Costa Rica – Health Issues

What are the most common health issues and diseases in Costa Rica?

In common with many middle-income nations experiencing demographic ageing, Costa Rica has seen its primary disease burden shift markedly over recent decades toward non-communicable conditions. Cardiovascular disease, cancer, diabetes, and chronic respiratory illness are now the leading drivers of premature mortality. According to WHO World Health Statistics 2024, the probability of dying between age 30 and exact age 70 from any of these four conditions stood at 9.9% as of 2019.

High blood pressure is pervasive throughout the adult population. The age-standardised prevalence among adults aged 30 to 79 reached 37.8% as of 2019 — a considerable public health challenge. Studies have highlighted a high rate of poorly managed hypertension in Costa Rica, pointing to gaps in chronic disease management even within a broadly capable healthcare system.

Infectious diseases continue to demand attention, particularly those transmitted by insects. Dengue fever is the most frequently occurring mosquito-borne illness in the country, with more than 31,200 cases recorded in 2024. The disease circulates throughout the year but intensifies during the rainy season, which runs from May to November, with the Central Pacific and central regions bearing the heaviest case loads. Zika and chikungunya are also present, though at substantially lower levels.

Chagas disease, caused by parasites carried by the Reduviid bug, primarily affects people living in rural communities. Hepatitis occurs more frequently in Costa Rica than in North America, though at far lower rates than in some neighbouring Central American countries. Gastrointestinal illness resulting from contaminated food or water is another common complaint, particularly among those who have recently arrived and whose digestive systems have yet to adjust to the local environment.

Is Costa Rica considered a healthy country? How do health outcomes compare internationally?

Costa Rica achieves health outcomes that far exceed what might be expected given its level of economic development. Life expectancy at birth in 2024 stood at 81 years — above the regional average for the Americas and 3.7 years higher than the figure recorded in 2000. This places Costa Rica at the top tier of Latin American countries for longevity, broadly comparable to several prosperous European nations.

In 2019, Costa Rica’s adjusted rate of potentially avoidable premature mortality was 155.9 deaths per 100,000 population — a figure 31.2% lower than the overall average for the Region of the Americas. This represents a remarkable achievement for a country that spends considerably less per capita on health than wealthier nations.

Through the widespread delivery of cost-effective primary care and community health programmes, the Costa Rican system has largely overcome the disadvantage typically associated with developing countries in terms of communicable disease mortality. As a result, overall life expectancy has climbed to levels seen in high-income nations. This stands in striking contrast to much of Central America, where communicable diseases still account for a disproportionate share of deaths.

Between 2000 and 2019, infant mortality fell from 10.2 to 8.25 deaths per 1,000 live births, a decline of 19.1%. The maternal mortality ratio in 2020 was estimated at 22.0 deaths per 100,000 live births, representing a 42.9% reduction compared with 2000. For the most up-to-date statistics, readers are encouraged to consult the WHO’s Costa Rica data profile or the PAHO Health in the Americas country profile.

A particular feature of Costa Rica’s health story is its celebrated “Blue Zone” — the Nicoya Peninsula — where an exceptional proportion of the population lives past 90. Mortality at age 90 in Costa Rica is at least 14% lower than the average across 13 high-income countries, with this advantage growing by roughly 1% for each additional year of age. Researchers point to diet, close-knit social networks, and a strong sense of personal purpose as contributing factors, alongside lower rates of obesity in older generations.

What infectious diseases or environmental health risks should expats be aware of in Costa Rica?

Costa Rica’s tropical and subtropical climate sustains a variety of vector-borne and environmental health hazards that may be unfamiliar to those relocating from temperate regions. Arriving well-prepared is the most practical approach.

Dengue fever is the foremost infectious disease concern. It is the most common mosquito-borne illness in the country, with over 31,200 cases reported in 2024. Transmission occurs throughout the year but surges during the rainy season between May and November, and is not confined to rural locations — cities, towns, and tourist destinations are all affected. The Aedes mosquito responsible for spreading dengue bites primarily during daylight hours, particularly in the early morning and late afternoon, triggering symptoms that resemble a severe bout of influenza: high fever, intense headache, pain behind the eyes, and deep aching in the joints and muscles.

Zika and chikungunya are also circulating, though at considerably lower rates. Zika has declined markedly from its peak: just 37 confirmed cases were recorded in 2023 and 32 in 2024. The CDC identifies pregnant women or those intending to become pregnant as the group most at risk from Zika, owing to the association between the virus and the birth defect microcephaly.

Malaria risk is generally low but geographically concentrated. Local transmission has risen in recent years, but remains largely regional: of 590 total cases recorded in 2023, 474 originated within Costa Rica. The great majority of cases occur in the Huetar Carib region centred on the Caribbean city of Limón and along the northern border with Nicaragua. Anyone planning to settle in or make frequent visits to these areas should seek current medical advice.

