The Role of Place of Birth and Residence in Puerto Rican Health Disparities: Evidence From Disability Prevalence Among Archipelago- Vs. Mainland-Born Puerto Ricans

Objectives This paper provides new estimates of disability prevalence for the archipelago and mainland-residing Puerto Rican populations ages 40 and above and compares disability by place of birth and place of residence to investigate drivers of middle and older age health. Methods Large nationally representative samples from 2013 to 2017 American Community Survey and Puerto Rico Community Survey data are used to estimate age-specific disability prevalence for archipelago-born/archipelago-residing, archipelago-born/mainland-residing, mainland-born/mainland-residing Puerto Ricans. Results Mainland-born/mainland-residing Puerto Ricans have the lowest age-adjusted disability rates and archipelago-born/archipelago-residing Puerto Ricans have the highest rates. Differences in education explain part of this disparity. Discussion Similarities in disability prevalence are strongest based on where one was born as opposed to current residence, pointing to early life as a critical period in the disablement process for later-life health. Early life socio-economic disadvantage on the archipelago may have an enduring impact on later-life disability prevalence for archipelago-born Puerto Ricans.