In 2021, Hannah Hinders left the U.S. for Costa Rica on the heels of a bad breakup that left her wracked with anxiety, causing her to have panic attacks and drinking to excess. Hinders had even lost weight in the wake of her heartbreak. “I wasn’t healthy mentally or physically,” she tells Yahoo.
Fast forward nearly four years, and Hinders is still living and surfing daily in Santa Teresa. Her mental and physical health are the “best they’ve ever been,” she says. “I can’t even describe the change I’ve had in my life.”
Moving to Costa Rica isn’t the answer for everyone. But doctors I spoke to agreed that there really is something special about the country. When I interviewed Johns Hopkins University oncology professor, Dr. Otis Brawley, in early 2025, about the concerning rise in colorectal cancer rates among young adults, he told me that “prevention is the reason I’ve become obsessed with Costa Rica.”
His statement seemed, at first, to come out of left field. But then Brawley rattled off some surprising statistics: Life expectancy in the tiny island country is two to three years longer than that of the U.S., where the gross domestic product is 300 times larger. Costa Rica spends one-tenth what the U.S. does on health care (which is universal there), yet its cancer death rate is 40% lower.
“And it’s all based on healthy living,” Brawley said in our previous interview.
He’s not the only health expert who’s been studying the secrets to Costa Rica’s success. Could it be a blueprint for a healthier U.S.? Here’s what we learned.
Costa Rica’s better health, by the numbers
The average life expectancy in Costa Rica was 78.6 years in 2021, according to the World Health Organization (WHO). That same year, Americans could expect to live an average of 76.4 years. That may not sound like a big difference, but in health demographic terms, it is, experts say. Cancer death rates are also lower in Costa Rica — with 75.3 out of every 100,000 people dying of the disease there each year, according to the WHO. This year in the U.S., that figure is nearly double: 145.4 per 100,000 each year, per the National Cancer Institute.
Costa Rica’s list of top causes of death looked similar to that of the U.S. in 2021 (the latest year the WHO has data for), with the exception of COVID-19, which was the number one killer of Costa Ricans and the third deadliest threat to Americans that year. But the difference is in the rates: For each of the top 10 leading causes of death, the U.S. had significantly more deaths than Costa Rica.
“Costa Rica is not the only country that has done this, so it’s evidence that [reducing mortality rates] is doable,” says Brawley. “But the reason I use Costa Rica as an example is that it’s a very nice place, and the numbers are just so perfect.”
Both Brawley and Edward Ruiz-Narvaez, a University of Michigan associate professor of public health who grew up in Costa Rica, attribute these perfect numbers to four key factors:
Few Costa Ricans smoke
Tobacco use is a leading cause of cancer and deaths from the disease, but Costa Rica may have been spared the harms of smoking to some extent. Smoking rates have fallen precipitously in both countries since tobacco’s heyday in the 1960s. But cigarette use in Costa Rica never reached the same heights as in the U.S.
Brawley suspects that’s in part because “Costa Rica was too small a market to bother with” for big tobacco companies in the 1950s and 1960s. Companies like Philip Morris looked at Costa Rica’s small population and figured it wouldn’t be profitable enough to make advertising its cigarettes there worthwhile. Instead, tobacco companies focused their efforts on larger, wealthier nations like the U.S. and U.K. — until those countries realized the incredible harms associated with smoking and adopted regulations to prevent aggressive marketing. Tobacco companies then pivoted to advertising in smaller, lower-income countries, and even used Costa Rica as a testing ground for marketing strategies for Latin America, in the 1990s. But the small nation had great success adopting its own regulations against tobacco in the 2000s, and rates have since fallen by about 10 percentage points. While smoking rates are down in the U.S. as a whole, they’re still very high in some states: 21% of West Virginians were cigarette smokers as of 2022. And it remains the leading cause of preventable death, disease and disability from conditions including cancer, heart disease, lung disease and diabetes.
1. Fruits, vegetables and the ‘traditional’ diet
Brawley suspects that Costa Rica hasn’t seen the same upward trend in colorectal cancer rates as the U.S. because the traditional diet there is healthier than the typical American’s eating habits. “The fruits and vegetables and good-diet-stuff [Costa Ricans] eat is a factor” in their lower rates of cancers, including colorectal cancer, he says. That’s in part because these whole foods are less associated with obesity and, in turn, cancer. By contrast, “in our American diet, one of the things contributing to the obesity epidemic is the increasing number of processed foods,” says Brawley.
