Immigrants go to the doctor less, but visit the emergency room more
A report from the Ministry of Health says that foreigners have fewer chronic diseases and take fewer medications
BarcelonaMigrants living in the State visit the doctor less often, have fewer chronic illnesses, and consume fewer medications than those born in the country. However, the lack of early access to the healthcare system leads them to go to emergency services more often and require more hospitalizations. This is the snapshot offered by the report "State of Health and Use of the Healthcare System by the Migrant Population in Spain" from the Ministry of Health, which concludes that people of foreign origin have, on average, a better state of health, use fewer healthcare resources than natives, although they contribute almost equally to the economic sustainability of the system.
The study, prepared with data from 2024, compares the health status of people born in Spain with that of residents from five major geographical areas: the rest of the European Union, Africa, Latin America, the Eastern Mediterranean, and other regions. Minister Mónica García presented the report this Monday, which comes at a time of growing political polarization over what the access of foreigners to the healthcare system should be and, according to the Spanish government, far from saturating it, the migrant population contributes more than is spent on them.
According to the analysis, migrants register a lower prevalence of most frequent diseases, suffer fewer simultaneous chronic problems, and consume fewer medications. They also visit primary care and hospital consultations less often, and require fewer medical procedures than the native population. The main conclusion of the study is clear: immigrants do not make greater use of the healthcare system than natives; rather, in general, "even when they have access," they use fewer healthcare resources than the population born in Spain.
Although the report does not detail them, one of the factors influencing this behavior is the age of the population: immigrants tend to be younger –the bulk is concentrated in the age groups from 20 to 49 years old–, which is why they have fewer chronic diseases and less need for continuous medical follow-up. "The great challenge of Spanish healthcare has nothing to do with people's origin, but with a demographic and epidemiological reality: the aging of the population, the increase in life expectancy, the rise in chronic diseases and the growing need for care and continuous follow-up," summarized García.
The only exception appears in emergency services and hospital admissions. According to the Health Barometer, migrants report going to these facilities more frequently than people born in Spain: residents from outside Spain use these services 56.5% compared to people born in Spain (51.2%). The Ministry of Health interprets this phenomenon as a possible consequence of difficulties in accessing follow-up and prevention services, especially primary care. Furthermore, this lack of continuity of care could favor some health problems ending up requiring urgent or hospital attention.
Differences by disease
The data feeding this report indicate that citizens born in Spain visit primary care centers (CAP) between 18% and 51% more, consume between 32% and 69% more medication, and suffer from chronic diseases between 24% and 38% more than the population born outside of Spain. To reach this conclusion, the study analyzes the 21 health problems that concentrate the most expenditure and care pressure, and the result is that those born in Spain present a higher prevalence in 16 of these problems.
According to the primary care clinical database (BDCAP), those born in Spain present higher rates of anxiety, metabolic disorders, respiratory infections, asthma, depression, obesity, and various cardiovascular diseases. Regarding the burden of chronic illness, they register the highest rate of multimorbidity –presence of at least one chronic health problem–, with 472.3 cases per 1,000 people. This is a figure between 24% and 38% higher than that of people from Latin America or the rest of the EU countries. In the case of people with three or more chronic health problems, the rate is up to 65% higher.
There are five areas where the situation among the various groups is very similar. This is the case with acute myocardial infarction, with a rate of 8.8 among the native population and 8.7 among people from the EU. This also happens with uncomplicated hypertension (172.2 among Spaniards and 174.4 among Africans) or with mental health: 18.2% of natives have consulted a mental health professional in the last year, compared to 18.1% of foreigners.
Only in five indicators do migrants show worse results. This is the case with non-insulin-dependent diabetes mellitus, with a rate of 103.2 among people from the Eastern Mediterranean, compared to 69.3 among Spaniards; or with uncomplicated hypertension and chronic kidney failure, with rates of 174.4 and 26.2 among the African population, compared to 172.2 and 21.2 of the Spanish, respectively.
The "healthy immigrant" effect"
The report attributes this situation to the so-called "healthy immigrant effect", according to which migrating people tend to arrive with a better state of health than the population of the receiving country. However, this advantage tends to decrease over the years due to factors such as precarious employment, difficulties in accessing housing, social inequalities, and administrative or linguistic barriers to accessing public services. All of this is intensified even more in the case of women.
The report is part of the debate on access for immigrants, especially those in an irregular administrative situation, to the National Health System. In this regard, the document argues that universal healthcare systems achieve better health outcomes and are more economically efficient than those that restrict care to emergencies.
The text also contextualizes the approval of the new Royal Decree 180/2026, which facilitates the recognition of the right to healthcare for foreigners without legal residence in Spain. According to the ministry, reducing administrative barriers should allow greater access to primary care and avoid more costly medical complications. Treating pathologies in advanced stages or through emergency hospital services has a greater impact on people's health and system costs, the report concludes.