Nicaraguan immigrants in Costa Rica: Health status and healthcare utilization
Morbidity, health status, health behaviors and healthcare utilization among the Nicaraguan immigrants in Costa Rica are analyzed. This is a descriptive cross-sectional comparative and epidemiological study. Data comes from the National Health Survey for Costa Rica 2006 (ENSA 2006). We analyze a sample of 7400 individuals of both sexes including 188 Nicaraguan immigrants. High hypertension, high cholesterol and respiratory diseases were significantly lower among the immigrant population. The level of obesity in the immigrant population is significantly higher. Nicaraguan immigrants are qualify less often a healthy state, they consume less alcohol, smoke more and do less physical exercise than the local population. The percentage of immigrants who attended a medical consultation in the last 6 months is significantly lower than the local population (26.4 versus 43.9). The percentage of immigrant women who underwent mammography is lower than the local female population (12.7 vs. 25.6). Likewise, consumption of medicines in the immigrant population is significantly lower than the local population (35.2 versus 53.2). Only 4.7% of immigrants got the flu vaccine versus 15.5% of the local population. In multivariate analysis, the Nicaraguan immigrants earn less often an appropriate state of health (very good / good) with respect to the local population (12% lower). By incorporating other variables in multivariate analysis, the differences increase to 27%. Nicaraguan immigrant population enjoys a health status equal to or even higher than that of the local population. High hypertension, high cholesterol and respiratory diseases were significantly lower among the immigrant population. In general, immigrants have a significant low rate of healthcare utilization. The belief that Nicaraguan immigrants represent an unsustainable burden for the public health system in Costa Rica is questioned. The results of this study should encourage health policy makers to expand medical services access to immigrants without fearing a disproportionate tax burden. Further research is needed.
Keywords: health status, health behaviour, healthcare utilization, inmigrants, Nicaragua, Costa Rica, health social determinants