The Harvard study estimates more than 4,600 people died as a result of that storm, though the official death toll is only 64. That staggering difference has prompted leaders to call for more resources to help with the crisis, and some of the strongest reaction to this vast difference in the death toll is coming from the Bronx -- home to 400,000 Puerto Ricans.
"When I read this and saw the study, my reaction is, 'You see, this is what we have been saying all along," Bronx Borough President Ruben Diaz said. "They need insulin. Diabetes is up. Other health ailments are exacerbated because the lack of medical attention."
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The study, published in the New England Journal of Medicine, found that many died from delayed medical care and at significantly higher rates during the three months after the hurricane than in the previous year.
New York City Mayor Bill de Blasio reacted, tweeting, "Imagine if nine months after a hurricane hit the state of Connecticut, we still didn't know how many people it killed. That is the reality in Puerto Rico."
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The governor of Puerto Rico said he welcomes studies like this one.
"We still don't have the details of that study, but certainly one of the main objectives that we've had and that we've established is to significantly improve out public healthcare response to a national natural disaster," Gov. Ricardo Rossello said.
Congresswoman Nydia Velazquez also reacted, saying she believes government needs to do more.
"Congress and all federal agencies need an accurate accounting of the scope of the devastation to direct adequate resources for recover," she said.
Diaz is cautiously hopeful.
"I hope that the federal government will finally respond in a way that they should," he said. "I am concerned, however, that there is very little interest there."
Click here for more from The New England Journal of Medicine.
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