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close this bookThe Nutrition and Health Transition of Democratic Costa Rica (INFDC, 1995, 228 p.)
View the document(introduction...)
View the documentContributors to this volume
View the documentIntroduction
close this folder1. Health policies and strategies
View the document(introduction...)
View the documentA brief description of Costa Rica
View the documentPublic health development
View the documentThe decade of the 1970s
View the documentThe decade of the 1980s
View the documentFinal reflections
View the documentReferences
close this folder2. Development of the social security institute
View the document(introduction...)
View the documentBackground
View the documentSocial security in Costa Rica
View the documentThe extension of direct insurance
View the documentExtension of insurance to the family
View the documentThe financial crisis
View the documentThe constitutional amendment
View the documentToward universalization
View the documentDevelopment of human resources
View the documentThe integration
View the documentThe new health care models
View the documentFinal comments
close this folder3. Development and characteristics of health and nutrition services for urban and rural communities of Costa Rica
View the document(introduction...)
View the documentIntroduction
View the documentBackground information on community outreach programs
View the documentMethodological characteristics of the Costa Rican health programs
View the documentNutrition programs
View the documentImpact of the programs on the health of children living in rural areas
View the documentConclusions
View the documentReferences
View the documentBibliography
close this folder4. Evolution of an epidemiological profile
View the document(introduction...)
View the documentIntroduction
View the documentStages of a process
View the documentThe first four decades of the century
View the documentThe period between 1940 and 1970
View the documentThe decade of the 1970s
View the documentThe decade of the 1980s
View the documentThe last decade of the century
View the documentFinal comments
View the documentReferences
close this folder5. Socioeconomic factors for the understanding of health policy during the 1970s
View the document(introduction...)
View the documentIntroduction
View the documentRecognition of social demands and the regulation of the conflict during the 1930s and 1940s
View the documentThe social government in the new development strategy of Costa Rica during the 1950s and 1960s
View the documentThe consolidated social government
View the documentFinal reflections
View the documentAcknowledgement
View the documentReferences
close this folder6. Problems and challenges of the health sector during the 1980s
View the document(introduction...)
View the documentIntroduction
View the documentSome problems of the health sector in the 1980s
View the documentBalance of the 1980s and perspectives for the 1990s in the health sector
View the documentReferences
View the documentAppendix 1 - Glossary
close this folderAppendix 2 - Supplementary reading list
View the document(introduction...)
View the documentEnglish-language supplementary reading list
View the documentSpanish-language supplementary reading list
View the documentSupplementary reading list - INCAP publications
close this folderAppendix 3 - Health conditions in Costa Rica 1994
View the documentGeneral information
View the documentSpecific health problems

General information

Population

In 1987 Costa Rica had 2,790,600 inhabitants. Based on official projections, the 1992 population was estimated at 3,099,063, with an age structure as follows: 0-4 years of age, 12.8%; 5-14 years, 23.1%; 15-64 years, 59.8%; 65 years or older, 4.3%. The population density increased from 50 inhabitants per km² in 1984 to 60.7 in 1992. The Central region is home to 65% of the population, with a density of 230.1 inhabitants per km²; in other regions of the country the population density ranges from 19 to 40 inhabitants per km². The population is 47% urban and 53% rural. Between 1960 and 1990 the urban population grew at an average annual rate of 3.9%.

The growth of the Central region has been largely the result of internal migration, although international migration has also played a part, particularly during the period 1975 to 1985, when three regions of the country registered net immigration (Central, Huetar Norte, Huetar Atlica). There continue to be two main currents of migration: from small cities and rural areas to the country's principal urban centers, and from economically depressed rural areas where employment opportunities are limited and most of the land is owned by a few individuals to other rural areas in which development is taking place and the demand for workers is greater.

In 1989, 40,800 refugees were living in the country. By July 1993, the number had fallen to 31,875. In addition, there are an estimated 250,000 undocumented aliens.

The natural population growth rate for the period 1991-1992 was 2.26%. The total fertility rate decreased from 3.5 children per woman between 1980 and 1985 to 3.26 between 1985 and 1990. In 1991 the birth rate was 26.3 per 1,000 population, and life expectancy at birth for the period 1990-1995 was estimated at 75.2 years.

Mortality

Birth and death records suffer from late registration of mortality, which is estimated at 2.8% for general mortality and 3% for infant mortality. No medical death certificate is issued for 24% of deaths in general, whereas only 2.8% of infant deaths lack medical certification.

The general mortality rate recorded in 1991 was 3.8 per 1,000 population and there were a total of 11,792 deaths. The infant mortality rate in 1991 was 13.9 per 1,000 live births. Deaths attributed to signs, symptoms, and ill-defined conditions made up 1.7% of the total.

In 1991 four major groups of causes accounted for 70% of all deaths: 29.4% were due to diseases of the circulatory system, 20% to malignant neoplasms, 10.5% to external causes, and 10.2% to diseases of the respiratory system, with rates of 11.2, 7.6, 4.0, and 3.9 per 10,000 population, respectively. Infectious and parasitic diseases, which in 1970 ranked as the leading cause of death and accounted for 20.5% of all deaths (a mortality rate of 13.6 per 10,000 population), in 1991 ranked 10th and were responsible for 2.8% of all deaths (a rate of 1.1 per 10,000 population).

Among the general population in 1991 acute myocardial infarction was the leading cause of death, accounting for 9.6% of all deaths. The mortality rate from this cause increased from 2.6 per 10,000 population in 1970 to 3.7 in 1991. In second place was malignant neoplasm of the stomach, which caused 5% of all deaths. The mortality rate from this cause, 2.0 per 10,000 population, has changed very little since 1970. The third leading cause of death was other forms of chronic ischemic heart disease, at a rate of 1.6. Chronic airway obstruction ranked fourth, at a rate of 1.2, and acute cerebrovascular disease and diabetes mellitus ranked fifth and sixth, respectively, at rates of 1.2 and 1.0 per 10,000 population.