TY - JOUR T1 - UNderstanding health care disparities in the us territories AU - Gutierrez N Y1 - 2011/09/26 N1 - 10.1001/archinternmed.2011.305 JO - Archives of Internal Medicine SP - 1579 EP - 1581 VL - 171 IS - 17 N2 - Congress has played a major role in shaping the financing of health care services since the passage of the Social Security Act of 1965. Laws involving Medicare and Medicaid often include language about application in the US territories. Typically, formulas used for territorial Medicaid allocations direct most funding to Puerto Rico, the largest territory. With a population of 4 million, Puerto Rico accounts for 90% of the total territorial population and has a larger population than 26 US states and Washington, DC. This leads the US Virgin Islands, Guam, American Samoa, and the Commonwealth of the Northern Mariana Islands, with population sizes between 70 000 and 170 000 people, to raise concerns about the impact of the current allocation methodology on their ability to strengthen a fragile health care infrastructure and respond to the changing demands of medical practice and service delivery. SN - 0003-9926 M3 - doi: 10.1001/archinternmed.2011.305 UR - http://dx.doi.org/10.1001/archinternmed.2011.305 ER -