Abstract
Robust data from a voter registry show that Costa Rican nonagenarians have an exceptionally high live expectancy. Mortality at age 90 in Costa Rica is at least 14% lower than an average of 13 high-income countries. This advantage increases with age by 1% per year. Males have an additional 12% advantage. Age-90 life expectancy for males is 4.4 years, one-half year more than any other country in the world. These estimates do not use problematic data on reported ages, but ages are computed from birth dates in the Costa Rican birth-registration ledgers. Census data con rm the exceptionally high survival of elderly Costa Ricans, especially males. Comparisons with the United States and Sweden show that the Costa Rican advantage comes mostly from reduced incidence of cardiovascular diseases, coupled with a low prevalence of obesity, as the only available explanatory risk factor. Costa Rican nonagenarians are survivors of cohorts that underwent extremely harsh health conditions when young, and their advantage might be just a heterogeneity in frailty effect that might disappear in more recent cohorts. The availability of reliable estimates for the oldest-old in low- income populations is extremely rare. These results may enlighten the debate over how harsh early-life health conditions affect older-age mortality.
The text of this article is only available as a PDF.
References
Arroyo, P., Avila-Rosas, H., Fernandez, V., Casanueva, E., & Galvan, D. (
1995
). Parity and the Prevalence of Overweight
. International Journal of Gynaecology and Obstetrics
, 48
, 269
–72
. 10.1016/0020-7292(94)02284-6Barbi, E., Caselli, G., & Vallin, J. (
2003
). Trajectories of Extreme Survival in Heterogeneous Populations
. Population
, 58
, 43
–65
.Barbi, E., & Vaupel, J.W. (
2005
). Comment on ‘In ammatory Exposure and Historical Changes in Human Life-Spans.’
. Science
, 308
, 1743.
–1743.
. 10.1126/science.1108707Brass, W. (
1971
). On the Scale of Mortality
Biological Aspects of Mortality
(pp. 69
–110
). London
: Taylor and Francis Ltd
.Caldwell, J.C. (
1986
). Routes to Low Mortality in Poor Countries
. Population and Development Review
, 12
, 171
–220
. 10.2307/1973108Caselli, G., & Lipsi, R.M. (
2006
). Survival Differences Among the Oldest Old in Sardinia: Who, What, Where, and Why?
. Demographic Research
, 14
(13
), 267
–94
. 10.4054/DemRes.2006.14.13Clayton, D.G., & Cuzick, J. (
1985
). The EM Algorithm for Cox’s Regression Model Using GLIM
. Applied Statistics
, 34
, 148
–56
. 10.2307/2347367Coale, A.J. 1977. “The Development of New Models of Nuptiality and Fertility.” Population numéro spécial:131–54.
Coale, A.J., & Kisker, E.E. (
1986
). Mortality Crossovers: Reality or Bad Data
. Population Studies
, 40
, 389
–401
. 10.1080/0032472031000142316Cockerham, W.C., & Yamori, Y. (
2001
). Okinawa: An Exception to the Social Gradient of Life Expectancy in Japan
. Asia and Pacific Journal of Clinical Nutrition
, 10
, 154
–58
. 10.1046/j.1440-6047.2001.00232.xDoblhammer, G. (
2004
). The Late Life Legacy of Very Early Life
. Berlin
: Springer-Verlag
.Elo, I.T., Turra, C.M., Kestenbaum, B., & Ferguson, B.R. (
2004
). Mortality Among Elderly Hispanics in the United States
. Demography
, 41
, 109
–20
. 10.1353/dem.2004.0001Finch, C.E., & Crimmins, E.M. (
2004
). Inflammatory Exposure and Historical Changes in Human Life
. Science
, 305
, 1736
–39
. 10.1126/science.1092556Finch, C.E., & Crimmins, E.M. (