Food and water safety requires consideration. Municipal water in Costa Rica is treated and subject to government-mandated laboratory testing every few months. In most cities and towns this water is safe to drink directly from the tap. However, during the rainy season — particularly in less developed coastal areas — heavy rainfall and wave activity can cause saltwater to contaminate freshwater storage tanks, making bottled water the safer choice. Those venturing into backcountry areas or travelling on very tight budgets should also be mindful of Giardiasis, which is found in unpurified water sources.

Vaccinations: No vaccines are legally required to enter Costa Rica unless you are travelling from a country where yellow fever is present, in which case a yellow fever vaccination certificate must be produced. Nevertheless, several immunisations are strongly recommended. Hepatitis A spreads through contaminated food and water and is more common in Costa Rica than in North America; full protection requires two doses. A typhoid vaccine is advisable for anyone who will be eating street food or visiting rural communities where food preparation standards can be inconsistent; it is available as an injection or in oral form. Before relocating, always consult your home country’s national travel health authority — such as the CDC (US), Travel Health Pro (UK/Ireland), or an equivalent body — and review the Costa Rica Ministry of Health website for current official recommendations.

Mosquitoes, ticks, and fleas in Costa Rica are capable of transmitting a range of illnesses, many of which cannot be countered by vaccination or medication alone, making personal protective measures indispensable. Apply insect repellent containing at least 20% DEET or picaridin, choose long-sleeved clothing and trousers for the evenings, and confirm that any accommodation is properly screened.

Is smoking common in Costa Rica, and what are the laws around it?

Tobacco use in Costa Rica is relatively uncommon by both regional and global standards. The Global Adult Tobacco Survey conducted in 2015 recorded a smoking rate of 8.9% among Costa Rican adults, with just 5.8% smoking on a daily basis — lower than the rates found in much of Europe and beyond. Public sentiment is broadly hostile to tobacco. Readers seeking the most current figures should refer to the WHO Global Adult Tobacco Survey, as the 2015 data may since have been updated.

Comprehensive tobacco control legislation is firmly in place. Costa Rica ratified the WHO Framework Convention on Tobacco Control in 2008, and the General Law for the Control of Tobacco and its Harmful Effects on Health was enacted in March 2012, addressing smoke-free environments, tobacco advertising, promotion, and sponsorship, as well as product packaging and labelling, all in accordance with FCTC guidelines.

The Tobacco Control Law sets out an extensive catalogue of smoke-free locations, including all indoor workplaces, the entire public transport network, and virtually every indoor public space. Certain outdoor settings are also designated smoke-free, among them outdoor workplaces, stadiums, arenas and other mass-gathering venues, petrol stations, and ports and public transit stops. This represents a stricter framework than exists in many countries, broadly comparable to the smoke-free regimes operating across much of Western Europe.

The sale of e-cigarettes is permitted under specific restrictions, but their use is banned in all indoor public spaces, indoor workplaces, and public transport, and their advertising, promotion, and sponsorship are broadly prohibited. A 2015 survey found that 93.1% of respondents supported smoke-free legislation for all public places — a level of popular backing that underpins enforcement. Expats should expect full compliance with these rules, with smoking effectively confined to designated outdoor spaces or private settings.

Is obesity or poor diet a significant health concern in Costa Rica?

Notwithstanding its reputation for fresh tropical produce and an outdoor-oriented way of life, Costa Rica is grappling with a serious and worsening obesity crisis. The age-standardised prevalence of obesity among adults aged 18 and over was 31.4% as of 2022, according to WHO World Health Statistics 2024. WHO projections indicate that Costa Rica will rank third in overweight and obesity rates within its region by 2060.

Traditional Costa Rican cuisine — known as “comida típica” — is centred on rice and beans (gallo pinto), plantains, root vegetables, and moderate quantities of meat. This dietary pattern is nourishing and relatively free of heavily processed ingredients. However, urbanisation and increased purchasing power have accelerated a swift transition toward processed and fast food, especially among younger generations and residents of the Greater Metropolitan Area around San José.

Insufficient access to affordable, nutritious food — a form of food insecurity — is linked to elevated risk of chronic conditions including obesity, diabetes, cardiovascular disease, and mental health difficulties. This is a pressing concern in lower-income communities. To help address this, the government has introduced front-of-pack warning labels on processed foods — modelled on systems used in Chile and Mexico — designed to help shoppers identify products high in fat, sugar, or salt.

The prevalence of overweight among children under 5 was 7.6% as of 2022, suggesting that diet-related health problems are taking root from an early age. For expats, the essential takeaway is that while fresh and wholesome food is abundantly available in Costa Rica, heavily processed alternatives are just as easy to find — eating well requires the same deliberate choices as in most middle-income countries.

