National Geographic : 2017 Nov
happiest places 45 Chaves as she toted a backpack and a small cooler of vaccines on her rounds through the leafy Central Valley town of Paraíso. She works with Equipos Básicos de Atención Integral en Salud (EBAIS), the national system that was set up in the mid-1990s to support the health of every Costa Rican. (Health and happiness are inextricably linked.) Small teams including a doctor, a nurse, a recordkeeper, and several technicians are assigned the care of about 3,500 people. Álvarez Chaves’s quota called for her to visit as many as a dozen homes a day. At each one she’d spend 30 minutes to update medical histories, take blood pressures, give vaccinations, dispense advice, and check for standing water (where Zika virus–bearing mosquitoes breed). At the Hernández Torres home, Álvarez Chaves counseled a young mother on a healthy diet for her two-year-old son and left behind vita- mins and antiparasitic pills. As she walked through the house, she noted the white bread and milk on the kitchen table. “ Try to eat more beans, fruits, and vegetables,” she advised. At the home of 89-year-old Aurora Brenes, Álvarez Chaves in- ventoried medicines, took blood pressure read- ings, and set up an appointment for Brenes with her team’s doctor. “I can often catch diseases be- fore they erupt into full-blown diabetes or a heart attack,” she said. “Many of my clients are lonely, and they just appreciate someone who cares.” Since 1970 Costa Rica has seen life expectan- cy jump from 66 years to 80 years and infant mortality drop by a factor of seven. The death rate from heart disease for men is about a third less than that in the United States, even though Costa Rica spends one-tenth as much per capita on health care as the United States. As former president José María Figueres, who implement- ed the EBAIS program, told me, the nation’s health care system works so well because it aims to keep people healthy in the first place. “In the U.S., incentives are aligned to drive up costs,” he said. “Here for years the emphasis has been on the preventive health system because, quite frankly, the objective of a good health policy is for people not to get sick.” In short Costa Rica’s social system takes care of most people’s needs, said Mariano Rojas, a Costa Rican economist and happiness expert at the Latin American Faculty of Social Sciences in Mexico City. “It leaves them feeling safe, com- paratively healthy, free of most of life’s biggest worries, while providing an environment where most people can still make a living.” IN COSTA RICA AN ALCHEMY OF GEOGRAPHY AND SMART SOCIAL POLICIES HAS CREATED A POWERFUL BLEND OF FAMILY BONDS, UNIVERSAL HEALTH CARE, FAITH, PEACE, EQUALITY, AND GENEROSITY.