Association between legal status regularization and self-rated health among undocumented migrants

Abstract

Abstract Background Little is known about the social determinants of undocumented migrants' health. The canton of Geneva, which hosts 10-15'000 undocumented migrants, implemented a selective regularization policy in 2017-2018. We sought to assess whether the regularization of the residence status was associated with self-rated health. Methods Analyses were based on the first-wave data of the Parchemins Project, a prospective multidisciplinary study evaluating the impact of regularization on undocumented migrants' health and wellbeing. We included 444 undocumented or recently (<3 months) regularized migrants living in Geneva for at least 3 years recruited in the community and healthcare settings. We used multivariate logistic regression to estimate odds of excellent or very good versus good, fair or bad self-rated health. Explanatory variables included measures of integration, financial situation and social support. Models were adjusted for health variables. Results Of the 444 undocumented migrants included, 204 (46%) had recently obtained a residence permit. These regularized migrants reported excellent or very good health more frequently than those undocumented (44.6% vs. 29.2% respectively, p-value < 0.01). However, this difference was not explained by the residence permit (OR = 1.14 [0.70, 1.85]), but rather by the ability to overcome financial hardships (OR = 1.66 [1.02, 2.71]) and better social support (OR = 1.67 [1.07, 2.62]). Adjustment for health variables did not alter these associations. Conclusions Policies aiming at promoting better health among undocumented migrants should include measures strengthening financial security and social resources. Further evidence is needed to assess the impact of residence status regularization on self-rated health in the longer term. Key messages Studies assessing the impact of the regularization of the legal status on health are generally scarce and evidence in the European context is lacking. This study contributes to fill these gaps. The relationships between the regularization of the residence status, socioeconomic conditions and social participation are of central interest to better understand undocumented migrants’ health.