The relationship between political power and the various pathways to health inequalities in Vieques, Puerto Rico, is explored. The U.S. Navy used the island for 62 years for bombing and other military exercises. The article focuses on the resulting changes to the island's socioeconomic positioning and the health inequalities over six decades. Secondary data analysis of census data using a revised World Health Organization model is used to examine the relationships of political power, labor markets, employment, material deprivation, social and family networks, and health inequalities. Findings are interpreted through a social justice lens and implications suggest the use of political advocacy for social change.
Keywords: Puerto Rico; health inequalities; labor markets; material deprivation; political power.