Journal of
Public Health and Epidemiology

  • Abbreviation: J. Public Health Epidemiol.
  • Language: English
  • ISSN: 2141-2316
  • DOI: 10.5897/JPHE
  • Start Year: 2009
  • Published Articles: 613

Full Length Research Paper

Family engagement: A model for improved health outcomes in Puerto Rico

Carlos Nesbeth1, Wilfredo Alonso2, Vincent Agboto1, Manuel Acevedo2 and Elmang Nchako1
¹Department of Family and Community Medicine, Meharry Medical College, Nashville, Tennessee. 2Department of Internal Medicine, Hospital Buen Samaritano, Aguadilla, Puerto Rico.  
Email: [email protected]

  •  Received: 08 February 2019
  •  Accepted: 16 July 2019
  •  Published: 31 August 2019


Puerto Rico has been undergoing economic and health crises, which were exacerbated by damages from hurricane Maria in 2017. Family is central to the Latino culture, in which it is commonly referred to as familismo. The term implies strong family ties and engagement in all aspects of Puerto Rican life. This study examined how it could be harnessed as a powerful tool to improve health outcomes in that context. The researchers conducted electronic searches in PubMed and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) for articles published between 2000 and 2018 on familismo in the Puerto Rican health care context.  A hand search of selected specialist journals and reference lists of articles obtained was then conducted.  A total of 23 articles were reviewed. This study’s literature review indicated that family engagement was fundamental to Puerto Rican life. CDC publications revealed that family engagement was also important for achieving successful health outcomes in that context. Strong family engagement in the context of Puerto Rican familismo is a great tool that can readily be used to improve health outcomes within the strained territorial health care system. Public health interventions are thus needed to harness and incorporate family engagement in the health care delivery process. Such interventions could significantly improve the quality of care while decreasing related costs throughout the island.

Key words: Family engagement, health outcomes, healthcare cost, Puerto Rico healthcare, Familismo.