Power outage impacts on adult hospital occupancy and summary of health indicators in Puerto Rico

Puerto Rico’s electric grid has experienced mounting grid reliability challenges since Hurricane Maria devastated its infrastructure in 2017. This study examines trends in intermittent power outages in 2022 and their association with adult hospital occupancy across selected municipalities (Arecibo, Bayamón, Caguas, Carolina, Mayagüez, Ponce, and San Juan). A comprehensive literature search and analysis of health data revealed negative trends in public health – specifically all-cause mortality and hypertension on the island. Outage data from the U.S. Department of Energy’s EAGLE-I system were integrated with publicly available hospital occupancy data from the Department of Health in Puerto Rico. Mortality and hypertension data from the World Health Organization were reviewed with a time-series analysis. Results indicate that frequent outages coincided with some increases in adult hospital occupancy during certain months (January, May, July, August, September, October, November, December), though the association was relatively weak when aggregated over the entire year (adjusted R²= 0.2458). Outage events clustered in less populated and more remote western municipalities such as Mayagüez, Arecibo, and Ponce, where restoration was slower and outage durations longer. Both mortality and hypertension rates in Puerto Rico have trended upward since 2015, with cardiovascular disease consistently noted as a leading cause of death. These trends suggest that stress from grid instability and barriers to healthcare access may compound preexisting vulnerabilities, including a large population dependent on electrically powered medical devices. Findings underscore a need for more reliable electricity infrastructure and targeted community-level mitigation strategies to address public health risks. Further research incorporating granular hospital and emergency department data is warranted to identify causal pathways linking power interruptions to declining health outcomes in Puerto Rico.