Vidas en Contexto: Unpacking Social Determinants of Health and Related Health Outcomes among Puerto Ricans through a Person-Centered Approach.

This study used a person-centered approach to uncover patterns of Social Determinants of Health (SDOH) among adults aged 18 and older residing in Puerto Rico. This research addresses a knowledge/population gap relating to the co-occurrence of SDOH among Puerto Ricans who may experience unique patterns of unmet social needs associated with the island's colonial status. Data were drawn from the 2023 Behavioral Risk Factor Surveillance System survey, which included respondents residing in Puerto Rico (n = 4,594), of whom the largest age group was aged 65 and older (26.9%). Latent class analyses uncovered SDOH clusters, while descriptive statistics identified various health outcome correlates. Model selection was based on relative fit indices, log likelihood test, entropy, and interpretability. SDOH was best represented by four latent classes: Low Material and Psychosocial Needs (n = 2,872), High Material Scarcity (n = 801), High Psychosocial Needs (n = 677), and High Material and Psychosocial Needs (n = 244). Demographic characteristics and health risk profiles also varied significantly across the four classes, with most social need classes exhibiting a higher risk for negative health outcomes in comparison to the Low Material and Psychosocial Needs class. Our findings provide insights into patterns of SDOH classes in this population that vary across classes and correspond with different burdens of chronic physical and behavioral health conditions. This work informs efforts targeting distinct patterns of social needs within Puerto Rico's colonial context that may enable precise allocation of resources, tailored screening, and structural intervention to alleviate health disparities.