title: Differential mortality patterns between Nicaraguan immigrants and native-born residents of Costa Rica.
abstract: 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.
authors.affiliation: Harvard Medical School, 1493 Cambridge Street, Cambridge, MA 02139, USA. Andrew_herring@student.hms.harvard.edu
authors.forename: Andrew Avery
authors.initials: AA
authors.lastname: Herring
authors.forename: Roger Enrique
authors.initials: RE
authors.lastname: Bonilla-Carrión
authors.forename: Rosilyne Mae
authors.initials: RM
authors.lastname: Borland
authors.forename: Kenneth Hailey
authors.initials: KH
authors.lastname: Hill
mesh_terms: 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