State Overview

 

In September 2018, marking the one year anniversary post Hurricanes Irma and Maria, the Government released an extensive hurricane recovery report outlining the cumulative effects of the storms in damages to infrastructure and systems.  The report spoke to underlying factors that compounded damages and provided a guide toward long-term recovery efforts intended to strengthen infrastructure and systems throughout the Territory.  The following updates are cited from the USVI Hurricane Recovery and Resilience Task Force report:

 

The storms severely damaged the islands’ critical infrastructure, knocking out electricity and telecommunications for months, blocking roads, shutting down ports and airports, damaging water and wastewater facilities, generating hundreds of thousands of tons of debris, and damaging more than half of the Territory’s housing stock. Total damage is estimated at $10.7 billion: $6.9 billion to infrastructure, $2.3 billion to housing, and $1.5 billion to the economy. Specific damage included:

 

• Energy: More than 90 percent of aboveground power lines were damaged and more than half of all poles were completely knocked down. Customers on all three large islands experienced total service outages, most for at least several weeks. Over 90 percent of customers who could accept power were restored by January 1, 2018.

• Transportation: Airports on St. Croix and  St. Thomas closed for two weeks and reopened with only limited capacity. Seaports closed for three weeks due to the sinking of more than 400 vessels; roads blocked with debris and the loss of power to traffic lights—or the lights themselves—resulted in a more than a sevenfold increase in crashes at intersections.

• Housing: 52 percent of all housing stock was damaged (12 percent damaged severely); renters and low- and moderate-income (LMI) households were disproportionately affected. Senior centers were closed and homes for the elderly were damaged.

• Health: Both of the Territory’s main hospitals were severely damaged to the point of becoming nonoperational for most services; total daily inpatient capacity across the Territory was down 50 percent and hundreds of patients were evacuated to the mainland and have been unable to return because services like dialysis and cancer treatments are no longer available. 

• Education: All public schools closed for over a month, with 17 of 31 schools more than 50 percent damaged. Once open, most public schools operated on split sessions until the end of the academic year, and private schools saw steep enrollment drops.

• Economic impacts: Hotel reservations saw a 78 percent drop in December 2017 compared to a year before; by June 2018, major airlines were still reporting a 43 percent drop in flight seats available compared to a year before. There were 4,300 additional jobless claims after the storms, with roughly 8 percent of all jobs lost, comparatively marking the third worst job loss from a US hurricane in the last 30 years.

Source: USVI Hurricane Recovery and Resilience Task Force Report, 2018

 

US Virgin Islands Overview

Political Status

The US Virgin Islands is an unincorporated territory under the jurisdiction of the President of the United States. Residents are citizens of the United States. Pursuant to the Organic Act of 1936, The USVI is run by an elected Governor, with a non-voting Delegate to Congress, and a fifteen member Legislature.  In 2010, a proposed Constitution for the USVI, as drafted by the Fifth Constitutional Convention, was forwarded to the President of the United States for review.
 

Geography

The U.S. Virgin Islands (USVI) is comprised of four major islands-St. Croix, St. Thomas, St. John, Water Island, and approximately 50 small, mostly uninhabited islands.  The USVI is located in the Caribbean Sea at the eastern end of the Greater Antilles and the northern end of the Lesser Antilles.  The Territory is 1,600 miles south southeast of New York; 1,100 miles east southeast of Miami; and 100 miles southeast of San Juan.
 

Of the many islands and cays comprising the U.S. Virgin Islands, only four are of economic or clinical significance at the present time.  The largest, St. Croix, is 82.9 square miles, mostly flat and therefore, the most suitable for intensive industrial and agricultural development. St. Croix has two main towns-Christiansted, the larger of the two on the east, and Frederiksted, the smaller and more depressed on the west.

St. Thomas lying forty miles due north of St. Croix, is a major cruise and tourism destination and differs in both economic and geographic structure.  St. Thomas is approximately 32 square miles with rugged mountains that rise sharply from the sea to heights of up to 1,500 square feet.  The population density is 1,543.8 persons per square mile, more than twice that of St. Croix.  Charlotte Amalie, the Territory’s capital, is located on the south east quadrant of St. Thomas.