2005
). Response to Comment on ‘Inflammatory Exposure and Historical Changes in Human Life-Spans
. Science
, 308
, 1743
–1743
. 10.1126/science.1109017Garson, L.K. (
1991
). The Centenarian Question: Old-Age Mortality in the Soviet Union, 1897 to 1970
. Population Studies
, 45
, 265
–78
. 10.1080/0032472031000145436Halstead, S.B., Walsh, J.A., & Warren, K.S. (
1985
). Good Health at Low Cost
Proceedings of a Conference Held at the Bellagio Conference Center
. New York
: The Rockefeller Foundation
.Henry, L. (
1972
). On the Measurement of Human Fertility: Selected Writings
. Amsterdam
: Elsevier
.Hill, K., Pande, R., Mahy, M., & Jones, G. (
1999
). Trends in Child Mortality in the Developing World: 1960 to 1996
. New York
: UNICEF
.Holford, T.R. (
1980
). The Analysis of Rates and of Survivorship Using Log-Linear Models
. Biometrics
, 36
, 299
–305
. 10.2307/2529982Horiuchi, S., & Wilmoth, J.R. (
1998
). Deceleration in the Age Pattern of Mortality at Older Ages
. Demography
, 35
, 391
–412
. 10.2307/3004009Costa Rica: Estimaciones y proyecciones de población 1970–2050 actualizadas al año 2000 y evaluación del censo del 2000 y otras fuentes de información
. (2002
). San José, Costa Rica
: INEC
.Kannisto, V. (
1988
). On the Survival of Centenarians and the Span of Life
. Population Studies
, 42
, 389
–406
. 10.1080/0032472031000143546Kannisto, V., Lauritsen, J., Thatcher, A.R., & Vaupel, J.W. (
1994
). Reductions in Mortality at Advanced Ages: Several Decades of Evidence From 27 Countries
. Population and Development Review
, 20
, 793
–810
. 10.2307/2137662Khlat, M., & Darmon, N. (
2003
). Is There a Mediterranean Migrants Mortality Paradox in Europe?
. International Journal of Epidemiology
, 32
, 1115
–18
. 10.1093/ije/dyg308Laird, N., & Olivier, D. (
1981
). Covariance Analysis of Censored Survival Data Using Log-linear Analysis Techniques
. Journal of the American Statistical Association
, 76
, 231
–40
. 10.2307/2287816Manton, K.G., Stallard, E., & Vaupel, J.W. (
1981
). Methods for Comparing the Mortality Experience of Heterogeneous Populations
. Demography
, 18
, 389
–410
. 10.2307/2061005McCullagh, P., & Nelder, J.A. (
1989
). Generalized Linear Models
. London
: Chapman and Hall
.Mesa-Lago, C. (
2000
). Market, Socialist, and Mixed Economies: Comparative Policy and Performance— Chile, Cuba, and Costa Rica
. Baltimore, MD
: Johns Hopkins University Press
.Costa Rica. Estimaciones y Proyecciones de Población 1950–2025
. (1988
). San José, Costa Rica
: Imprenta Nacional
.Palloni, A., & Morenoff, J. (
2001
). Interpreting the Paradoxical in the Hispanic Paradox: Demographic and Epidemiological Approaches
. Annals of the New York Academy of Sciences
, 954
, 140
–74
. 10.1111/j.1749-6632.2001.tb02751.xPreston, S.H., Elo, I.T, & Stewart, Q. (
1999
). Effects of Age Misreporting on Mortality Estimates at Older Ages
. Population Studies
, 53
, 165
–77
. 10.1080/00324720308075Robine, J.M, Caselli, G., Rasulo, D., & Cournil, A. (
2006
). Differentials in the Femininity Ratio Among Centenarians: Variations Between Northern and Southern Italy From 1870
. Population Studies
, 60
, 99
–113
. 10.1080/00324720500466000Robine, J.M., & Paccaud, F. (
2005
). Nonagenarians and Centenarians in Switzerland, 1860–2001: A Demographic Analysis
. Journal of Epidemiology and Community Health
, 59
, 31
–37
. 10.1136/jech.2003.018663Rodríguez, G., & Cleland, J. (
1988
