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Spanish is spoken in Puerto Rico, and English is taught as a second language. But, all Puerto Rican residents are born U.S. citizens, and their hospital staff also receives much training from and in the mainland U.S. This commonwealth associated with the U.S. also seems to have the same problems with their health care systems as America. Health care costs have skyrocketed in recent years, and nurse shortages are also common.
As with many islands, the main population centers are located along the coastline, and this is also where you'll find the major medical systems. The hospitals on this island also serve Culebra and Vieques, two neighboring and populated Puerto Rican islands. The Department of Health has the sole public authority responsible for planning health services, and they've shifted an emphasis in the past decade to a preventative course to help their residents achieve a healthier lifestyle.
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