I can see all of my blessings, and I can see him everywhere I look.
A recent college graduate expressed similar sentiments about finding comfort in religion, in communion with family, particularly that has helped to cope and “see light in so much darkness.” She said,
But that day, that night, my mom said, "Let's pray together." And that was, for me, very significant, because we all literally held hands, and we made like a prayer circle, and I think that was a very significant moment. And I say that it was also that God has helped us to face the day-to-day to get here, because without that, maybe not…I think that those were moments that helped us and gave us a little bit of light in so much darkness, as I say, a little bit of faith, that is what has helped us and continues to help us.
Theme 3: Future Selves Amidst the Economic and Socio-Political Crisis of Puerto Rico
Many of the Puerto Rican college students and recent college graduates mentioned the unresolved colonial status, political corruption, and dire economic crisis in Puerto Rico as having an impact on their present and future. They often viewed the social, economic, and political challenges of Puerto Rico as ongoing sources of stress, frustration, and community and personal struggle. For instance, a recent college graduate talked about the turbulence of his life in Puerto Rico, amidst ongoing economic and bureaucratic challenges. He said,
It’s sort of like a roller coaster that doesn't stop. A lot of the problems that have been exacerbated right now with the pandemic are problems that go back way back more than four years ago, maybe ten years ago and there's still a recession going on…Sometimes it feels daunting, there's a whole world outside and you're stuck here in Puerto Rico. At least, that’s what it sometimes feels like, mostly because of the chaos that's going on around you, you have absolutely no control of what's going on. When you try to make yourself better, there's a lot of obstacles in the way. Whether it’s bureaucratic obstacles, or even the sort of obstacles that require you to have connections.
In addition to the debt crisis, the young adults expressed their distress about Puerto Rico’s unresolved political status. A college student indicated her dreams for the future of her homeland: self-determination, a trustworthy government, and social-economic stability. She said,
The most stressful part is the fact that we're a colony. We're second-class US citizens, so we don't matter that much… I really wish we weren't a colony anymore. That's my biggest dream, that we can make our own decisions, but at the same time, I wish that there isn't any corruption in the government, because there is just so much corruption in the government, and the needs of many people are not met. My dream for Puerto Rico is that we can get enough resources to be able to deal with this situation.
A recent college graduate also shared about Puerto Rico’s political status, the debt crisis, and the related migration and exodus of professionals from the archipelago. Ultimately, she is motivated to help resolve these issues. She said,
The colonial status. We are in a limbo, and we are not moving forward. We are being economically drained and stepped on and we have a huge debt. The stuff that they import here costs a lot of money. This is why we have a lot of migration because they can’t find jobs even though they are professionals. Great people that can contribute and help with research, especially in science. But they aren’t getting the opportunity… I want to help the potential of Puerto Rico and I want to help change the status.
Theme 4: Commitment to Community and Puerto Rico
Nonetheless, many of the young Puerto Rican adults were hopeful, proud, and committed to positive change in their communities. They expressed their desire to remain in Puerto Rico, pride in their homeland, and dedication to contribute to the future of the archipelago and people. For instance, a recent college graduate, when asked to provide any advice for Puerto Rican youth, referred to the following quote by J.R.R. Tolkien, “I wish this had never happened to me. I wish none of this had ever happened. So do I and so does everyone who lives to see these times, but that is not for us to decide. All we have to decide is what to do with the time we are given.” When probed for the meaning of the quote, he said, “there are times when we are concerned with the reality that we are faced with, but maybe one way to look at it is not to look at the time that we were given to live but what we do with that time.” For him, the quote provided a message to remain hopeful and active in times of struggle and hardship. Similarly, a current graduate student expressed her desire to remain in Puerto Rico and pride in her homeland. She said,
The truth is, I would never want to leave here, and I would always like to work here. I would love to never have to leave this country, and to be able to help in some way, to help my homeland, because Puerto Rico is Puerto Rico. Whose chest doesn’t swell with pride?
When asked about her dreams for the future, a college student mentioned the wellbeing of her mother, progress for her homeland, and the desire to secure and advance culture in Puerto Rico. She said,
To live well and for my mother to be well and for the island to be better. In Puerto Rico I would like to develop a cultural space and…to continue to cultivate culture since it is being taken away.
In summary, our in-depth interviews revealed both the immediate and longer-term impacts of the natural disasters and the pandemic on young adults currently residing in Puerto Rico, as well as the array of support and individual, familial, and community resilience. We also found that while respondents reported the most direct impacts from the natural disasters, the COVID-19 pandemic following these disasters brought its own set of challenges to both home and community life. Lastly, participants in the qualitative study shared their hopes and dreams for Puerto Rico despite psychological and economic stressors.
