In graying Puerto Rico, elderly face climate disasters alone
VEGA ALTA, Puerto Rico — Hector Colón and Ana Serrano fell in love in Brooklyn in the 1950s as both tried to scratch out new lives from less than nothing.
They had fled Puerto Rico as young adults for factory jobs that offered workingclass wages and the conveniences of big-city life: walkable streets, easy public transit and everything they might need within blocks.
But when Serrano’s mother fell ill in 2000, Serrano returned to the island to care for her. Her husband soon followed. They took their savings and retired, leaving their support system and inheriting the older woman’s home in the coastal town of Vega Alta after she died.
That is where they were living when Hurricane Maria damaged the roof. Colón didn’t want to bother anyone for help, thinking he could do it himself. But he couldn’t. Five years later, the elderly couple was still living under a waterlogged roof until a foundation offered to chip in.
“It hurts,” Serrano, 86, said. “We have family, but nobody thinks of us. They have their own lives and should live them.”
As Puerto Rico struggles to recover from a series of brutal natural disasters, the island is aging more rapidly than most places on Earth.
More than one in five residents is over 65, making Puerto Rico’s share of older adults the 10th highest in the world.
But what makes Puerto Rico’s demographic patterns so unique is what researchers call “aging by compression,” meaning the commonwealth is graying because its working adults are leaving. The share of older Puerto Ricans doubled in less than 20 years while U.S. Census Bureau figures show more than 700,000 residents left in the past decade - accelerated by economic truncation and disaster.
That emigration has emptied out the barrios of Puerto Rico, leaving large numbers of senior adults alone to face the ravages of cyclones that are ever more frequent, powerful and variable.
“Their children migrated to the United States, and senior citizens were left alone in Puerto Rico. And they are the most vulnerable population right now,” said Jessika López Montalvo, a social worker who has watched her caseload shift from mostly children to all older adults.
The shift has massive implications for Puerto Rico, which is still struggling to recover from Category 5 Hurricane Maria in 2017 and subsequent earthquakes and political tumult. The main island where the capital, San Juan, is located and two smaller islands with fewer resources need workers to rebuild and stimulate the territory’s fragile economy.
But most residents will be retirement age in less than a decade, data shows. Poverty is expected to deepen as elderly residents make up a greater share of the population, all the while grappling with unequal access to federal benefits such as Supplemental Security Income and Medicaid because of Puerto Rico’s status as a U.S. territory, experts said. And with physicians and medical specialists leaving in droves, the health-care system is teetering precariously.
“Puerto Rico is experiencing a demographic phenomenon not seen anywhere else before on the planet, and we don’t know yet what the consequences will be, not just for older adults, but for everyone on the island,” said Amilcar Matos-Moreno, a social epidemiologist. “If nothing changes, the repercussions will be severe in terms of mortality and quality of life.”
A problem like Maria
Hurricane Maria resulted in more than 3,000 deaths — the majority involving people over the age of 60 — after it ravaged Puerto Rico five years ago.
Since then, each subsequent disaster has unveiled another facet of the social safety net’s inadequacies as stories about Puerto Rico’s elderly living in subhuman conditions become frequent segments of local newscasts and tabloids.
“We have been sounding the alarm for years. It was no secret that this would happen,” said Carmen Delia Sánchez, Puerto Rico’s special advocate for elderly and retired adults. Her office administers federal funds for critical services through the Older Americans Act. “The government was not preparing or prioritizing this shift. Now, we are a country of old people.”
The legislature has strengthened elder abuse laws and protections against workplace age discrimination, offered platitudes in budget documents and, in 2022, set aside millions to house about 4,000 seniors during disaster. But while efforts are perpetually underway, critics say, the government has not revealed any strategic plan to respond to what amounts to a massive reordering of society, according to experts and a review of government documents and reports.
Matos-Moreno, along with a group of researchers, analyzed data showing that nearly half of older Puerto Rican adults have at least one child living in the states or in other countries and that about 30 percent live alone - a worrying statistic.
“We don’t know what to expect, because no one in the world has lived this,” MatosMoreno said, adding that about two of every five older Puerto Rico residents live below the poverty line.
Puerto Rico’s policymakers have been focused on bringing their government out of economic crisis since 2006. But they are emerging from bankruptcy to create budgets for a population that looks radically different than it did then. Nonetheless, Gov. Pedro Pierluisi’s policies, from economic development plans to the relentless pursuit of statehood, do not reflect these changes, said more than a dozen advocates and researchers pushing the government to rethink its focus.
The Center for Investigative Reporting in Puerto Rico found that the local health department failed to implement a federal program that helps governments track and deliver lifesaving services to the neediest before, during and after a disaster.
Some municipalities kept a census of need, but there was little to no communication between the central government and its mayors before Fiona struck to evacuate individuals such as dialysis patients to equipped shelters. The federal database identified more than 40,000 energy-dependent patients in Puerto Rico, but experts say the number is higher.
The central government initially blamed municipalities for the failure, saying local authorities have more information than federal officials on which residents need aid. But CPI’s analysis found that the federal database contained far more names and addresses but still went unused.
Though the death toll is much lower from the most recent storm, the Puerto Rico government is in no better position to prevent death in another prolonged power outage that could threaten the lives of its elderly population, according to data and experts.
The Puerto Rico departments of health and family affairs did not respond to phone calls and messages.
At the federal level, congressionally imposed caps on Medicare and Medicaid in Puerto Rico, which are funded at lower rates than in the states, also put seniors at a huge disadvantage.
“The health-care system here is so fragmented over the struggle for federal funding that people don’t know how to navigate it, and they fall between the cracks,” said José Acarón, AARP’s Puerto Rico director. “We need to rethink everything in this country to face the reality.”
Sánchez, the government’s special advocate, said she used her limited budget and worked with AARP to provide generators and kitchen equipment to more than 130 private and municipal-run senior housing and community centers ahead of hurricane season. But just 2 percent of Puerto Rico’s elderly and older adults live in such facilities.
The majority are aging inside their own homes in urban areas near San Juan that have not adapted to changing climate and health needs, experts said. After Fiona, seniors found themselves trapped and in need of rescue from public housing condominiums where elevators were useless in a power outage. Elderly couples abandoned by family or unknown to neighbors went hungry inside overheated and damaged homes. Octogenarians burned to death or died of carbon monoxide poisoning while trying to operate generators.
But while the outlook is grim, researchers say, there is also evidence that the high levels of social cohesion in Puerto Rico’s more rural communities could offer solutions for policymakers. In the wake of tropical cyclones, older adults took charge of their communities. They volunteered to care for and provide for elderly and bedridden neighbors. They coordinated with local governments and nonprofits to meet needs. And they stood up to demand more when they needed it.