Alondra Soto-González
Lizandra Domínguez-Orona
Valeria Cordero Berríos
Isabel Falcón Asencio
Gabriela Cañizares Díaz
Heidy Rivera Santa
Eduardo Pérez Delgado
Gabriel Camareno-Soto
Universidad Central del Caribe, Bayamón, Puerto Rico
University of Puerto Rico, Río Piedras Campus, San Juan, Puerto Rico
Universidad del Sagrado Corazón, San Juan, Puerto Rico
Introduction
Clínicas Padre Venard is a student-led free clinic in Old San Juan, Puerto Rico, dedicated to providing healthcare to underserved, uninsured, and houseless individuals since 1999. Social determinants of health (SDOH) significantly impact patient outcomes, yet comprehensive data about this in Puerto Rico remains limited. This study aims to assess the prevalence of various SDOH among clinic patients to inform the development of targeted interventions and improve health equity in the community.
Methods
From February to December 2024, we conducted in-depth interviews with 35 patients during routine clinic visits. Participants aged 21 or older completed a 44-item survey assessing SDOH-related disparities, including demographic details, medical history, and data on food security, finance, housing, transportation, and social support.
Results
Participants averaged 57 years old (range: 24–63), with 94% being male. Transportation instability affected 90% of participants, though 62% maintained clinic attendance. Financially, 74% relied on social security benefits, while 31% earned income through non-formal work. Housing instability was significant, with only 60% reporting consistent housing over the past year. Food insecurity affected 40% of participants, while 57% reported limited food access within 12 months. Although 67% maintained family communication, 37% lacked reliable support systems. Healthcare barriers were substantial, with 63% reporting inadequate care and 29% experiencing discrimination. Substance use was notable, with 43% using tobacco and 23% reporting non-prescribed controlled substance use. Many participants expressed the need for additional support services, including mental health counseling, nutritional assistance, health education, and improved healthcare access.
Conclusion
Our findings describe the SDOH challenges faced by Old San Juan’s vulnerable populations. Social isolation and insufficient support likely contribute to unhealthy behaviors, notably substance misuse, potentially compromising long-term health outcomes. Addressing these disparities requires integrating social support services, enhancing healthcare accessibility, and implementing community-based interventions to improve health equity.
IRB Approval Number
#2024-01
