One of the biggest changes since moving to Ecuador from rural Missouri has been the shift in my overall health. I’m still trying to pinpoint the cause of some lingering fatigue and occasional hypersomnia, but I’ve lost 40 pounds in the eleven months since leaving the United States. There are so many advantages to living in a developed country like the U.S., but it’s hard to put a price on the improvement to my health now, and on the years of good health this move may be adding to my future. What makes the Andes so healthy? I think it comes down to four things: climate and environment, lifestyle and dietary changes, cognitive and social health, and easy access to quality healthcare.
Climate and Environment
At an elevation of 8,500 feet, Cuenca offers its residents the natural benefits of moderate altitude living. Living between 5,000 and 10,000 feet has been linked to improved pulmonary and cardiovascular function, along with lower rates of heart disease. Metabolically, altitude also seems to reduce obesity and improve blood sugar regulation. I imagine these concrete benefits are part of why Andean communities are among the longest-lived in the world.
Cuenca’s spring-like weather, hovering between 55° and 75°F nearly year-round, adds to the case. Without sweltering heat or bitter cold, there’s less seasonal stress on the body and fewer weather-related illnesses. It also makes for a more active lifestyle, since there’s no harsh weather to hide from. More time outside generally means more time moving.
Compared to most major U.S. cities, Cuenca has remarkably clean air, with an Air Quality Index between 9 and 20 on the U.S. EPA scale. The city center does get some traffic fumes, but the surrounding suburban and rural areas enjoy excellent air quality, thanks in part to the altitude and mountain breezes. It’s air that’s practically made for being outside.
Lifestyle Changes
My whole lifestyle has transformed since the move to South America. The biggest shift, and probably the most significant for my physical health, has been how walkable the city is. Because I can get to the mercado, pick up my medication at the farmacia, or run just about any errand on foot, I usually walk a minimum of three miles a day, and some days I’ll hit five or more. My rule of thumb is to walk anywhere I can reach in thirty minutes, though if I’m on my own, I’ll often go even farther.
The culture here also lends itself to a slower pace of life. There’s far less rush and pressure to get things done than I experienced in the U.S. That’s allowed me to relax into slower days, though I’ll admit the slower pace comes with its own occasional frustrations.
One of the best health benefits, though, is that the lower cost of living means I can work substantially less than I did back home. I work twenty hours a week and still help support my family. That leaves so much more room for the things that actually protect my health: time to cook nutritious meals, time to squeeze in a little self-care, and, most importantly, time with my little girl.
Diet
The Andean diet is one of the oldest continuously practiced food cultures in the world, and it shows in the health benefits. Staples include potatoes, corn, quinoa (a high-protein grain), and native legumes, alongside proteins like fish, seafood, chicken, and pork. Vegetables and fruit from both the highlands and the tropical coast are plentiful and inexpensive, while processed food is comparatively rare and expensive. Like many Cuenca residents, I’ve gravitated toward a whole-food diet almost by default.
My meat consumption has gone down considerably as I’ve leaned into more high-fiber, complex-carbohydrate foods. Oversized meat portions are rare here, especially at the local almuerzos that make up most of our meals outside the home. I’ve really leaned into the food culture, cooking with whole, local ingredients whenever I can, and I love trying my hand at Ecuadorian recipes from Laylita’s Recetas.
Cognitive and Social Health
Starting over somewhere new is always energizing, and I should know. I’ve lived in five states and one U.S. territory before picking up my life and setting it down in South America. Studies consistently link novelty to improved cognitive health and longevity, and learning a new language is thought to build cognitive reserve, creating denser neural connections that help stave off age-related dementia.
Social life matters just as much for cognitive health. Because Cuenca is such a well-established expat destination, we’ve had ample opportunity to meet other English-speaking families, digital nomads, and retirees. Honestly, I have a more robust social network here than I ever did in Missouri.
Healthcare
My experience with healthcare in Ecuador has, by far, been the best I’ve ever had. I started using the private system almost immediately after arriving, when the stress of the move triggered a shingles episode. As soon as I recognized what was happening, I contacted an English-speaking doctor and saw him that same afternoon for $20. My husband picked up the prescribed pain medication and antivirals at the farmacia for less than $40. The care itself was thorough and attentive.
Since then, I’ve seen specialists ($40–$50 a visit), the dentist ($40 for a cleaning and checkup), and our regular family doctor, all within days and at a fraction of what the same care would cost in the U.S. Our family doctor makes house calls to check on my husband’s blood condition, my psychiatrist typically answers emails or WhatsApp messages within a day, and I can usually get an ultrasound scheduled for the next day. I still have some health issues I’m working to figure out, so not waiting weeks or months between appointments has been an enormous relief.
I want to be clear that I recognize my privilege in being able to access the private healthcare system, something not available to many native Ecuadorians, who rely on the public system instead. But for those of us who’ve battled the beast that is privatized healthcare in the United States, Cuenca’s combination of quality, access, and cost means getting care sooner and with far less stress.
Other Considerations
Not everything about health in Cuenca is rainbows and sunshine. Altitude can be genuinely difficult for people with certain cardiac or pulmonary conditions, and I’ve heard of North Americans who ended up moving back home or relocating to lower-lying coastal areas because of it. The elevation also means significantly more UV exposure, which is why it’s common to see big hats and parasols here as people guard against skin cancer and premature aging.
And, of course, the life of an immigrant is inherently stressful. Navigating a new culture, or worse, not speaking the local language, can be genuinely isolating. It’s worth weighing these downsides honestly alongside everything else this move has given me.
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