• Puerto Rico has many health care issues prominent in developed and underdeveloped countries.Aaron Graubart/Digital Vision/Getty Images
  
  Puerto Rico has been a possession of the United States for many years, but the advances of modern medicine have not always been so forthcoming. As late as the 1900s, tropical diseases and parasites contributed to high mortality rates and low life expectancy rates. While medical progress has since been implemented, many health care issues continue to exist.
  
  

AIDS

• Puerto Rico has a high number of citizens who are diagnosed with either AIDS or the HIV virus. It was among the top 10 American states and possessions that had the highest number of cumulative AIDS diagnoses through 2008, according to the Centers for Disease Control and Prevention (CDC). More than 32,000 adults and 400 children were diagnosed with the life-threatening condition. Puerto Rico was the only dependent area listed on the top areas affected by AIDS.
  
  

Malnutrition

• Up until the mid-20th century, much of Puerto Rico's health problems stemmed from the dire health conditions that are prominent in underdeveloped countries. Many of these diseases have been eradicated; however, Puerto Rico continues to see poor health conditions due to malnutrition. According to the CDC, Puerto Rico is ranked last in the nation for its citizen consumption of healthy fruits and vegetables.
  
  

Diabetes

• Many Puerto Rico residents are living with diabetes or have shown signs of developing the condition. Approximately 27 percent of its citizens have high blood pressure. Nearly 13 percent of Puerto Ricans are living with diabetes, according to the American Diabetes Association. In 2005, more than 178,000 people in the United States and Puerto Rico lived with end-stage kidney disease caused by an onset of diabetes. These people were living on chronic dialysis or had to have a kidney transplant because of health complications.
  
  

Health Reform

• Talk of organizing and uniting a universal health care system in America has made little mention on how Puerto Rico will be affected by the new system. President Barack Obama championed the cause during his 2008 presidential campaign, promising equal health care assistance for the 4 million people who live in Puerto Rico. But early on in the debate, Puerto Rico and the other territories were left out of the equation. Puerto Rico was included in the House and Senate versions that passed through Congress in 2010. According to Puerto Rico Daily Sun, Puerto Rico has between 350,000 and 500,000 people who do not have health insurance. While the law attempts to make health insurance more affordable, it also requires Americans to purchase a form of health insurance and those who do not comply could be subject to penalties.