Health standards have steadily improved in Costa Rica. The crude death rate per 1,000 people decreased from 22.1 in the early 1930s to 4 in 1995. The infant mortality rate, 166.7 per 1,000 live births in 1927, was 62.3 in 1968 and 10 in 2000. The decreases in mortality rates were attributed to improvements in sanitary and medical facilities under the national health program administered by the Ministry of Health. The fertility rate was 3.1 in 1994, a 1.3% yearly reduction since 1984, and was reduced further to 2.5 as of 2000. The use of contraceptives is one of the highest in Latin America and the Caribbean. In the mid-1990s, 75% of married females aged 15–49 were using a form of contraception. During 2000, life expectancy at birth was an average of 77 years.
Hospitals are located in the principal cities and about 95% of the hospital beds are in urban areas. In 1999, Costa Rica had 6,422 physicians, 1,204 nurses, 1,543 dentists, and 1,452 pharmacists. In the same year, there were an estimated 0.9 physicians and 1.7 hospital beds per 1,000 people.
Health services for the rural population are generally inadequate and the refugee problem has severely taxed urban services. However, there are sanitary units and dispensaries to care for the health needs of the poor. During the 1980s, the greatest health problem was protein-calorie malnutrition, particularly among infants and children. Diseases of the circulatory system are the leading cause of death. As of 1995, 100% of the population had access to safe water. In 1997, Costa Rica immunized children up to one year old as follows: diphtheria, pertussis, and tetanus, 91%; measles, 99%; polio, 93%; and tuberculosis, 91%. The incidence of tuberculosis was 17 per 100,000 in 1999.
As of 1999, the number of people living with HIV/AIDS was estimated at 12,000 and deaths from AIDS that year were estimated at 750. HIV prevalence was 0.54 per 100 adults.