Contextualizing the relationship between culture and Puerto Rican health: Towards a place-based framework of minority health disparities

In both the culture of poverty literature and the acculturation literature, Puerto Ricans are portrayed in negative terms. The culture of poverty framework attributes Puerto Rican poverty to the mental, behavioral, and moral pathology of Puerto Rican individuals and to Puerto Rican culture. Similarly, outdated acculturation frameworks also trace the poor health of immigrants and racialized minorities, such as Puerto Ricans, to equivalent perceived deficiencies. In this paper, we argue that both the culture of poverty and acculturation frameworks are two pillars of the White Racial Frame (Feagin 2009) that sustains racial inequality in the United States. To build our case, we provide an overview of Puerto Rican physical health disparities and highlight key findings. Then, we analyze this literature using natural language processing (NLP) tools to examine the lexicon of words that scholars use to understand such disparities. Our literature review shows that Puerto Ricans are generally doing worse than other groups across a range of health indicators. Results from the NLP analyses reveal that the lexicon of the culture of poverty and outdated notions of acculturation are rhetorical tools that scholars still use to make sense of these conditions. We conclude by arguing that moving away from a White Racial Frame of Puerto Rican health requires a theoretical model that puts race, place, and culture within a multilevel framework that we call the Racialized Place Inequality Framework.