Health inequality between immigrants and natives in Spain: the loss of the healthy immigrant effect in times of economic crisis

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Title: Health inequality between immigrants and natives in Spain: the loss of the healthy immigrant effect in times of economic crisis
Authors: Gotsens, Mercè | Malmusi, Davide | Villarroel, Nazmy | Vives-Cases, Carmen | Garcia Subirats, Irene | Hernando, Cristina | Borrell, Carme
Research Group/s: Salud Pública
Center, Department or Service: Universidad de Alicante. Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia
Keywords: Health inequality | Immigrants | Economic crisis | Gender | Socioeconomic exposures
Knowledge Area: Medicina Preventiva y Salud Pública
Issue Date: 1-Jul-2015
Publisher: Oxford University Press
Citation: European Journal of Public Health. 2015, First published online: 1 July 2015. doi:10.1093/eurpub/ckv126
Abstract: Background: The immigrant population living in Spain grew exponentially in the early 2000s but has been particularly affected by the economic crisis. This study aims to analyse health inequalities between immigrants born in middle- or low-income countries and natives in Spain, in 2006 and 2012, taking into account gender, year of arrival and socioeconomic exposures. Methods: Study of trends using two cross-sections, the 2006 and 2012 editions of the Spanish National Health Survey, including residents in Spain aged 15–64 years (20 810 natives and 2950 immigrants in 2006, 14 291 natives and 2448 immigrants in 2012). Fair/poor self-rated health, poor mental health (GHQ-12 > 2), chronic activity limitation and use of psychotropic drugs were compared between natives and immigrants who arrived in Spain before 2006, adjusting robust Poisson regression models for age and socioeconomic variables to obtain prevalence ratios (PR) and 95% confidence interval (CI). Results: Inequalities in poor self-rated health between immigrants and natives tend to increase among women (age-adjusted PR2006 = 1.39; 95% CI: 1.24–1.56, PR2012 = 1.56; 95% CI: 1.33–1.82). Among men, there is a new onset of inequalities in poor mental health (PR2006 = 1.10; 95% CI: 0.86–1.40, PR2012 = 1.34; 95% CI: 1.06–1.69) and an equalization of the previously lower use of psychotropic drugs (PR2006 = 0.22; 95% CI: 0.11–0.43, PR2012 = 1.20; 95% CI: 0.73–2.01). Conclusions: Between 2006 and 2012, immigrants who arrived in Spain before 2006 appeared to worsen their health status when compared with natives. The loss of the healthy immigrant effect in the context of a worse impact of the economic crisis on immigrants appears as potential explanation. Employment, social protection and re-universalization of healthcare would prevent further deterioration of immigrants’ health status.
Sponsor: This research was partially supported by the CIBER Epidemiología y Salud Pública Subprogram on Immigration and Health and the European Community’s Seventh Framework Programme (FP7/2007-2013) under grant agreement 278173 (SOPHIE project).
URI: http://hdl.handle.net/10045/48318
ISSN: 1101-1262 (Print) | 1464-360X (Online)
DOI: 10.1093/eurpub/ckv126
Language: eng
Type: info:eu-repo/semantics/article
Rights: © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association
Peer Review: si
Publisher version: http://dx.doi.org/10.1093/eurpub/ckv126
Appears in Collections:INV - SP - Artículos de Revistas
Research funded by the EU
INV - Investigación en Género - Artículos de Revistas
Institucional - IUIEG - Publicaciones

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