). Modelling Marital Fertility by Age and Duration: An Empirical Appraisal of the Page Model
. Population Studies
, 42
, 241
–57
. 10.1080/0032472031000143346Rosenwaike, I. (
1981
). A Note on New Estimates of the Mortality of the Extreme Aged
. Demography
, 18
, 257
–66
. 10.2307/2061098Rosero-Bixby, L. (
1986
). Infant Mortality in Costa Rica: Explaining the Recent Decline
. Studies in Family Planning
, 17
, 57
–65
. 10.2307/1967066Rosero-Bixby, L. (
1991
). Socioeconomic Development, Health Interventions, and Mortality Decline in Costa Rica
. Scandinavian Journal of Social Medicine
, 46
, 33
–42
.Rosero-Bixby, L. (
1996
). The Decline in Adult Mortality in Costa Rica
. In Chackiel, J., Ruzicka, L., & Timoeus, I. (Eds.), Adult Mortality in Latin America
(pp. 166
–95
). Oxford, United Kingdom
: Oxford University Press
.Rosero-Bixby, L. (
2004
). Evaluación del impacto de la reforma del sector salud en Costa Rica. Revista Panamericana de salud Pública
, 15
, 94
–103
.Rosero-Bixby, L., G. Brenes-Camacho, and A. Collado-Chaves. 2004. “Tablas de vida para cálculo actuarial de rentas vitalicias y retiro programado. Costa Rica circa 2000” [Life tables for actuarial computations of life-long rents and programmed retirement. Costa Rica circa 2000]. Población y Salud En Mesoamérica (Revista Electrónica) Vol. 1, article 4. Available online at http://ccp.ucr .ac.cr/revista/index.htm.
Rosero-Bixby, L., Dow, W.H., & Lacle, A. (
2005
). nsurance and Other Determinants of Elderly Longevity in a Costa Rican Panel
. Journal of Biosocial Sciences
, 37
, 705
–20
. 10.1017/S0021932004006996Roth, G.S., Lane, M.A., Ingram, D.K., Mattison, J.A., Elahi, D., Tobin, J.D., Muller, D., & Metter, E.J. (
2002
). Biomarkers of Caloric Restriction May Predict Longevity in Humans
. Science
, 297
, 811
–811
. 10.1126/science.1071851Shryock, H.S, & Siegel, J.S. (
1976
). The Methods and Materials of Demography
. New York
: Academic Press
.Stata Statistical Software: Release 9.0
. (2005
). College Station, TX
: Stata Corporation
.Demographic Yearbook
. (1961
). New York
: United Nations
.Trends in Total Migrant Stock: The 2005 Revision
. (2006
). New York
: United Nations
.Vaupel, J.W., & Carey, J.R. (
1993
). Compositional Interpretations of Medfly Mortality
. Science
, 260
, 1666
–67
. 10.1126/science.8503016Vaupel, J.W., Carey, J.R., Christensen, K., Johnson, T.E, Yashin, A.I., Holm, N.V., Iachine, I.A., Kan-nisto, V., Khazaeli, A.A., Liedo, P., Longo, V.D., Zeng, Y., Manton, K.G., & Curtsinger, J.W. (
1998
). Biodemographic Trajectories of Longevity
. Science
, 280
, 855
–60
. 10.1126/science.280.5365.855Vaupel, J.W., Manton, K.G., & Stallard, E. (
1979
). The Impact of Heterogeneity in Individual Frailty on the Dynamics of Mortality
. Demography
, 16
, 439
–54
. 10.2307/2061224Wedderburn, R.W.M. (
1974
). Quasi-Likelihood Functions, Generalized Linear Models, and the Gauss-Newton Method
. Biometrika
, 61
, 439
–47
.Whitehead, J. (
1980
). Fitting Cox’s Regression Model to Survival Data Using GLIM
. Applied Statistics
, 29
, 268
–75
. 10.2307/2346901World Development Report 2006: Equity and Development
. (2006
). New York
: Oxford University Press
.Yashin, A.I., & Iachine, I.A. (
1997
). How Frailty Models Can Be Used for Evaluating Longevity Limits: Taking Advantage of an Interdisciplinary Approach
. Demography
, 34
, 31
–48
. 10.2307/2061658© Population Association of America 2008
2008
Issue Section:
Articles
