This application proposes to field two waves of a new, nationally representative longitudinal Costa Rican Health and Retirement Survey targeting Costa Rican adults near retirement age, born 1945-1955. This would complement an on-going longitudinal household survey of older Costa Ricans born before 1945 (CRELES). A number of factors make Costa Rica an important site for the study of older adults'health and economic status: (a) Costa Rica has higher life expectancy than even the United States, with lower age-specific mortality rates among adults. The proposed data would allow unique new insight into life-course social and economic determinants of Costa Rica's success, as well as investigation of the bi-directional relationships between health and work among older adults in this exemplar population. (b) Past work has found Costa Rica to have unusually small socioeconomic gradients in health and economic well-being. This project is designed to allow deeper exploration of the role of public and private support underlying these remarkable inequality patterns. (c) Costa Rica experienced one of the earliest and fastest fertility transitions in the developing world, with total fertility dropping from 7.3 births in 1960 to 3.7 by 1976. By focusing on the parental cohorts experiencing this decline, this survey can uniquely advance understanding of the long- term demographic dividends of fertility decline. (d) Costa Rica provides a particularly rich study setting due to the ability to retrospectively and prospectively link the proposed microdata with high quality registries of vital events such as deaths, creating the ability to follow the sampled cohort at low cost indefinitely into the future.

Public Health Relevance

The proposed project would generate a unique new dataset for studying the determinants of longevity in a country considered a success story for having achieved """"""""good health at low cost."""""""" Furthermore, it would enable detailed study of social and economic conditions surrounding retirement in a country on the leading edge of the aging transition in Latin America.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Research Project (R01)
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Study Section
Social Sciences and Population Studies Study Section (SSPS)
Program Officer
Phillips, John
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University of California Berkeley
Schools of Public Health
United States
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Rosero-Bixby, Luis; Dow, William H (2016) Exploring why Costa Rica outperforms the United States in life expectancy: A tale of two inequality gradients. Proc Natl Acad Sci U S A 113:1130-7
Glei, Dana A; Goldman, Noreen; Risques, Rosa Ana et al. (2016) Predicting Survival from Telomere Length versus Conventional Predictors: A Multinational Population-Based Cohort Study. PLoS One 11:e0152486
Rosero-Bixby, L; Coto-Yglesias, F; Dow, W H (2016) Pulse blood pressure and cardiovascular mortality in a population-based cohort of elderly Costa Ricans. J Hum Hypertens 30:555-62
Domino, Marisa Elena; Dow, William H; Coto-Yglesias, Fernando (2014) Educational gradients in psychotropic medication use among older adults in Costa Rica and the United States. Psychiatr Serv 65:1218-25
Rehkopf, David H; Dow, William H; Rosero-Bixby, Luis et al. (2014) Seasonal variation of peripheral blood leukocyte telomere length in Costa Rica: A population-based observational study. Am J Hum Biol 26:367-75
Rosero-Bixby, Luis; Dow, William H; Rehkopf, David H (2013) The Nicoya region of Costa Rica: a high longevity island for elderly males. Vienna Yearb Popul Res 11:109-136
Rehkopf, David H; Dow, William H; Rosero-Bixby, Luis et al. (2013) Longer leukocyte telomere length in Costa Rica's Nicoya Peninsula: a population-based study. Exp Gerontol 48:1266-73
Modrek, Sepideh; Dow, William H; Rosero-Bixby, Luis (2012) Long-term association of economic inequality and mortality in adult Costa Ricans. Soc Sci Med 74:158-66
Rosero-Bixby, Luis; Dow, William H (2012) Predicting mortality with biomarkers: a population-based prospective cohort study for elderly Costa Ricans. Popul Health Metr 10:11
Goldman, Noreen; Turra, Cassio M; Rosero-Bixby, Luis et al. (2011) Do biological measures mediate the relationship between education and health: A comparative study. Soc Sci Med 72:307-15

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