St. John lies approximately four miles east of St. Thomas, with picturesque hills and pristine waters. More than half of the island is designated as a National Park through the United States National Park Service, which has served to preserve much of this island's natural beauty.  St. John is only accessible by boat; the main town Cruz Bay is centrally located.

The fourth isle is Water Island, transferred from the Department of Interior on December 12, 1996.  The size of the island is 2-1/2 miles long and 2 miles wide with an area of 500 acres.  Water Island is separated from St. Thomas by 2 miles and is close enough to draw life support from. 

 

A.    Demographics

 

Population

According to the 2010 United States Census, the USVI population consisted of 106,405 persons; 50,601 on St. Croix and 51,634 on St. Thomas and 4,170 people living on St. John. This corresponded to a 2% decrease from the 2000 U.S. Census population of 108,612.  The 2010 US Census estimated that Males represented 48% (50,867) of the population with females at 52% (55,538).  In 2014, the USVI Community Survey indicated a total of 102,007 persons representing a 6% decrease from 2010.  The breakdown by gender and distribution remain roughly the same with 52% female, 48% male; 47% living on St. Croix and 53% living in the St. Thomas/St. John district.

 

Population less than 19 years

 In 2013, children represented 21% of the population, down from 24% in 2010 and 32% in 2000 and similar to the nation which was 23% for 2013. Over the past thirteen years the per cent of children as compared to the total population has declined. 52% of the children of the VI live on St. Croix, 45% on St. Thomas, and 2% live on St. John.

 

The VI population decreased 6% overall during the period 2000-2010 (101,809 to 106,405), with significant decreases evident in the 0 – 5 (12%) and 5-19 (16%) age groups.  Conversely, during this period, the 20- 59 and 60+ age groups showed increases of 3% and 56% respectively.

 

Regarding the number of children birth to five years, the VI Department of Health, Division of Vital Statistics and Research, indicated that there were 7,978 births between 2009 (1,753 births) and 2013 (1,320 births). This number does not account for children moving into the territory or moving off-island. These figures reflect a decline over the last five years by more than 400 births from 2009 to 2013. The general consensus is that many have moved off-island for economic reasons and better employment opportunities, impacting the birth rate since the economic downturn in the USVI, particularly on St. Croix.

 

 

Race and Ethnicity

The USVI population primarily consists of persons who are predominantly of African descent, i.e., Black, West Indian or African-American. The district of St. Thomas/St. John holds the highest percentage of people of African descent, while St. Croix holds the highest percentage of Hispanics, whose place of origin is more often nearby Spanish-speaking islands, such as Puerto Rico or the Dominican Republic.  The 2010 Census estimated the racial composition of the V.I. population as Black/African American 76%, Whites 16%, and Other races 8%. Most recent estimates from the 2014 Virgin Islands Community Survey (VICS) characterize the population as 77% Black (African American or African Caribbean), 10.5% White, and 12.4% Other Races with 17% of the population reporting Hispanic origins.

 

 

Population by Hispanic or Latino Origin

The 2010 Census estimated 18,504 persons of Hispanic origin. Demographics for this population

showed a decrease among Puerto Rican and Other Latino/Hispanics, while there was an increase

among Dominican residents.

 

 Languages Spoken in the Home

According to 2010 Census results, of the various languages spoken in the homes of families in the Virgin Islands, two-thirds, or 64.9% speak English only. Of the households in which Spanish or Spanish Creole is spoken, approximately 75% of those have at least one person 14 years of age or older who speaks English or speaks English well. Of the households in which French or French Creole is spoken, approximately 80% of those have at least one person 14 years of age or older who speaks English or speaks English well. Approximately 6.67% (or 2,886) of all households do not have a person over age 14 who speaks English only or English very well.

