Gender differences in the association of cardiovascular risk factors with education: a comparison of Costa Rica (CRELES) and the United States (NHANES)

David Rehkopf, University of California, San Francisco
William H. Dow, University of California, Berkeley
Luis Rosero-Bixby, Universidad de Costa Rica

Despite different levels of economic development, Costa Rica and the United States have surprisingly similar mortality rates among women and men. In contrast to the United States, in Costa Rica there are only minor differences in adult mortality rates by education. We used data on adults aged 60 and over from the Costa Rican Healthy Aging Study (CRELES) and from the United States National Health and Nutrition Examination Survey NHANES to analyze the cross sectional association between educational level and risk factors for coronary heart disease (CHD) among men and women. Among the 17 gender specific outcomes examined, the only association with education that was similar across the two countries was for sedentary behavior among women. We find that there is not a uniform association of education with risk factors in the U.S. nor a uniform lack of association with education in Costa Rica.