According to the 2017 United States Census Bureau, 30 percent of Puerto Rico’s population at the time was over 55 years of age, and 24 percent were over 60 years old. Families are having fewer children, and many young people are leaving the island. And after Hurricane Maria, the Census Bureau estimated 130,000 more left. While some people have returned, that still leaves a population estimated to be about 2.8 million with a median age of 44 years and presenting serious challenges to the health system.
The health issues that accompany an aging population intensified following the hurricane. Chronic disease such as diabetes and hypertension are common among an older population. The fragility of an infrastructure that could not withstand hurricanes and earthquakes meant that the collapse of power grid, water and sanitation only added to the health threats of water and mosquito borne diseases. When many health facilities could no longer provide services, an already vulnerable population confronted an unprecedented public health crisis. Americares establishment of an office and an in- country was in response to the magnitude of that crisis.