RESUMEN
Puerto Rico is aging more rapidly than almost any country, with 2020 estimates placing its population share of adults older than 65 as being the 10th highest in the world. Unlike most locales, Puerto Rico's aging is driven by both (a) the culmination of long-running fertility and mortality trends and (b) high levels of outmigration of working-age adults, which contributes both directly (removal of young people) and indirectly (reduced births) to its pace of population aging. This article offers an overview of the main issues surrounding population aging in Puerto Rico. Policymakers and government leaders must plan for Puerto Rico's unconventional population aging, which will exacerbate traditional concerns about the sustainability of government services and long-term economic prospects. Additional concerns emerge related to reduced social support networks and their impact on caregiving dynamics and implications for health. Puerto Rico's unique history and political relationship with the United States present challenges and benefits for its aging population. Research on aging in Puerto Rico and public health policies must adapt to the needs of the country's aging society.
Asunto(s)
Emigración e Inmigración , Servicios de Salud , Adolescente , Anciano , Envejecimiento , Humanos , Puerto Rico , Estados UnidosRESUMEN
BACKGROUND: Researchers use a variety of population size estimation methods to determine the sizes of key populations at elevated risk of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), an important step in quantifying epidemic impact, advocating for high-risk groups, and planning, implementing, and monitoring prevention, care, and treatment programs. Conventional procedures often use information about sample respondents' social network contacts to estimate the sizes of key populations of interest. A recent study proposes a generalized network scale-up method that combines two samples-a traditional sample of the general population and a link-tracing sample of the hidden population-and produces more accurate results with fewer assumptions than conventional approaches. METHODS: We extended the generalized network scale-up method from link-tracing samples to samples collected with venue-based sampling designs popular in sampling key populations at risk of HIV. Our method obviates the need for a traditional sample of the general population, as long as the size of the venue-attending population is approximately known. We tested the venue-based generalized network scale-up method in a comprehensive simulation evaluation framework. RESULTS: The venue-based generalized network scale-up method provided accurate and efficient estimates of key population sizes, even when few members of the key population were sampled, yielding average biases below ±6% except when false-positive reporting error is high. It relies on limited assumptions and, in our tests, was robust to numerous threats to inference. CONCLUSIONS: Key population size estimation is vital to the successful implementation of efforts to combat HIV/AIDS. Venue-based network scale-up approaches offer another tool that researchers and policymakers can apply to these problems.
Asunto(s)
Infecciones por VIH/epidemiología , Densidad de Población , Estadística como Asunto , Consumidores de Drogas/estadística & datos numéricos , Infecciones por VIH/diagnóstico , Infecciones por VIH/tratamiento farmacológico , Política de Salud , Humanos , Formulación de Políticas , Factores de Riesgo , Trabajadores Sexuales/estadística & datos numéricos , Minorías Sexuales y de Género/estadística & datos numéricos , Abuso de Sustancias por Vía Intravenosa/epidemiologíaRESUMEN
Recent reports indicate that populations of the black sea urchin Diadema antillarum are slowly coming back in several localities in the Caribbean after 15 years of absence. In La Parguera, Puerto Rico, urchins were totally absent from reef localities until 1996, when isolated, medium size individuals were observed in shallow reef habitats. To assess the status (distribution, densities and size structure) of populations of D. antillarum 17 years after the die-off, twelve 20 m2 (10 x 2 m) band transects in each of four depth interval (0-3, 3-7, 7-11 and >11 m) in each of four fringing coral reefs, and six-eight band-transects in each of two depth intervals (0-3 and >3 m) in three lagoonal mounds were surveyed in 2001. All urchins present in the band transects in two depth intervals (0-3 and 3-8 m) were collected and measured (test diameter) in situ to determine the average size and size (age) structure of populations. Overall, average densities were low and not significantly different (F = 1.29, p = 0.125) across reef sites (0.83-1.39 ind/m2) and the seagrass mounds (1.09 +/- 0.6-1.30 +/- 0.6 ind/m2). Urchins were only found in the shallow areas (<3 m) on the seagrass mounds where they formed tight aggregations during daytime. Densities decreased significantly with increasing depth (r2 = -0.60) in reef sites and were significantly higher (F = 5.97, p < 0.001) in shallow reef platforms (0.89 +/- 0.69 - 1.98 +/- 0.65 ind/m2) (0-3 m), and the upper fore-reef (0.56 +/- 0.14 - 2.33 +/- 1.1 ind/m2) habitats (3-7m), compared to deeper (> 7 m) habitats (0.01 +/- 0.02 - 0.88 +/- 1.06 ind/m2). Enrique reef had a significantly higher (K-W, H = 165.19, p < 0.001) population average size (Median = 7.7) compared to all other sites. Populations in the sea grass mounds were dominated by midsize to large individuals. Within reefs, the average size did not vary significantly across depth intervals with medium to large size urchins dominating. Higher number of aggregations and higher number of urchins per aggregation were correlated with low complexity (rugosity) habitats (Pearson's r = -0.772, p < 0.001 and r = -0.778, p < 0.001 respectively), which supports the idea that this behavior provides protection. Although average densities were well below pre-mass-mortality densities in Puerto Rico, results of this study indicate that Diadema seem to be making a slow come back in La Parguera.