 

Population by Nativity / Citizenship

The Virgin Islands is a diverse and multicultural society.  The 2010 Census estimated that approximately 66.2% of the population was comprised of people born in the VI.  This is a noted increase from the 2000 US Census which estimated that 62% of the population was born in the V.I. and 37 % born outside of the territory at that time.  The 2010 Census further notes that 21% (28,199) of the population are naturalized citizens, 32% are born outside of the territory and 12% are not US citizens, which is inclusive of those that are undocumented.  Many of the persons who migrated to the territory seeking employment establish citizenship here.

 

B. Economic Indicators

 

Median Income

In 2010, the per capita income of households in the Virgin Islands was reported as $21,367, equivalent to about half (53%) of the average per capita income of households in the U.S. St. John had the highest per capita income of $26,326, followed by St. Thomas at $16,260 and St. Croix at $16,083.  The median income for the VI in 2010 was $45,058 while up from the previous year ($43,691) it still lags far behind the national family median income of $61,544.

 

 Cost of Living Indicators

VI family median income 2010 was $45,058. This compares unfavorably to the national US family median income for 2010 of $61,544. Thus on average, VI families have over $16,000 less per year to meet their regular expenses than do their stateside counterparts. The per capita income was $21,362 in 2010 (up from $17,860 in 2009) and considerably less than the national rate of $39,937 (USVI Kids Count Data Book 2012). The cost of living in the USVI is higher than in most jurisdictions as indicated by the fact that federal workers living in the USVI receive a cost of living adjustment to their salaries of 22.5%. Therefore, the difference in income is felt even more, as money doesn't buy as much, putting greater stress on families.

 

Studies have shown that the cost of living in the Territory is about 30% higher than Washington, D.C., the place with which the Territory is usually compared.  A common indicator of this is the 25% Cost of Living Allowance (COLA) that Federal government employees working and living in the VI receive to supplement their salary due to the high cost of living.  The inflation rate in the Virgin Islands is currently about 4.0 %.  The consumer price index (CPI) which is used as a measure of inflation has significantly increased in the VI from 14.2% in 2005, to 17.6% in 2006, and 23.3% in 2007 to 32.1% in 2008.  According to the most recent survey by the VI Bureau of Economic Research the annual percent change for the consumer price index is approximately 7.1% each year compared to 3.8% nationwide.

 

Poverty Status 

 

Poverty rates in the Virgin Islands are extraordinarily high compared to rates in the US.  The most recent 2016 VI Kids Count reported increased poverty levels for USVI families with children (32%, up from 27% in 2012) as well as increases in the number of children in the USVI living in poverty (37%, up from 35% in 2013). The highest number of children in families living below the poverty line are recorded on St. Croix (41%). The magnitude of the challenge poverty imposes on the Virgin Islands community is visible in data reporting 47% (up from 44% in 2013) of single female head of household families living in poverty (below the federal poverty level). These percentages are even higher for female-headed families with children under six years of age, with 58% of these families categorized as poor, compared to 44% of female-headed households with children ages 6 – 17 (CERC, 2019).

 

In 2014, roughly half (49.6%) of all children under age 6 (2,700 children) lived in families in poverty, compared to 32% of children age 6 to 17 (4,084 children). Children in St. Croix had the highest poverty rate of the islands at 40.6% (nearly the same as the rate in 2013: 40.5%). In St. Thomas, 34% of children lived in families in poverty (up from 29% in 2013). In St. John, 14% of children lived in families in poverty (a decrease of 10% percentage points from 2013) (2016 Kids Count).

 

The 2014 poverty threshold, adjusted for family size, was $24,008 in annual income for

a family of four with two related children under age 18. Because the cost of living (for food,

housing, energy etc.) in the USVI is documented as among the nation’s highest, actual VI

poverty levels are likely higher than indicated. Despite the general rise in median family incomes, more than a quarter of families with children reported incomes below the federal poverty level in 2014. Families headed by single mothers are especially vulnerable to poverty. Children’s families headed by unmarried females made up the majority of all poor families, representing just over ¾ (76%) of all families (with children) in poverty, similar to that in 2013 (74.5%) and 2010 (74.7%). Almost five out of every 10 single-female families with children lived below the federal poverty level (47.1%, up from 43.7% in 2013, and 39% in 2012, but similar to the rate of 47.8% in 2010) (2016 Kids Count).

