Project Summary
Puerto Rico (PR) faces frequent power outages due to damage caused by natural disasters to its electric grid.
Aging Puerto Ricans (≥50 years) are a vulnerable population during natural disasters as they are more likely to
have multiple chronic health conditions when compared to other non-Hispanic whites and other Hispanic
groups in the US. Power outages can increase these disparities, and elevate morbidity and mortality due to co-
morbid conditions. Research has demonstrated that energy independence has positive health impacts. Energy
independence through direct access to solar power has begun to appear in PR through the work of the non-
profit community organization Casa Pueblo (CP). We propose to explore, from a multilevel perspective, the
factors that enable local government agencies, communities and individuals to adapt to energy independence
in their settings, and their implications for chronic disease management via these aims: Aim 1 – Through our
partnership with CP, explore the process experienced by communities and the aging population (≥50 years)
living with chronic diseases while adapting to energy independence (e.g., introduction of the technology,
training on its use, access to energized communal points) in order to better understand how communal
characteristics (e.g., collective identity, perceived individualism) can hinder or foster CDM among those with
renal disease, respiratory disease, and diabetes. Aim 2 – Systematically document from a multilevel
perspective (i.e., individual, community and structural) the perceived barriers and facilitators for adopting
energy independence strategies in PR. Aim 3 – Document resilience related variables at the individual level
(e.g., self-efficacy, positive attitudes, knowledge, altruism), communal (e.g., emotional connection, group
membership), and structural (i.e., power outages, geographical variables) levels that can foster effective CDM
among aging populations in need of electricity-based treatments (i.e., renal disease, respiratory diseases,
diabetes). To achieve Aim 1 and 2, we will conduct: (a) a detailed ethnographic observation/mapping of CP,
involving 30 months of immersive and ongoing institutional exchange and (b) a multilevel analysis of the
community-based energy independence through 45 tiered in-depth interviews with individuals ≥50 years with a
range of access to CP’s solar installations: 1) direct access (n=15), indirect access (n=15) and no access
(n=15). In addition, we will conduct qualitative interviews with individuals engaged at the policy-, administrative-
or technical-levels working within the field of sustainable energy and disaster recovery (n=15). To achieve Aim
3, we will administer a survey to a sample of 345 aging persons in the town of Adjuntas who have direct,
indirect and no access to independent energy sources. Our research will contribute to policy development and
dissemination regarding the role of community engagement and energy independence in managing chronic
diseases among aging populations in areas of the United States and the Caribbean that are vulnerable to
health inequities magnified by disasters.