Before moving to Costa Rica, Hinders had worked a busy, high-pressure job at the Pentagon, so she wasn’t doing much home cooking. “I was eating out at regular American restaurants; processed foods basically,” she says. “It was not a clean, whole-food diet,” she says. When she got to Costa Rica, her surfer friends asked, “why are you eating that or putting that in your food,” Hinders recalls. Her diet didn’t change overnight, but her mindset began to. She realized: “To improve my surfing, I needed to improve my diet.” Now, Hinders and her surfing friends eat fish they catch locally and tropical fruits they pick every day, she says.
Eating like a Costa Rican has benefits well beyond surfing, though. “We’ve found that diet plays a significant role in longevity,” Ruiz-Narvaez tells Yahoo. Ruiz-Narvaez and his team have been collecting data on the habits and lifestyles of nearly 3,000 Costa Ricans ages 60 and older for 20 years now. In 2024, they published a paper showing that people who most frequently ate a “traditional” diet — built on the staples of high-protein, high-fiber beans and white rice — have an 18% lower mortality rate compared to those who eat rice and beans infrequently. Beans’ nutrient density makes them uniquely beneficial, says Ruiz-Narvaez. But it’s not just beans and rice, he notes. The traditional Costa Rican diet is also rich in the fruits and vegetables that grow abundantly there.
But the highly processed foods that are ubiquitous in the American diet — deli meats, potato chips, fast food, to name a few examples — are becoming increasingly prevalent in Costa Rica. And so is colorectal cancer: Rates rose by 35% between 2000 and 2020.
2. Fewer cars, more walking
When Hinders visited Costa Rica for the first time, she was charmed by Santa Teresa’s one gravel main street, lined with store fronts. “Everyone’s walking and biking,” she recalls of her first visit. “It was just so different from where I grew up in northern Virginia, where it’s very suburban.” Nearly four years after moving there, Hinders still doesn’t own a car (though she’s had motorcycles at various points). She walks to the grocery store, sometimes three times a day. It’s a far cry from the weekly car trip to Costco to stock up on groceries that she thinks of as the typical American ritual.
Historically, Costa Ricans have walked many of the places they need to go and worked jobs that required physical activity. It’s not that the country has been healthier because there are more gym devotees there than in the U.S.; The exercise Costa Ricans get is incidental, woven into the fabric of their daily living. When Ruiz-Narvaez began studying longevity among Costa Ricans in 2005, “people were active, working in farms and had more family support,” he says. “People 60 years old and older have very different behaviors and lifestyles compared to the current Costa Rican,” he adds. For many people, desk-jobs come with higher pay and less daily physical strain. But there’s a downside. “Middle-income and high-income countries very frequently have higher cancer death rates than lower-income countries,” says Brawley. “That’s because with increasing income comes adoption of bad habits: less exercise, more use of cars” and an increasing reliance on convenient, processed foods.
Though Costa Ricans, especially older folks, are still seeing the protective effects of living in a country that wasn’t clogged with cars, that’s changing. Ruiz-Narvaez says that urbanization has come with a growing number of cars and desk jobs. “There is less opportunity to walk to a job or to school” than there was when he was growing up in Costa Rica, he says.
3. Community meals and church gatherings
Another longevity factor that Ruiz-Narvaez studied was social connections.
In the U.S., the former surgeon general declared loneliness an epidemic tied to greater risks of death and disease. Ruiz-Narvaez found that Costa Ricans with plenty of social connections through friends, church and civic groups have a nearly 30% lower mortality rate than similar people with lower levels of social ties. “In Costa Rica, it’s common to observe houses with three generations [living in them] — parents, grandparents and kids — and that’s a part of social connection, You have family members around,” says Ruiz-Narvaez. In addition to high rates of church attendance, these family groups tend to eat meals together. “People look to food,” as a factor in Costa Ricans’ longevity, “but I see food as more like a social ritual,” says Ruiz-Narvaez.
Although urbanization might be cutting into these rituals for many in Costa Rica’s growing cities, Hinders says they’re an important part of her day-to-day in her adopted country. She and her friends get together to barbecue their catches-of-the-day on a nearly daily basis. Since moving to Costa Rica, Hinders says she’s “a completely different person, because of where I live and the lifestyle, but also because of the people and community.” It’s not just her surfing friends that provide a sense of community. “I had never lived somewhere where I got to know everyone at the grocery store, or the coffee shop; you’re friends with everyone and you can’t drive down the road without waving to 10 people,” she says.
Lessons to learn from Costa Rica
It’s worth noting that Ruiz-Narvaez also credits Costa Rica’s good health to its universal health care model, which is a public option that anyone can take advantage of, as well as higher-end private insurers. But much of the country’s good health can be credited to a culture and lifestyle that include whole foods like fruits, vegetables and beans, physical movement that’s baked into day-to-day activities and a sense of community.
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