 

C.     Community Economic Factors

 

The economic situation in the territory has worsened over the last five years as a result of the recession; the exodus of businesses which had EDC (Economic Development Corporations) benefits; and the closure of Hovensa Oil Refinery, the largest private employer with no significant relief.  St. Croix's economy is primarily based on manufacturing.  Major industries have historically include Hovensa Oil Corporation, V.I. Rum Industries, watch factories and several pharmaceutical companies.  St. Thomas' economy is largely based on tourism and the retail industry. In 2010 the U.S. Virgin Islands economy remained in the throes of a recession, with virtually all sectors of the local economy being impacted by the US and global recession.  Declines were seen in employment, visitor arrivals, building permits and government general fund tax revenues as effects of the widespread economic recession continued to be felt from the first to the fourth quarter of the 2009 fiscal year.

 

Employment losses spread across most industries with a net loss of 1,069 in non-agricultural employment.  In 2010, the territory’s unemployment rate reached 9.6% in St. Thomas/St. John and 11.7% on St. Croix. the highest rate since April 2001. The jobless rate averaged 7.1% for 2009, up from 5.8% in 2008. Unemployment insurance claims remain above historic levels although they have moderated from the peak of 607 in September 2008.  An increase in the unemployment rate is expected through the first quarter of the 2010 fiscal year.

 

In January, 2012, the Hovensa Oil Refinery on St Croix announced their intent to close the refinery and operate only an oil storage facility.  2,150 employees and sub-contractors were dismissed in April 2012 and only a small work force of approximately 350 persons were retained.  This represented an annual payroll loss between $269 million and $301 million dollars.  Their plans are to dismiss most remaining workers in July and September retaining only 100 long-term staff to operate the oil storage terminal.[1][2]  To put this in perspective, the April dismissals represent a loss of 27% of the average private sector gross pay on St Croix. The manufacturing sector counts for 20% of the VI economy and Hovensa represents more than 50% of the manufacturing sector.[2][3]

 

The impact on government revenue was dire.  Tax collections from Hovensa peaked in 2007 and declined considerably by 2009, when the refinery began experiencing annual losses.  The expected impact on VI Government revenue for FY2013 was $92 million dollars.  Of this, $69 million reflect the reduction in payroll taxes; $30 million in corporate taxes and fees and $23 million is estimated as the tax loss due to the ripple effect the closing will have on other businesses.  The economic impact on St Croix was harsh.  In 2011, Hovensa’s total economic activity in the VI was $420 million of which $346 million was in payments to individuals and vendors, the vast majority spent on St. Croix.  Losing this amount of spending on a small island  undoubtedly had a large impact on all businesses including landlords, retailers, restaurants, bars, private schools, and so forth.[3][4] 

 

St. Croix's unemployment increased from 9% when the closure was announced to 17% by December 2012. It is estimated that 30% of the employees migrated off-island to seek employment elsewhere. 1,300 of those laid off received unemployment compensation.37 The impact on government revenue has been dire. Tax collections from Hovensa peaked in 2007 and declined considerably by 2009, when the refinery began experiencing annual losses. The Director of the VI Bureau of Economic Research was quoted as estimating the total tax revenue loss as $140 million from the closing of the refinery reflected in the reduction in payroll taxes, corporate taxes and fees, and the tax loss due to the ripple effect the closing had on other businesses.

 

Beginning in January, 2012, the Government had its first ever employee dismissals for economic reasons as all departments were required to further reduce their budgets mostly through staff reductions.   Overall, Government employment was down about 1,000 employees since 2007 to under 8,000 before the recent dismissals.  Staff who have retired or resigned have largely not been replaced unless their salary comes from federal funds or the position is necessary to continue to receive federal funds.  In 2014, the Governor has requested Legislative approval of a loan to help fund government services at the current level.