Impact of the Dire Trio
The young adults in our survey (N = 68) reported a variety of immediate impacts from the recent natural disasters. For instance, over half (53%) reported damage to their homes and 16% had to move residences following Hurricane Maria. Respondents also reported that family (29%) or friends (50%) left Puerto Rico for the continental United States following Hurricane Maria. Only 12% of the young adults reported damage to homes by the earthquakes.
Following, and currently, during the COVID-19 pandemic, some respondents reported a family member had died (17%) and a third reported an ill family member. The majority (72%) also reported that they were ill themselves, though not necessarily from the COVID-19 virus. In terms of mental health, many of the respondents indicated that they experienced depression or anxiety after Hurricane Maria (57%), the 2019/2020 earthquakes (47%), and the COVID-19 pandemic (72%).
The (CYRM-R) was used to measure overall resilience. The mean score across participants was 68 (Range: 44-85) out of a potential high score of 85. This mean score is similar to other studies of youth and young adults in the United States and internationally, indicating that youth in our sample can be described as having “moderate” resilience (Resilience Research Centre, 201828). The moderate to high resilience scores in this sample corroborates our qualitative findings whereby participants described adaptation and growth following the disasters as well as popular media reports of youth action and resilience following Hurricane Maria (e.g., CNN, 201829).
Among the coping mechanisms measured in the COPE scale, respondents, on average, scored highest on what is considered positive coping styles such as positive reframing, self-distraction, use of emotional support, and active coping. These coping mechanisms are also reflected in the qualitative interviews. There was a low endorsement of more negative mechanisms such as denial, substance abuse, and venting.
Despite the devastating psychological, social, and economic impacts of two major natural disasters and the COVID-19 pandemic, Puerto Rican college students and recent college graduates shared stories of resilience, perseverance, and healing. They stressed the importance of support systems, including family, friends, religion, and our research partner, MPA. They also talked about their commitment to remain in Puerto Rico and work toward a better political future there, demonstrating strong place-attachment despite numerous disasters and ongoing social and economic difficulties that hinder their recovery and resilience.
At the same time, the young adults reported an increase in depression, anxiety, and stress following compounding disasters. Over half of respondents self-reported depression and anxiety. This is consistent with recent research suggesting that over 50% of youth have reported depression and anxiety since the start of the pandemic, compared to 10% pre-pandemic (Abbott, 202130).
Implications for Practice
Study findings offer several implications for practice, particularly within disaster recovery efforts. First, given familial interdependence, practitioners could leverage these insights by incorporating multi-generational approaches to wellness and mental health programming. Also, the young adults’ connection to MPA, our community-based research partner, underscores the role of non-profits as spaces for solidarity, mutual aid, and social networks during disaster recovery.
Dissemination of Findings
We plan to disseminate these findings via scholarly presentations and conferences in collaboration with, MPA, including at universities, community-based organizations, and governmental agencies across the archipelago of Puerto Rico. We plan to present these findings at the next Natural Hazards Workshop and the Caribbean Studies Association conference and submit them for publication in academic and practitioner publications.
As with the majority of studies, there are several limitations to consider with the findings of this study. First, the small sample size of the survey data limits the generalizability of the findings. Given the exploratory nature of our study, the data collected provided initial descriptive information to understand the experiences of young Puerto Rican college students and recent college graduates. Our sample was distinct in that it included college students and college-educated young people who had chosen to stay in Puerto Rico after the natural disasters and through the pandemic. We acknowledge that this sample is not representative of all young people in Puerto Rico and excludes the voices of those that have not had similar educational opportunities. Also, most of the survey respondents lived in the San Juan metropolitan area, despite our Puerto-Rico based research partner’s recruitment efforts. A final limitation of the study concerns the need to translate the interviews to English from Spanish. A Puerto-Rico based credentialed professional conducted a conceptual equivalence of all the interviews to promote trustworthy results (Jandt, 200331).
Future Research Directions
This exploratory study begins to tell the story of the impacts of these compounding disasters on college students and recent college graduates living in Puerto Rico and their resilience, coping mechanisms, and hope for the future. Future research could build on this study by expanding the sample, exploring mechanisms for community resilience, and using additional measures of mental health and wellness to assess ongoing impacts. Future research can explore non-college attending or college-educated young adults and expand the sample to include the differing experiences of those who moved to the United States and elsewhere. Interviews with the young adults revealed a strong emphasis on friends and community support; this echoes previous work focusing on the role of community mobilization following disasters in Puerto Rico (Hayward, et al., 2019). Future research should focus on young adults' role in building community resilience as disaster preparation, mitigation, and response. This study also found that young adults self-reported relatively high rates of depression and anxiety, especially during and following the pandemic. Other researchers had similar findings both in Puerto Rico following Hurricane Maria (Scaramutti et al., 2019) and in youth populations generally during the COVID-19 pandemic (Abbott, 2021). Although we explored a self-report of common mental health conditions, future research should include a focus on mental health and use a contextualized analysis of resilience that considers the “the politics of resilience” embedded in the island’s colonial history.
