Evidence map›Paper›PMID 41668067›Full record

ArticleBMC public health2026

Energy insecurity and health among older adults: chronic disease management and resilience strategies in rural Puerto Rico.

Sheilla R Madera, Nelson Varas-Díaz, Mark Padilla, Kariela Rivera-Bustelo, Jeffrey Ramos, Sergio Rivera-Rodriguez, Adrián Santiago-Santiago, Claudia Mercado-Rios, Jack Vertovec, Arturo Massol Deyá and 4 more

Abstract read
In one paragraph

Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Sheilla R MaderaGlobal and Sociocultural Studies Department, Florida International University, Miami, FL, USA. shrodrig@fiu.edu.
Nelson Varas-DíazGlobal and Sociocultural Studies Department, Florida International University, Miami, FL, USA.
Mark PadillaGlobal and Sociocultural Studies Department, Florida International University, Miami, FL, USA.
Kariela Rivera-BusteloGlobal and Sociocultural Studies Department, Florida International University, Miami, FL, USA.
Jeffrey RamosDepartment of Surgery, Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA.
Sergio Rivera-RodriguezGlobal and Sociocultural Studies Department, Florida International University, Miami, FL, USA.
Adrián Santiago-SantiagoSchool of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, Puerto Rico.
Claudia Mercado-RiosSchool of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, Puerto Rico.
Jack VertovecBehavioral Science Research Institute, Coral Gables, FL, USA.
Arturo Massol DeyáDepartment of Biology, University of Puerto Rico, Mayagüez campus, Mayagüez, Puerto Rico.
Rebeca Rodríguez-BanchCasa Pueblo (NPO), Adjuntas, Puerto Rico.
Emil Varas RodríguezSchool of Medicine, Ponce Health Sciences University, Ponce, Puerto Rico.
Genevieve ReidGlobal and Sociocultural Studies Department, Florida International University, Miami, FL, USA.
Kevin GroveGlobal and Sociocultural Studies Department, Florida International University, Miami, FL, USA.

Funding

Clinical and Translational Cancer Control Research Training ProgramT32CA102618 · NCI · UNIVERSITY OF ROCHESTER · PI Michelle C Janelsins, Gary R Morrow · 2019 to 2026
$2.7M
NCI NIH HHS T32 CA102618NIH HHS 1R01AG072613
6 · The paper itself

Abstract

objectivesThis article explores the impact of energy insecurity on chronic disease management among older adults (≥ 50 years) in rural areas of Puerto Rico. It documents their lived experiences during power outages and assesses the role of community-driven solar energy initiatives led by the community-based organization Casa Pueblo in enhancing health resilience in a disaster-prone region.

methodsAn exploratory-descriptive qualitative approach was employed, incorporating semi-structured interviews with 60 participants across three levels of solar energy access (direct, indirect, and no access) and key stakeholders. Thematic analysis was conducted using NVivo to explore the health impacts of energy insecurity and the resilience strategies used to address it.

resultsEnergy insecurity exacerbated health vulnerabilities by disrupting the use of critical medical equipment and the refrigeration of medications, worsening chronic conditions such as diabetes and respiratory ailments. Participants reported significant psychological stress, including elevated anxiety during blackouts. Casa Pueblo’s solar initiative proved essential, mitigating immediate health risks while fostering a sense of security and well-being. Yet systemic challenges—such as insufficient government support—highlighted the urgent need for scalable, sustainable solutions that ensure equity.

conclusionsReliable energy access is crucial for managing chronic diseases among older adults and strengthening public health resilience in disaster-prone settings like Puerto Rico. Community-driven solar initiatives, exemplified by Casa Pueblo, offer scalable models to enhance health outcomes in vulnerable populations. Realizing their full potential will require coordinated efforts, including public-private partnerships, policy reforms, and measures to overcome structural barriers. This study provides actionable insights for disaster-prone regions worldwide, emphasizing the integration of energy resilience into public health planning.

Indexed as

Disease ManagementResilience, PsychologicalRural PopulationSolar EnergyAgedChronic DiseaseFemaleHumansInterviews as TopicMaleMiddle AgedPuerto RicoQualitative ResearchChronic disease managementCommunity-based interventions, and older adultsDisaster-prone regionsEnergy insecurityPublic health resilienceSolar energy

Identifiers

PMID41668067
PMCPMC12998279

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.