 

Mass Transit System  

The Virgin Islands Transit System (VITRAN), under the auspices of the Department of Public Works, Office of Transportation, is responsible for coordinating and providing public transportation to residents of the Virgin Islands.  VITRAN provides transportation between remote locales, the main towns, and along the major thoroughfares.   Buses are equipped and available to provide transportation for individuals with disabilities who require use of wheelchairs or other assistive devices.  Major cutbacks in the scheduling and operation of these buses limits the service available to the public.  Private taxi services are frequently utilized as the primary mode of transportation. VITRAN-PLUS Para transit Services (VITRAN-PLUS) provides public transportation to certified disabled persons, in accordance with the Americans with Disabilities Act.

Environment

A unique factor, which affects the territory’s infrastructure, is the threat of tropical depressions and / or named storms/hurricanes.    While there have been no major storms in the past three years, the territory and its residents continue to experience the economic impact of high insurance rates.  In addition, delays in service and systems begin from the moment hurricane warnings are issued.  The community is encouraged to begin hurricane preparedness from the start of the hurricane season.  Service disruptions in all sectors of the community can last from one day to weeks or months depending upon the severity of the storm and its destruction of utilities and buildings, when and if it makes land fall.

 

 D. Socioeconomic Factors

The total number of individuals receiving SNAP (formerly Food Stamps) benefits at any point in FY 2013 was 34,154 within 15,527 households, which breaks down to 15,023 recipients on STT/J and 19,131 on STX. This represents an increase or almost 2000 recipients from 2012. It should be noted that 32% of households that receive SNAP, excluding those headed by seniors, have employed adults in the home. 
 

TANF provides cash assistance to single parents with dependents based primarily on asset and income tests. In the Virgin Islands, the head of household receives $180 a month plus $80 for each qualifying dependent. The table below shows the TANF statistics for 2013. These numbers may be surprisingly low to some, as there is a perception about the large number of persons receiving welfare assistance. The reality is 1,854 people received TANF benefits, 496 of these were adults and 1,358 children. The total TANF expenditure for 2013 was $1,606,190 (ECAC Strategic Report 2014).

 

Children in Families

Children’s well-being is significantly tied to family structure. Research indicates that children do best when raised by their biological mother and father in a low-conflict marriage. Even after controlling for family socioeconomic status, race/ethnicity, and other background characteristics, studies show that children in never-married, single-parent, or divorced families face higher risks of poor outcomes. Of all USVI families living in poverty, 74.7% were headed by single mothers and of all the single mother families with children, almost half (47.8%) lived in poverty. In the VI, 47% of children live in households headed by a single parent (ECAC Strategic Report 2014).

Health Insurance

Economic changes have led to changes in health care insurance coverage. A 2012 study revealed a major drop in employer group insurance and an increase in coverage through public programs, i.e., Medicaid and Medicare. The number of uninsured increased from 28.7% to 29. 7%, with 18.8 % of children birth to five years uninsured. The local structure of the State Children’s Health Insurance Program (SCHIP) did not insure any additional children. Individuals in the prime parenting age-group are uninsured at the rate of 39.4% of 18 to 24 year olds and 45.4% of 25 to 34 year olds. Any efforts to address elimination of health disparities in this population are severely hampered by stringent eligibility criteria of the local Medicaid Program (ECAC Strategic Report 2014).

Medicaid Cap

Residents of the territory are not eligible for the Supplemental Security Income (SSI) Program which provides assistive devices, therapeutic or rehabilitative services beyond acute care to children under the age of 16 with disabilities.  The Medical Assistance Program does not provide these services, due to the Medicaid Cap imposed by Congress.  These services are provided on a limited case by case basis by the Title V Program when required.

 

MAP in the VI provides medical assistance based on income and asset test o individuals and families that are medically and categorically eligible.  The poverty threshold for annual allowable income to qualify for Medicaid in the VI is $17,888 for a family of four compared to the national average of $33,465 (Census Bureau 2014) for a family of four.  This requirement causes difficulty for uninsured families to qualify for Medical Assistance and creates barriers to health care resources and services.  These uninsured individuals are generally unable to afford health insurance premiums and therefore not as likely to seek early prenatal care which may contribute to poor birth outcomes.  The actual cost of providing Medicaid services to this population who would otherwise meet eligibility criteria is unknown.  Government programs, clinics and hospitals (3) provide health care services at little or no cost.  Everyone, including low income, uninsured or underinsured individuals and families have access to essential services.  Prenatal patients with Medicaid coverage do not have the ability under program requirements to access care at private providers which limits their choices of providers.

