Disasters, solar energy, and chronic disease management in aging Puerto Ricans

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A. Project Abstract On September 2017 Hurricane María hit Puerto Rico (PR), a US territory populated by 3.2 million American citizens. The event reached PR as a category 4 hurricane and caused the longest electric power outage in US history. Two years later the electric grid was further damaged by a series of earthquakes in the southern part of the Island. Some communities still experience a complete lack of electricity, and most face frequent power outages. The implications of this interrupted access to electricity on the population’s health have gone unexplored in the Caribbean, where extreme events are expected to increase in intensity. Energy independence through direct access to solar power has begun to appear in PR through the work of community organizations. One model case is that of Casa Pueblo (CP), a non-profit community organization that has spearheaded the movement for energy independence on the Island. Located in the rural town of Adjuntas, CP has begun to provide solar panels to members in the communities. They have electrified essential locations in adjacent communities (e.g., small food markets, restaurants) and individual homes of elderly populations and those with energy-dependent chronic conditions – such as renal disease, respiratory disease, and diabetes – with the aim of improving CDM during the Island’s frequent power outages. In response to PAR-19-250 (Environmental Influences on Aging: Effects of Extreme Weather and Disaster Events on Aging Populations) we currently carrying out a project theoretically informed by a framework on disaster and climate-resilience approaches to health in order to explore the multilevel factors that enable local government agencies, communities, and individuals to adapt to energy independence in their settings, and thereby address their implications for CDM. These are the study’s current 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 (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 disease, diabetes). To achieve the proposed aims we will conduct a detailed ethnographic observation/mapping of CP, we will engage in a multilevel analysis of the community-based energy independence through 45 tiered in-depth semi-structured qualitative interviews with chronic disease patients ≥50 years with a range of access to CP’s solar installations, and qualitative interviews will be conducted with individuals engaged at the policy-, administrative- or technical-levels working within the field of sustainable energy and disaster recovery. In addition, we will administer a survey to a sample of 345 chronic disease patients 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 technology-dependent chronic diseases among aging populations in the United States and the Caribbean that are vulnerable to energy insecurity and natural disasters.