The complex relationship between education and sex-specific life expectancy in Costa Rica. An analysis at the district level for 1984, 2000 and 2011

Abstract: This paper explores associations between education and life expectancy by sex at the district level in Costa Rica for the Census years 1984, 2000 and 2011. Previous research on the topic have shown mixed results on the gradient between SES and health outcomes for Costa Rica. This ecological study is the first to use districts as the unit of observation, which allows for a more elaborate analysis including several sociodemographic and health care controls, as well as age-specific mortality rates and mortality by causes of death. Results showed a strong positive relationship between education and life expectancy for women for all years, but for men results were less consistent. The association with education seems to be larger for the age groups adult and old-age adults, with a relevant link found to cardiovascular diseases, lung-related diseases and injuries.