What are the mental health attitudes and services like in Costa Rica?

Mental health in Costa Rica, as across much of Latin America, still carries a degree of social stigma. While perspectives are slowly evolving — particularly among younger urban populations and in professional settings — many people remain reluctant to speak openly about psychological difficulties or to pursue formal support. Expats accustomed to environments where mental health is discussed more freely may find this reticence somewhat unfamiliar.

Within the public health system, the Caja Costarricense de Seguro Social (CCSS) — the social security body that forms the backbone of public healthcare — does offer mental health services, including psychiatry and psychology. Availability is uneven, however: public mental health resources are concentrated in the Central Valley around San José, and waiting lists can be considerable. This mirrors challenges faced by publicly funded mental health systems in many other countries, where demand regularly outstrips capacity.

Private mental health care is accessible and reasonably available in urban centres, particularly in San José and other major towns. A growing number of private psychologists and psychiatrists work in multiple languages and have experience serving the expatriate community. Fees are substantially lower than in Western Europe or North America, though they vary considerably by practitioner and location. Expats holding comprehensive international health insurance will typically find that private mental health consultations are reimbursable — confirm the details of your coverage before committing to a provider.

The suicide mortality rate in Costa Rica was 8.1 per 100,000 population as of 2021 — below the OECD average of approximately 11 per 100,000 — but this figure nonetheless underscores the importance of accessible mental health support. Expats who experience isolation, cultural adjustment difficulties, or language-related barriers may find assistance through expat community organisations, international religious communities, or the increasing number of therapists who conduct sessions in multiple languages and via video call.

Are there any health risks specific to expats living in Costa Rica?

Expats encounter several health challenges that are especially pertinent to those transitioning from different disease environments, climates, and ways of life. Understanding these in advance enables thoughtful preparation rather than unpleasant surprises.

Climate adjustment: Costa Rica is warm and humid throughout the year, with temperatures typically ranging from 21–32°C (70–90°F) depending on altitude and region. Those arriving from cooler or drier climates face a heightened risk of dehydration and heat-related illness. Heat stroke can be life-threatening; it is important to eat and drink regularly, choose loose, breathable clothing, and avoid strenuous activity during the hottest parts of the day.

Altitude considerations: The Central Valley — home to San José and many popular expat communities — lies at elevations of roughly 1,000–1,500 metres. People relocating from sea level may initially notice breathlessness or fatigue. These symptoms generally resolve within days to weeks, but anyone with existing heart or lung conditions should seek medical advice before moving to higher-elevation areas.

Gastrointestinal adjustment: Even the most careful newcomer is likely to experience at least a mild episode of traveller’s diarrhoea — frequently caused not by disease but by the gut flora adapting to different foods and a new microbial environment. This is a routine experience for international relocations and usually passes within a few days. Careful food hygiene, especially in the early months of residence, helps guard against more serious gastrointestinal infections.

Mosquito-borne disease exposure: Expats arriving from regions where dengue and similar illnesses are rare will have no built-up immunity and may be more susceptible than long-established local residents. Investing in quality insect repellent, properly screened windows, and mosquito nets in higher-risk areas is strongly advised, particularly through the rainy season.

Practical steps to take:

1. Register with a local doctor or clinic as soon as possible after arrival. If you are enrolled in the CCSS, register with your assigned EBAIS (primary care unit) — the nearest equivalent to a GP surgery in many countries with universal healthcare.
2. Ensure you have comprehensive health insurance before arriving, particularly if you will not be immediately eligible for public healthcare. International health insurance or Costa Rica’s INS (National Insurance Institute) plans are widely used by expats.
3. Obtain a full health screening and ensure your vaccinations are up to date before departure, including hepatitis A, typhoid, tetanus, and any others recommended by your national travel health authority.
4. Carry sufficient supplies of any regular prescription medication, and verify with Costa Rica’s embassy or the Ministry of Health that your medications are legally permitted in the country.
5. Acclimatise gradually, especially if moving to higher elevations, and allow time for your digestive system to adjust to local foods and water.

Where can expats find reliable health information and services in Costa Rica?

Finding your footing in an unfamiliar healthcare system is considerably easier when you know which sources carry authoritative, current information. For Costa Rica, several key official and practical resources should serve as your primary reference points.

The Costa Rica Ministry of Health (Ministerio de Salud) is the government’s principal public health authority. Its website publishes disease outbreak notifications, vaccination guidance, health regulations, and official statistics. Although most content is in Spanish, automated translation tools make the key material accessible to non-Spanish speakers.

