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


Por: Gotsens M., Malmusi D., Villarroel N., Vives-Cases C., Garcia-Subirats I., Hernando C., Borrell C.

Publicada: 1 ene 2015
Resumen:
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 1564 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: 1.241.56, PR2012 = 1.56; 95% CI: 1.331.82). Among men, there is a new onset of inequalities in poor mental health (PR2006 = 1.10; 95% CI: 0.861.40, PR2012 = 1.34; 95% CI: 1.061.69) and an equalization of the previously lower use of psychotropic drugs (PR2006 = 0.22; 95% CI: 0.110.43, PR2012 = 1.20; 95% CI: 0.732.01). 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. © The Author 2015.

Filiaciones:
Gotsens M.:
 CIBER Epidemiología y Salud Pública, Spain

 Agència de Salut Pública de Barcelona, Health Information Systems Unit, Plaça Lesseps 1, Barcelona, 08023, Spain

 Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain

Malmusi D.:
 CIBER Epidemiología y Salud Pública, Spain

 Agència de Salut Pública de Barcelona, Health Information Systems Unit, Plaça Lesseps 1, Barcelona, 08023, Spain

 Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain

Villarroel N.:
 CIBER Epidemiología y Salud Pública, Spain

Vives-Cases C.:
 CIBER Epidemiología y Salud Pública, Spain

 Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, Alicante, Spain

Garcia-Subirats I.:
 Health Policy and Health Services Research Group, Health Policy Research Unit, Consorci de Salut i Social de Catalunya, Barcelona, Spain

Hernando C.:
 CIBER Epidemiología y Salud Pública, Spain

 Centre DEstudis Epidemiologics Sobre les Infeccions de Transmissio Sexual i Sida de Catalunya, Badalona, Spain

 Universitat Autònoma de Barcelona, Bellaterra, Spain

Borrell C.:
 CIBER Epidemiología y Salud Pública, Spain

 Agència de Salut Pública de Barcelona, Health Information Systems Unit, Plaça Lesseps 1, Barcelona, 08023, Spain

 Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain

 Universitat Pompeu Fabra, Barcelona, Spain
ISSN: 11011262
Editorial
OXFORD UNIV PRESS, GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND, Reino Unido
Tipo de documento: Article
Volumen: 25 Número: 6
Páginas: 923-929
WOS Id: 000367163900006
ID de PubMed: 26136466
imagen All Open Access; Bronze

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