Puerto Rico: One of the World’s Oldest Populations and Still Aging Fast

By Dr Kristen Robinson

Puerto Rico may be famous for its beaches, vibrant music, and warm climate, but it’s also becoming known for another reason: it has one of the highest proportions of older adults in the world (U.S. Census Bureau, International Database). How does aging under conditions of economic hardship, migration, and limited caregiving shape the lives of older Puerto Ricans? (Center for Puerto Rican Studies; Van Dam, 2022)

A Shrinking, Aging Archipelago

Between 2010 and 2020, Puerto Rico’s total population fell nearly 12%, largely because younger adults moved to the U.S. mainland seeking work and opportunity (Center for Puerto Rican Studies, 2021; Van Dam, 2022). Meanwhile, in 2024, older adults make up historic shares of the population: 31% are 60+, 25% are 65+, and 4% are 85+, surpassing any U.S. state or territory and approaching global leaders like Japan and Italy (PRB 2024; U.S. Census Bureau 2025) (see Figure 1).

Figure 1.

Fewer births, longer life, and migration losses have created a rapidly aging population navigating poverty, fragile infrastructure, and caregiver shortages.

Social Determinants Shape Aging in Puerto Rico

Aging in Puerto Rico is profoundly shaped by social determinants of health (SDOH), the economic, social, and environmental conditions that influence quality of life and well-being. Key factors include:

• Economic Stability: Nearly 40% of older adults live at or below the poverty line, almost four times the rate on the U.S. mainland. Median household income is $17,905, roughly $28,000 lower than older households on the mainland (Shrider et al., 2021). Limited income affects access to nutritious food, safe housing, transportation, and healthcare.

• Healthcare Access: Many older adults depend on public health services, yet gaps in funding and infrastructure increase vulnerability, particularly for chronic illnesses. Travel to mainland facilities is often the only option for advanced care.

• Housing & Living Conditions: Affordable and safe housing is unevenly distributed, leaving some older adults at risk of isolation or unsafe living environments — particularly in rural or disaster-affected communities.

• Social & Family Support: Caregiver shortages are intensifying as younger adults migrate, leaving older adults increasingly reliant on family networks, volunteers, and community programs for daily support and social connection (Center for Puerto Rican Studies; Van Dam, 2022).

These factors interact in complex ways: economic hardship limits access to healthcare and housing, migration reduces caregiving support, and limited social infrastructure compounds isolation.

Supporting Older Adults Through the Aging Network

Puerto Rico’s Office of the Ombudsman for the Elderly coordinates services through two Area Agencies on Aging (San Juan and Ponce), funded via the Older Americans Act (OAA) (Office of the Ombudsman, 2021). Programs include:

• Home-delivered meals and senior centers

• Alzheimer’s and caregiver support

• Volunteer-based community services

To meet growing needs, the Office has expanded respite care, home-attendant services, and counseling, while volunteers and family networks continue to play critical roles. The broader U.S. Aging Network, including ACL and federal partners, ensures older adults in Puerto Rico have access to services similar to those on the mainland.

Yet aging under constrained social conditions demonstrates a key reality: without adequate income, healthcare, housing, and caregiving, longevity alone does not guarantee well-being.

Action Steps

• Invest in social determinants of health: income support, caregiving infrastructure, safe housing, and healthcare access.

• Strengthen community-based programs to reach rural and underserved populations.

• Expand volunteer networks and family caregiver supports to address gaps caused by migration.

• Use Puerto Rico as a case study for U.S. aging policy, showing how targeted interventions can sustain well-being despite economic and demographic challenges.

Summary

While Puerto Rico is neither a U.S. state nor an independent country, but rather an unincorporated territory of the United States, its residents are U.S. citizens by birth. Despite this status, older Puerto Ricans face unique challenges that differ from those on the mainland, including gaps in federal benefits, limited access to advanced healthcare, and a shrinking pool of family caregivers due to migration. These disparities make the role of the U.S. Aging Network and federal support systems critical. Older Puerto Ricans deserve the same opportunities to age with dignity, independence, and security as their mainland counterparts. Ensuring adequate income, healthcare, safe housing, and community support is not only a matter of social justice but also a reaffirmation of their citizenship and rights within the United States.

References

• Administration for Community Living. (n.d.). Aging network and services overview. https://acl.gov/about-acl

• Center for Puerto Rican Studies. (2021). Puerto Rico population trends 2010–2020. Hunter College.

• Office of the Ombudsman for the Elderly. (2021). Annual report on programs and services for older adults in Puerto Rico.

• Population Reference Bureau. (2024). Countries with the oldest populations in the world. https://www.prb.org/resources/countries-with-the-oldest-populations-in-the-world/

• Shrider, E. A., Kollar, M. A., Chen, F., & Semega, J. L. (2021). Income and poverty in the United States: 2020. U.S. Census Bureau. https://www.census.gov/library/publications/2021/demo/p60-273.html

• U.S. Census Bureau, International Database.

• U.S. Census Bureau, Population Estimates and Projections.

• Van Dam, A. (2022). Population decline in Puerto Rico: Causes and consequences. Center for Puerto Rican Studies.

About The Author:

Kristen Robinson, Ph.D. is an Evidence Oracle contributor and researcher focusing on older adults, people with disabilities, and family caregivers with the greatest social and economic needs.