What are the most significant health challenges facing residents of insular areas of the Caribbean?

Question

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The Answer is -Gap in life expectancy between males and females is eight years, compared with four years in the United States due to high level of homicides and vehicular injuries among adolescent and young adult Puerto Rican males.
-Residents of PR and USVI experience similar rates of chronic disease as mainland
United States Heart disease, cancer, cerebrovascular disease, and diabetes are leading causes of death.
-High preterm birth rates in PR and USVI.
-HIV/AIDS is major public health issue in PR and USVI.
-Infectious diseases are also major issues: endemic dengue fever, TB, and chikungunya. Dengue and chikungunya are difficult to diagnose due to limited access to lab tests and symptoms that resemble other diseases such as influenza.
-Impact of environmental events: hurricanes and large dust clouds containing particles that enter airways.
-Presence of toxic waste sites.

What Are the Most Significant Health Challenges Facing Residents of Insular