Multimorbidity and chronic diseases among undocumented migrants: evidence to contradict the myths

Abstract

Background: There is little verified information on the global health status of undocumented migrants (UMs). Our aim is to compare the prevalence of the main chronic diseases and of multimorbidity in undocumented migrants, documented migrants, and Spanish nationals in a Spanish autonomous community. Methods: Retrospective observational study of all users of the public health system of the region of Aragon over 1 year (2011): 930,131 Spanish nationals; 123,432 documented migrants (DMs); and 17,152 UMs. Binary logistic regression was performed to examine the association between migrant status (Spanish nationals versus DMs and UMs) and both multimorbidity and individual chronic diseases, adjusting for age and sex. Results: The prevalence of individual chronic diseases in UMs was lower than in DMs and much lower than in Spanish nationals. Comparison with the corresponding group of Spanish nationals revealed odds ratios (OR) of 0.1-0.3 and 0.3-0.5 for male and female UMs, respectively (p < 0.05 in all cases). The risk of multimorbidity was lower for UMs than DMs, both for men (OR, 0.12; 95%CI 0.11-0.13 versus OR, 0.53; 95%CI 0.51-0.54) and women (OR, 0.18; 95%CI 0.16-0.20 versus OR, 0.74; 95%CI 0.72-0.75). Conclusions: Analysis of data from a health system that offers universal coverage to all immigrants, irrespective of legal status, reveals that the prevalence of chronic disease and multimorbidity is lower in UMs as compared with both DMs and Spanish nationals. These findings refute previous claims that the morbidity burden in UM populations is higher than that of the native population of the host country.

Overuse or underuse? Use of healthcare services among irregular migrants in a north-eastern Spanish region

“…This cross-sectional population-based retrospective study analyzed clinical and administrative data from individuals assigned to all public primary care (PC) centres in Aragon, Spain, in 2011. These data were originally collected as part of the EpiChron Cohort, which gathers demographic, clinical, and pharmaceutical data from electronic health records (EHRs) and the health insurance database for almost all inhabitants of Aragon, using a unique anonymized personal identification code [ 20 , 21 ]. The Aragon health service is part of the Spanish national health system, which provides free care and medical testing, and is funded by taxes.…”

Migration status, physical limitations and associated self-rated health: a study of older Indian adults

“…Migration necessitates acclimating to new healthcare systems, where multi morbidity and susceptibility to infection may be a concern, and mobility impairment further exacerbates the situation [ 87 ]. However refuting previous research, two nationwide studies from Norway and Sweden confirm that migrants have lower multi-morbidity levels as compared to non-migrants [ 102 , 103 ].Further, our findings of sleep problems and chronic pain among the migrant ageing population suggest to have reported poor SRH and significant relationship have been consistent and well documented in numerous previous studies [ 104 – 108 ].…”

Downgraded dreams: Labor market outcomes and mental health in undocumented migration

“…A crucial caveat is that it is a selected sample of migrants seeking medical care at a single outpatient clinic in Milan ( Devillanova, 2008 ), warning on the generalizability of the results to other contexts. This limitation is common in studies on undocumented migrants, mainly based on convenience non-representative sample data ( Garcini et al, 2021 ), with exceptions ( Allegri et al, 2022 ; Gimeno-Feliu et al, 2020 ). Individual characteristics, except for medical diagnoses, are self-reported and may be subject to recall bias, as well as challenges related to language barriers.…”