The Caja Costarricense de Seguro Social (CCSS) — widely known as “La Caja” — administers Costa Rica’s public healthcare network, encompassing hospitals, clinics, and EBAIS primary care units. Expats who qualify and enrol in the CCSS gain access to this entire network. The CCSS website explains the registration process and the range of services on offer.

For international health data, the WHO’s Costa Rica data profile and the Pan American Health Organization (PAHO) Costa Rica country profile provide authoritative health statistics and an overview of the country’s public health priorities. The PAHO Core Indicators portal is a dependable reference for the latest regional health data.

For travel medicine and infectious disease information, the CDC’s Costa Rica traveller health page is regularly updated and covers immunisation recommendations, current disease outbreaks, and food and water safety guidance. Your home country’s national travel health authority — such as Travel Health Pro, the Australian Department of Health, or an equivalent body — will also have Costa Rica-specific advice worth reviewing before you relocate.

Expat community networks — both online forums and local in-person groups — can be a valuable informal source of practical recommendations for locating healthcare providers, pharmacies, and specialists who work in multiple languages. That said, always cross-check significant health information with official sources, as guidance on fees, procedures, and disease risks is subject to change over time.

Frequently Asked Questions About Health Issues in Costa Rica

Is the tap water safe to drink in Costa Rica?

Costa Rica’s municipal water supply is treated and subject to government-mandated laboratory testing every couple of months per municipality. In most urban and suburban areas, including San José, drinking tap water directly is generally regarded as safe. During the rainy season and especially in less developed coastal communities, bottled water is advisable, as heavy rains and wave activity can occasionally allow saltwater to contaminate freshwater storage. When uncertain about water quality in an unfamiliar area, use bottled or filtered water until the supply has been verified.

What vaccinations do I need before moving to Costa Rica?

No vaccines are required for entry to Costa Rica unless you are travelling from a country where yellow fever is endemic, in which case a yellow fever vaccination certificate is mandatory. Recommended immunisations include hepatitis A, typhoid, tetanus, and confirmation that your MMR (measles, mumps, rubella) vaccination is current. Consult your national travel health authority for a complete personalised list before you relocate.

How serious is the dengue fever risk for expats?

Dengue is the most prevalent mosquito-borne illness in Costa Rica, with more than 31,200 cases reported in 2024. It circulates year-round but intensifies during the rainy season from May through November. Expats who have not previously lived in dengue-endemic regions will have no prior immunity, making them potentially more vulnerable. Reliable use of insect repellent, screened accommodation, and appropriate clothing substantially reduces the risk. Because no specific treatment exists beyond rest and fluid intake, prevention is the critical priority.

What is the quality of healthcare like for expats?

Costa Rica’s public healthcare system through the CCSS is widely respected, and a flourishing private healthcare sector in urban areas is frequently used by expats seeking shorter waiting times and multilingual services. The system’s delivery of cost-effective primary care has pushed life expectancy to levels associated with high-income countries. Access to highly specialised procedures can be constrained, however, making comprehensive international health insurance a prudent investment.

Is mental health support available in English in Costa Rica?

Private mental health services — psychologists and psychiatrists — are available in major urban centres, and a growing number of practitioners offer consultations in multiple languages, including English and Spanish. The public CCSS system provides mental health care, though waiting times in many areas can be lengthy. Online therapy platforms offer an increasingly popular and flexible option for expats navigating the challenges of life in a new country.

Are there particular health risks for expats living on the coast or in rural areas?

Certain coastal and rural regions carry elevated risk for specific conditions. Mosquito-borne illnesses including dengue and malaria are more common in some lowland and coastal areas, particularly along the Caribbean coast around Limón, which accounts for the majority of malaria cases recorded in Costa Rica, along with the northern border region with Nicaragua. Rural settings may also experience less consistent water quality and more limited immediate access to medical care, making solid emergency planning and comprehensive insurance coverage especially important.

Is obesity a health issue I should be aware of in Costa Rica?

Costa Rica is facing a serious obesity challenge, with WHO projections forecasting that the country will rank third for overweight and obesity rates in its region by 2060. Adult obesity prevalence stood at 31.4% as of 2022. Fresh and nutritious food is plentiful, but heavily processed and fast food alternatives are equally accessible. Expats who adopt an active lifestyle and make use of Costa Rica’s abundant fresh produce typically find the country well-suited to maintaining good health.

What should I do if I have a medical emergency in Costa Rica?

In any medical emergency, dial 911 — Costa Rica’s unified emergency number for police, fire, and ambulance services. Public hospitals within the CCSS network are required to provide emergency care to everyone, regardless of insurance status or residency. For serious but non-emergency conditions, private hospitals in San José — including Hospital CIMA and Hospital La Católica — deliver care to internationally recognised standards. Comprehensive health insurance that includes emergency evacuation cover is strongly recommended for all expats living in the country.