Scaramutti, C., Salas-Wright, C. P., Vos, S. R., & Schwartz, S. J. (2019). The mental health impact of Hurricane Maria on Puerto Ricans in Puerto Rico and Florida. Disaster Medicine and Public Health Preparedness, 13(1), 24-27. https://doi.org/10.1017/dmp.2018.151 ↩
Carl, Y., Frias, R. L., Kurtevski, S., González Copo, T., Mustafa, A. R., Font, C. M., Blundell, A. R., Rodriguez, E. C., & Sacasa, R. (2020). The correlation of English language proficiency and indices of stress and anxiety in migrants from Puerto Rico after Hurricane Maria : A preliminary study. Disaster Medicine and Public Health Preparedness, 14(1), 23–27. https://doi.org/10.1017/dmp.2019.22 ↩
Ferré, I. M., Negrón, S., Shultz, J. M., Schwartz, S. J., Kossin, J. P., & Pantin, H. (2019). Hurricane Maria’s impact on Punta Santiago, Puerto Rico: Community needs and mental health assessment six months postimpact. Disaster Medicine and Public Health Preparedness, 13(1), 18-23. https://doi.org/10.1017/dmp.2018.103 ↩
Jiménez Chávez, J.C., Viruet Sánchez, E., Rosario Maldonado, F.J., Ramos Lucca, A.J., & Barros Cartagena, B. (2020). Promoting integrated mental health care services in disaster response programs: Lessons learned after the impact of Hurricane Maria in Puerto Rico. Disaster Medicine and Public Health Preparedness, 14(1), 130-138. https://doi.org/10.1017/dmp.2019.58 ↩
Ramphal, L. (2018). Medical and psychosocial needs of the Puerto Rican people after Hurricane Maria. Baylor University Medical Center Proceedings, 31(3), 294-296. https://doi.org/10.1080/08998280.2018.1459399 ↩
Diaz, J.O. (1999). Stressors in Puerto Rican children as a result of Hurricane Georges. Education, 119(4), 3-13. https://www.thefreelibrary.com/STRESSORS+IN+PUERTO+RICAN+CHILDREN+AS+A+RESULT+OF+HURRICANE+GEORGES.-a055409984 ↩
Felix, E., Hernández, L. A., Bravo, M., Ramirez, R., Cabiya, J., & Canino, G. (2011). Natural disaster and risk of psychiatric disorders in Puerto Rican children. Journal of Abnormal Child Psychology, 39(4), 589-600. https://doi.org/10.1007/s10802-010-9483-1 ↩
Felix, E., You, S., Vernberg, E., & Canino, G. (2013). Family influences on the long-term post-disaster recovery of Puerto Rican youth. Journal of Abnormal Child Psychology, 41(1), 111-124. https://doi.org/10.1007/s10802-012-9654-3 ↩
Rubens, S. L., Felix, E.D., Vernberg, E.M., & Canino, G. (2014). The role of peers in the relation between hurricane exposure and Ataques de Nervios among Puerto Rican adolescents. Psychological Trauma: Theory, Research, Practice and Policy, 6(6), 716-723. https://doi.org/10.1037/a0036701 ↩
Orengo-Aguayo R., Stewart R.W., De Arellano M.A., Suárez-Kindy J.L., & Young J. (2019). Disaster exposure and mental health among Puerto Rican youths after Hurricane Maria. JAMA Netw Open. 2(4):e192619. https://doi.org/10.1001/jamanetworkopen.2019.2619 ↩
Abramson, D. M., Stehling-Ariza, T., Park, Y. S., Walsh, L., & Culp, D. (2010). Measuring individual disaster recovery: A socioecological framework. Disaster Medicine and Public Health Preparedness, 4 Suppl 1, S46–S54. https://doi.org/10.1001/dmp.2010.14 ↩
Bonanno, G. A., Brewin, C. R., Kaniasty, K., & Greca, A. M. (2010). Weighing the costs of disaster: Consequences, risks, and resilience in individuals, families, and communities. Psychological Science in the Public Interest: A Journal of the American Psychological Society, 11(1), 1–49. https://doi.org/10.1177/1529100610387086 ↩
Norris, F. H., Friedman, M. J., Watson, P. J., Byrne, C. M., Diaz, E., & Kaniasty, K. (2002). 60,000 disaster victims speak: Part I. An empirical review of the empirical literature, 1981-2001. Psychiatry, 65(3), 207–239. https://doi.org/10.1521/psyc.188.8.131.5273 ↩
Goldmann, E., & Galea, S. (2014). Mental health consequences of disasters. Annual Review of Public Health, 35, 169-183. https://doi/10.1146/annurev-publhealth-032013-182435 ↩
