Comparative Analysis of Health Outcomes Between Migrants and Native Spaniards

Abstract

In 2012, Spain enacted a law which changed its Universal Health System from ensuring government funded healthcare for all residents, regardless of immigration status, to restricting migrant healthcare access. This study investigates health records from 2017, one year before this restrictive legislation was repealed, to determine if such legislative action coincides with disparities in health outcomes between migrants to Spain and native Spaniards. Because a health record analysis from 2012 suggests that migrants in Spain exhibited poorer overall health even before the legislative restrictions, we hypothesized that migrant communities would continue to demonstrate lower health outcomes than native Spaniards while these restrictions were enforced. We extracted nationality and health data from the Spanish Ministry of Health’s 2017 National Health Survey. We grouped thirteen health sub-indicators into four main health indicators to compare the general physical and mental well-being of migrants and native Spaniards. These main indicators included disease prevalence, risk factors for future infirmities, mental health, and self-perceived health. After quantifying interviewees’ responses, we compared population means of migrants and natives for each sub-indicator through an unpaired t-test of means to determine trend significance. We integrated the results of sub-indicator comparisons to determine overall trends in the four main indicators. With only one exception, all eight sub-indicators for disease prevalence demonstrated decreased prevalence among migrant populations which indicates lower overall disease for migrants compared to native Spaniards. This trend continued for self-perceived health as well as all sub- indicators used to assess mental health and predisposition to future illnesses. These results suggest that migrants in Spain are healthier than their native counterparts. The better health outcomes experienced by the migrants relative to native Spaniards contradict our hypothesis. Nevertheless, previous findings explain these results as demonstrative of an established phenomenon, the “healthy migrant effect,” in which migrants typically demonstrate higher healthcare outcomes than their native counterparts. The observed “healthy migrant effect” despite legislative restrictions on migrant healthcare access, as well as the effect’s apparent disappearance during the aftermath of Spain’s 2008 economic recession, suggests that the health disparities between migrants and natives correlated more directly with a nation’s economic well-being than their legislative actions.