Particularly hard hit were educational, health, and sanitation facilities. By World War II, Puerto Rico was forced to limit the services of or close numerous health care clinics, hospitals, and schools. Puerto Rico's location in the Caribbean and proximity to the United States, the Panama Canal, and Cuba made a place of strategic importance during World War II and the Cold War.
Specifically, educational, health, and sanitation establishments were severely affected. By the time of World War II, Puerto Rico was forced to scale back or close numerous medical centers, hospitals, and schools. The island's geographical location in the Caribbean and its proximity to major American interests, including the Panama Canal and Cuba, made it a crucial location during both wars and the Cold War.