If Americans spend more on healthcare, why do Costa Ricans live longer?

[Judi Lynn]

If Americans spend more on healthcare, why do Costa Ricans live longer?

Wealthy Americans live longer than Costa Ricans, but poorer Americans don't.

by Roheeni Saxena - Jan 13, 2016 9:27am CST



Citizens of the United States have a higher income than Costa Ricans, and they spend more of it on health care. In spite of this, Costa Rica has a higher life expectancy than the US—a new article published in PNAS attempts to explain why. The analysis focuses on the steep socioeconomic gradient in health that exists in the US, where the poor have considerably worse health outcomes than the wealthy.

The authors, Rosero-Bixby and Dow, argue that while the wealthiest people in the US have a higher life expectancy than anyone in Costa Rica, the poorest residents of the US have a considerably lower life expectancy.

In Costa Rica, the life expectancy is 78.5 years, though the per-capita GDP is quite low at $9,200. In contrast, the US has a GDP of $40,000, and a life expectancy of 77.4 years. Typically, economic development raises the national life expectancy, so it’s unusual that the US does not have a life expectancy commensurate with its income.

The authors point to one important difference between the US and Costa Rica that likely plays a factor in their different life expectancies: national health insurance. Costa Rica has a single national health insurance system that covers the majority of its residents. In comparison, though the US has drastically reduced the number of uninsured people in the US in recent years, the US healthcare system is still fragmented by private insurance companies. The authors of this article suggest that national health insurance helps Costa Rica to keep its healthcare costs low, whereas private, for-profit health insurance companies have failed to do so.

More:
http://arstechnica.com/science/2016/01/if-americans-spend-more-on-healthcare-why-do-costa-ricans-live-longer/

[geek tragedy]

1. they also eat a lot healthier food than Americans do

rice and beans and fresh fruit aren't sexy, but they beat 1000 calorie McMonster burgers.

[kristopher]

6. They walk a lot. Also....

...Pura Vida

Want cheese? Low fat cheeses are cheap; higher fat content costs more.

Like ice cream? You'll pay for the privilege of that creamy texture; but for about 1/3rd the price the ice milk is great.

[geek tragedy]

8. Yeah, they're less stressed out, which helps. nt

[glinda]

2. Less toxins in their food and environment?

[MisterP]

4. CR is full of banana plantations where it's so contaminated that not even birds fly over them for

miles after the banana trees end

[glinda]

5. wow

[kristopher]

7. Don't know about the bird part, but...

https://www.law.ufl.edu/law/wp-content/uploads/2012/04/2014-CR_Public-Health-Practicum_Report-final.pdf

Pesticides, Pollution, and People: An Overview of Public Health and Environment in Costa Rica

Executive Summary
Katherine Araya - UNA BS Candidate 2015
Bianca Lherisson - UF Law JD Candidate 2015 Faculty Supervisor: Franklin Paniagua Jennifer Lomberk - UF Law JD Candidate 2016 Research Assistant: Katherine Arroyo

In a developing country that prides itself on having a green reputation, a balance is required between sustainable development and economic progress. As Costa Rica’s healthcare system continues to evolve to meet the needs of its growing population, the legislation required to protect the country’s environmental assets is hard pressed to keep up. This project was designed to provide a comprehensive assessment of Costa Rica’s healthcare system and a general look at the current health problems that Costa Rica faces. It also provides an in-depth look at a few specific environmentally related health issues that the country is currently dealing with.
Health & Environmental Effects of Pesticide Use in Costa Rica
Costa Rica’s development relies heavily on the exportation of crops as well as a national devotion to environmental sustainability, Costa Rica is faced with the challenge of utilizing pesticides to maximize crop yields while simultaneously guarding against negative human health and environmental consequences. A heavy-handed approach to pesticide application paired with loose enforcement of safety standards has resulted in a high number of pesticide related deaths and illnesses including cancer, sterilization, and pesticide poisoning.
Additionally, excessive pesticide dosages and shoddy application methods result in the transfer of pesticides to the ecosystems surrounding agricultural land. Exposure to traces of pesticides is damaging to both the land that the pesticides are used on and the animal populations that inhabit the areas where the pesticides are used. Pesticide pollution is the cause of an array of different health effects in animal populations including reproductive and developmental disabilities and death. Furthermore, once pesticide pollution is introduced into an ecosystem, the pollution is hard to remove because the pesticides are placed directly on the cultivated land and the chemical characteristics of the pesticide compounds often make decomposition slow or impossible. Pesticide pollution results in a buildup of hazardous chemicals overtime that animals are exposed to which subsequently results in bioaccumulation in organisms.
In order to minimize and eventually eliminate pesticide pollution and its harmful effects on the environment and human health, Costa Rica needs to develop a comprehensive strategy to optimize pesticide use so that it is utilized in the most efficient way possible in conjunction with alternative pest control methods and thereby minimize and eventually eliminate the pesticide pollution that makes its way into the environment and comes into contact with both humans and animals. The current legislation regarding pesticide use in Costa Rica is well-written and comprehensive, but improvement is needed pertaining to enforcement mechanisms. Suggestions for improvement include:
• Imposition of stricter standards on pesticide companies
• Changes in international import policy that prohibits the import of agrochemicals
that have been banned for health reasons in foreign countries
ii
• Separate, delineate, and delegate specific aspects of enforcement of regulatory functions to certain agencies taking into consideration common policy objectives
• Secure funding to ensure that agencies have adequate means to conduct quality testing in a laboratory setting and that complete, organized records are kept
• Implementation of incentives for farms that utilize Integrated Pest Management
practices

....

Full paper at link above

[Jim Lane]

3. They don't have Republican candidates driving up their blood pressure. (n/t)

[FBaggins]

9. Probably because spending on healthcare is not the only contributing factor to life expectancy

Genetics, lifestyle, diet, climate (and on and on and on) all contribute as well.

There could also be statistical differences. It may be the case that the two countries do not report life expectancy statistics in the same way.