The genetic factors were also excluded as having a major influence in the medical condition according to studies that showed that genetic factors that may influence the illness are overcome in proportion of 3:1 by environmental factors (Guaranaccia, 1981, 11). In her study, Laura Gonzales points out that Puerto Rican migrants are keeping in close contact with their relatives, friends and acquaintances from the islands, traveling back and forth, being engaged in what Christenson had defined as a "circulatory migration"(Gonzales, 2008, 2). The fact that the first language on the Puerto Rican Island is Spanish, English being widely taught in schools, but as a second language, made things harder for the older generations who migrated to the mainland. On the other hand, in a city like New York, one of the most targeted cities for the Puerto Rican migrators, Spanish is one of the languages "most commonly heard" after English, of course (Hernan LaFontaine, 1973, 326). They will thus naturally tend to associate with other Spanish speaking groups residing here.

After the end of WWII, Puerto Ricans came to New York in large numbers and kept on coming during the next decades. LaFontaine found out that at some point during this massive migration to New York, the Puerto Rican students accounted for a quarter of the total number of students in this city (idem). Based on his findings, the author tends to conclude that in spite of the high number of students with Puerto Rican origins in New York, in the 1960s, the efforts to encourage them to pursue a higher degree education that the authorities made were kept to a minimum. Consequently, the number of dropouts within this ethnic group was very high compared to the rest of the population (idem).

As mentioned before, studies show that the native Puerto Rican women on the island have lower rates of infant mortality. One possible explanation is that the survival of these infants is guaranteed, like in the case of other Hispanic / Latino groups, by the overwhelming role family protection plays in the care giving for these children (Landale et al., 2000, 890). The cultural and behavioral transformations Puerto Ricans are undergoing consequently to their migration to the mainland as well as the added stress that naturally occurs following a relocation of such proportions may have a general negative contribution to the rate of infant mortality within this ethnic group. On one hand, family traditions are subjected to changes due to the new cultural influences, while on the other, shifts in gender roles mainly due to socio-economic conditions, encourage the women to assume more active roles as financial providers for the family. The mother's time and ability to care for her young will be consequently reduced, although she will still receive the help of those around her.

A higher level of poverty spread among the Puerto Ricans residing in the two Hartford neighborhoods Peter Guarnaccia used for his study of cases of asthma suffering patients is also adding to the general level of poor...

Guarnaccia takes into account environmental factors and the poor housing conditions that lead to the spread of parasites that cause infections such as Ascaris Lumbricoides or cockroaches and rats that contribute to the spread other infectious diseases. Deteriorating housing conditions, air pollution in the urban areas, along with the stress of family problems and the scarcity of programs to support families in need are all contributing to a deteriorating state of the health conditions of the Puerto Rican families that came under the attention of the scientists (idem). They are, of course, particular cases, but they are relevant in terms of the general population originating from the island or with Puerto Rican ancestry in so far similar socio-economic conditions are to be found prevailing elsewhere on the mainland for this ethnic group or on the island.
Among the very specific illnesses that the medical world had reported in the case of the Puerto Rican ethnic group, there is the so called Puerto Rican syndrome. This illness is categorized among the "culture-bond syndromes, a category of psychiatric illnesses standing for mental disorders whose pathology is induced not organically but by a specific culture" (Gherovici, 2003, 31). Patricia Gherovici further emphasizes that the Puerto Rican paternity of the syndrome still arises debates among scientists, but history testifies that it was first among Puerto Rican soldiers fighting in the Korean War that doctors first noticed manifestations that are now considered specific to the syndrome. Further studies confirmed that beside the Puerto Rican migrants on the mainland, many Puerto Ricans living on the island suffered from the illness. Although not restricted to this particular group, the syndrome deserves the attention of anthropologists and workers in the field of sociology just as it deserves that of the medicine world.

The diversity of the genetic material in Puerto Ricans along with the homogeneity of their culture makes them an ethnic group with specific characteristics. Their beliefs, practices, traditions, their whole cultural heritage along with the special patterns of circulatory migration gives them unique features that have a significant contribution to their general health situation as well as to their response to the health care system.

Cordasco, F. Bucchioni E. 1973. The Puerto Rican experience: a sociological sourcebook. Rowman & Littlefield

Gherovici, P. 2003. The Puerto Rican syndrome. Other Press, LLC

Gonzales, L. 2008. HEALTH-CARE SEEKING BEHAVIORS of PUERTO RICANS WITH DIABETES MELLITUS WHO LIVE in SOUTH FLORIDA: AN EXPLORATORY STUDY.

Guarnaccia, P. 1981. Puerto Ricans, Asthma, and the Health-Care System. Medical Anthropology Newsletter, Vol. 12, No. 2 (Feb., 1981), pp. 9-17

Landale et al. Migration and Infant Death: Assimilation or Selective Migration among Puerto Ricans? American Sociological Review, Vol. 65, No. 6 (Dec., 2000), pp. 888-909

Zayas, L.H.…