Immigrants living in Spain use public healthcare less than nationals, especially Primary Care. As a likely consequence of this, they go more to emergency rooms and require more hospitalizations, as they access the system later. The Ministry of Health has aimed to counter with data what its head, Mónica García, has described as “rumors that contaminate the public debate” and, particularly, Vox’s discourse: “Against that false national priority of the far right, our priority is universal, to protect everyone, protect human rights, care for everyone and leave no one behind.”
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What the report shows is that migrants have fewer chronic diseases, which leads them to consume fewer medications and, generally, spend fewer healthcare resources. This is due to several factors, including that on average they are younger (), although the report does not standardize by age.
The biggest difference is access to Primary Care. Each Spaniard visits their family doctor an average of 9.5 times a year, 51.2% more than Europeans living in the country, 39.1% more than Africans, and 17.8% more than Latin Americans, who have a frequency very similar to those from the Eastern Mediterranean.
In contrast, migrants have a higher rate of hospital admissions: 10.5% compared to 9.2% of Spaniards. The difference in emergency use is more pronounced: 43.3% for foreigners and 37.2% for nationals.
García explains that one thing is a consequence of the other: “They go less to Primary Care centers, attend fewer follow-up consultations, but in the end they end up having to resort to emergency services with greater exposure to hospital admissions.”
The minister believes that this lower frequency of visits to the family doctor is due to the “barriers to accessing the healthcare system that they had until now.” She refers to the bureaucratic obstacles that many immigrants in irregular administrative situations had to access the system, which her department eliminated in March with a royal decree so that anyone living in Spain receives a card that allows them to access public healthcare and can justify their residence afterwards.
“Primary Care is the level of care with the greatest prevention and where our public healthcare is most efficient. This pattern is very important because it helps us understand that the problem is not overuse, but the difficulties in attending, in timely access to healthcare that allows prevention, early diagnosis, and adequate follow-up of health problems. When that continuity of care is interrupted or when there are obstacles to accessing the system, people end up arriving late and in worse conditions,” García said during the presentation of the report, which draws on several sources with data from 2024.
The minister pointed out that beyond the administrative factors that prevent many migrants from accessing the system before an emergency arises, there are cultural and social barriers: “Complex procedures, language difficulties, lack of information, or previous experiences of discrimination that end up distancing them from healthcare services.”
shows that, generally, the migrant population arriving in Spain presents better health status than those born in Spain. It is a phenomenon known as the “healthy immigrant effect.” “The very act of migrating, sometimes overcoming extreme conditions that can put people’s lives at risk, means that those in better health are more likely to be able to make the move to the destination country,” the document states.
This is reflected in the statistics: the native population shows a higher prevalence in 16 of the 21 pathologies studied compared to all the regions analyzed. In four of them — anxiety disorders, lipid metabolism disorders, acute upper respiratory tract infections, and asthma — prevalence rates exceed those recorded in the other regions by more than 20 points.
The burden of chronic disease is also notably higher among those born in Spain. The presence of at least one chronic health problem is between 24% and 38% higher than that of migrants, although this also has much to do with the average age, which is lower among foreigners.
This epidemiological profile translates into much higher medication use among Spaniards, who exceed the population from Africa by 62.7% and that from Latin America by almost 50%.
There are several exceptions where immigrants show worse health indicators. The first is non-insulin-dependent diabetes mellitus, with a rate of 103.2 per thousand among people from the Eastern Mediterranean, compared to 69.3 in the population born in Spain. The population of African origin records a higher incidence of uncomplicated hypertension (174.4 versus 172.2) and chronic kidney failure (26.2 versus 21.2).
