Colonialism as a Social Determinant of Health in Puerto Rico: Using the Socioecological Model to Examine How the Jones Act Impacted Health After Hurricane María.

This article examines the impact of the Merchant Marine Act of 1920, commonly known as the Jones Act, on Puerto Rico's health and recovery following Hurricane María in 2017, using the socioecological model (SEM) as a framework. The Jones Act, a colonialist U.S. federal policy requiring goods shipped between the mainland and Puerto Rico to use U.S.-owned vessels, contributed to delayed shipments, increased costs, and shortages of essential supplies, which in turn prolonged infrastructure failures and institutional closures. These disruptions exacerbated acute and chronic physical and mental health issues among Puerto Ricans, illustrating how colonial policies function as social determinants of health (SDOH). The article highlights limited political agency for Puerto Rico within the U.S. government, restricting the island's ability to address such policies, and calls for nursing practice to recognize colonialism as an SDOH to better advocate for affected communities.