Bonanno G. A. (2004). Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? The American Psychologist, 59(1), 20–28. https:doi.org/10.1037/0003-066X.59.1.20 ↩
Abramson, D.M., Grattan, L.M., Mayer, B., Colten, C.E., Arosemena, F.A., Rung, A., & Lichtveld, M. (2015). The Resilience Activation Framework: A conceptual model of how access to social resources promotes adaptation and rapid recovery in post-disaster settings. Journal of Behavioral Health Services & Research, 42, 42-57. ↩
Hayward, R.A., Morris, Z., Otero, Y., Silva, A. (2019). ‘Todo ha sido a pulmón’: Organizing after disaster in Puerto Rico. Journal of Community Practice, 27(3-4), 249-259. https://doi.org/10.1080/10705422.2019.1649776 ↩
Jefferies, P., McGarrigle, L., & Ungar, M. (2019). The CYRM-R: A Rasch-validated revision of the child and youth resilience measure. Journal of Evidence-Informed Social Work, 16(1), 70–92. https://doi.org/10.1080/23761407.2018.154840 ↩
Khawaja, N. G. (2008). An investigation of the factor structure and psychometric properties of the COPE Scale with a Muslim migrant population in Australia. Journal of Muslim Mental Health, 3(2), 177–191. https://doi.org/10.1080/15564900802487584 ↩
Miyazaki, Y., Bodenhorn, N., Zalaquett, C., & Ng, K.-M. (2008). Factorial structure of brief COPE for international students attending U.S. colleges. College Student Journal, 42(3), 795-806. ↩
Panter-Brick, C., Hadfield, K., Dajani, R., Eggerman, M., Ager, A., & Ungar, M. (2018). Resilience in context: A brief and culturally grounded measure for Syrian refugee and Jordanian host-community adolescents. Child Development, 89(5), 1803-1820. https://doi.org/10.1111/cdev.12868 ↩
Yusoff, N., Low, W. Y., & Yip, C. H. (2010). Reliability and validity of the Brief COPE Scale (English version) among women with breast cancer undergoing treatment of adjuvant chemotherapy: A Malaysian study. The Medical Journal of Malaysia, 65(1), 41–44. ↩
Perczek, R., Carver, C. S., Price, A. A., & Pozo-Kaderman, C. (2000). Coping, mood, and aspects of personality in Spanish translation and evidence of convergence with English versions. Journal of Personality Assessment, 74(1), 63–87. https://doi.org/10.1207/S15327752JPA740105 ↩
Carver C. S. (1997). You want to measure coping but your protocol's too long: Consider the brief COPE. International Journal of Behavioral Medicine, 4(1), 92–100. https://doi.org/10.1207/s15327558ijbm0401_6 ↩
Delgado Bernal, D., Burciaga, R., & Flores Carmona, J. (2012) Chicana/Latina Testimonios: Mapping the methodological, pedagogical, and political, Equity & Excellence in Education, 45(3), 363-372. https://doi.org/10.1080/10665684.2012.698149 ↩
Resilience Research Centre. (2018). CYRM and ARM User Manual. Resilience Research Centre, Dalhousie University. https://cyrm.resilienceresearch.org/files/CYRM_&_ARM-User_Manual.pdf ↩
Cable News Network. (2018, November 22). Perspectives: I'm growing up in Hurricane Maria's aftermath. here's what the world can learn from youth resilience. CNN. https://edition.cnn.com/2018/11/22/perspectives/hurricane-maria-puerto-rico-resilience/index.html ↩
Abbott, A. (2021, February 23). Covid's mental-health toll: How scientists are tracking a surge in depression. Nature News. https://www.nature.com/articles/d41586-021-00175-z ↩
Jandt, F. (2003). An introduction to intercultural communication: Identities in a global community. Sage. ↩
Torres, M., Hayward, R.A., Meltzer, G., García, C., Bustos, T.E., & Silva Diaz, A. 2022. ¡Estamos bien, Puerto Rico!: Compounding Disasters and Young Adults in Puerto Rico. Natural Hazards Center Quick Response Research Report Series, 337. Boulder, CO: Natural Hazards Center, University of Colorado Boulder. Available at: https://hazards.colorado.edu/quick-response-report/estamos-bien-puerto-rico-compounding-disasters-and-young-adults-in-puerto-rico