Comparisons with the United States and Sweden show that the Costa Rican advantage comes mostly from reduced incidence of cardiovascular diseases, coupled with a low prevalence of obesity, as the only available explanatory risk factor.

Costa Rica’s life expectancy (consistently over 80 years) often surpasses that of the United States, a feat attributed to its "Good Health at Low Cost" model. A primary driver is the Caja (CCSS), the country's universal healthcare system, which emphasizes primary care and preventative medicine through "EBAIS" teams—small medical groups that regularly visit neighborhoods to monitor chronic conditions like hypertension. Culturally, the "Pura Vida" lifestyle promotes lower stress levels and strong social connections, which are proven longevity boosters. Diet also plays a massive role; the traditional intake is high in fiber and low in processed foods, centered on the "Nicoya Blue Zone" principles of beans, corn, and fresh fruit. Furthermore, the country's decision to abolish its military in 1948 allowed for significant budget redirection toward education and environmental protection, creating a clean, peaceful living environment that supports cardiovascular health and physical activity well into old age.