REGIONAL DISPARITIES IN HEALTH AND HEALTH BEHAVIORS OF COSTA RICAN OLDER ADULTS

Abstract

According to the WHO (2015), Costa Rica (CR) has the highest healthy life expectancy of the Central American region, being just second to Chile among all Latin American countries. However, important cultural and economic region disparities within the country exist (Human Development Index, 2017). Poverty, low education and other social determinants pose a risk factor for rural older adults’ health. In this study, we compared rural (Guanacaste) and urban (San Jose) older adults on different health indicators: reported chronic illnesses, BMI, sleep quality (PSQI), and community participation. Participants were part of the Epidemiology and Development of Alzheimer’s Disease (EDAD) study, which used a convenience sample of 311 cognitively healthy older adults (65 years and older). Results show that rural older adults had significantly more chronic conditions for (M = 4.80, SD =2.38) compared to urban dwellers (M = 4.20, SD = 2.28), p < .03. Specifically, rural older adults had significantly higher rates of diabetes, heart disease, chronic back pain, kidney problems, musculoskeletal conditions, and sleep disturbances (for all, p < .05). Urban older adults indicated higher frequencies of participation in community health activities compared to their rural counterparts (p = .02). No significant differences in BMI were found between the groups. These findings suggest that the study of healthy aging in Costa Ricans should be analyzed considering region as a social determinant of health. Public health policies in CR should aim at improving the social conditions associated to the poorer health status of rural older adults.