Differential mortality patterns between Nicaraguan immigrants and native-born residents of Costa Rica.
BACKGROUND
This study describes the all-cause and cause-specific mortality of Nicaraguan-born and native-born inhabitants of Costa Rica and examines the influence of socioeconomic and demographic factors on differential mortality risks.


METHODS
We analyzed Costa Rican vital records for the years 1996-2005 with negative binomial regression models to determine the relative mortality risks of Nicaraguan immigrants versus Costa Rican natives with adjustments for age, urbanization, unemployment, poverty, education, and residential segregation.


RESULTS
Nicaraguan-born men and women had reduced mortality risks of 32% and 34% relative to their Costa Rican-born counterparts. Excess homicide mortality was found among Nicaraguan-born men [rate ratio (RR) = 1.35, 95% CI: 1.19-1.53] and women (RR = 1.41, 95% CI: 1.02-1.95).


CONCLUSIONS
The Nicaraguan-born population had a reduced all-cause mortality risk versus Costa Rican-born people over the years 1996-2005, due to markedly lower disease mortality. Homicide is a major source of excess mortality among Nicaraguan-born immigrants versus Costa Rican natives.
Herring
Andrew Avery
AA
Harvard Medical School, 1493 Cambridge Street, Cambridge, MA 02139, USA. Andrew_herring@student.hms.harvard.edu
Bonilla-Carrión
Roger Enrique
RE
Borland
Rosilyne Mae
RM
Hill
Kenneth Hailey
KH
D000293:Adolescent; D000328:Adult; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003364:Costa Rica / Q000453:epidemiology; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000208:ethnology / Q000639:trends*; D009527:Nicaragua / Q000453:epidemiology / Q000208:ethnology; D012959:Socioeconomic Factors; D014171:Transients and Migrants; D055815:Young Adult