 

One limitation of the expanded Medicaid program is that income eligibility will remain fixed at $5,500 for new enrollees—mostly adults without children. This provision will limit the availability of health insurance coverage among lower-income residents. Medicaid coverage is also limited by the federal match formula that requires the Virgin Islands to cover much of the costs of providing coverage. This match will improve under the ACA (changing to 55 percent federal, 45 percent local funding) but still represents a significant burden for the territory.

The USVI Department of Health's MCH Program is currently working towards updating the Title 5/Title 19 Inter-agency agreement with the Department of Human Services.

 

ACA Fiscal Cliff--As a result of the hurricanes, there has been an increase in demand for Medicaid services, an increase in our Medicaid-eligible population, as well as increased demands for reimbursement from states providing services to displaced Virgin Islands residents. These factors will substantially increase Medicaid costs which will accelerate the rate at which federal Medicaid funds are accessed. Consequently, because of the hurricanes, there may be little or no ACA Medicaid allotment remaining as of September 30, 2019. Thus, elimination of the cap on Territorial Medicaid reimbursements or a renewal of the ACA allotments would extend the availability of any remaining ACA allotment beyond September 30, 2019 “fiscal cliff”. If the "fiscal cliff' is not addressed by September 30, 2019, the Virgin Islands' Medicaid program will be at risk, and up to 35,000 U.S. citizens-35% of our population-could lose access to healthcare coverage under Medicaid. Given the lack of a viable healthcare insurance market in the Territory, our low-income population would have nowhere else to go for healthcare coverage (COH Testimony).

 

In-migration

Due to the geographic proximity to British possessions of Tortola, British Virgin Islands, and the island of Hispaniola-Santo Domingo and Haiti, in-migration of undocumented residents from neighboring Caribbean islands regularly occurs. Immigrants come to deliver teir babies in the Virgin Islands in order to ensure U.S. citizenship for their offspring.  They are uninsured and ineligible for any formal government programs.  Most of the pregnant women present without records of prenatal care.  In complicated pregnancies, critical newborns are cared for at the expense of the local hospitals and ultimately the Government of the Virgin Islands.  Language differences present a challenge for effective communication and greater cultural competency is a developing need.  Actual numbers for undocumented residents are unavailable and estimates vary due to lack of data from reliable and knowledgeable sources.  Additionally, this population is considered itinerant and constantly changing. They generally live in certain geographic areas, are non-English speaking, and access the health care system only when necessary.

 

Health Disparities
Geography (location of services for clients, transportation deficits), race and ethnicity (cultural competency, language barriers), and socioeconomics (under or un-insured, low-income, at-risk) all play significant roles in the existence of health disparities for our population. This can often be seen in the predisposition or incidence of disease, lack of access and availability to care, high emergency room use, lack of health literacy and improper use of medications.  In the VI, these considerations are all crucial in addressing the exigent need and demonstrate the importance of health awareness in our community. During the past three years, in addition to the usual social determinants of health such as poverty, limited educational attainment, crime and violence victimization/ perpetration, poor environment and sub-standard housing, the VI witnessed new risk factors in the form of displaced former HOVENSA employees made especially vulnerable due to their often progressed chronic disease, age, lack of health insurance and viable employment (VIPHC Report).   The VI will continue employing a strengths-based approach to address prevalent health disparities through continuing partnerships and sharing resources to support our vulnerable populations.

 

Poverty remains one of the greatest threats to our children’s wellbeing in the USVI.  In 2014, 49.6% of children under the age of 6 lived in families in poverty.  By island, the poverty rates are disproportionately higher with 41% of children living with families in poverty on St. Croix, 29% on St. Thomas, and 24% on St. John (Kids  Count 2016).

 

Kids Count

The USVI Kids Count Data Book provides a comprehensive and notable look at the wellbeing of our children through demographical and socioeconomic lens. Key findings from the 2016 USVI Kids Count Report are included below: