The Impact of Legislation on Migrants’ Health: Evidence from Spain’s Legislative Response (RDL 16/2012) to the 2008 Economic Crisis

Hortense Fraser , Centre for Demographic Studies - Autonomous University of Barcelona
Iñaki Permanyer, Centre for Demographic Studies

Abstract This article investigates the impact of legislation on migrants’ health using as a case study, Spain’s implementation of Royal Decree 16/2012. Using pooled cross-sectional data 2009-2017 from the Spanish National Health Survey and European Survey of Health (Spain), the variables under investigation are self-reported general health and chronic illness, mental health, pap-smear and mammogram. We firstly examine the health differences between migrants and the native-born before and after the law change. The results of our multivariate models indicate that irrespective of the year, compared to foreign-born without Spanish nationality, the Spanish-born followed by foreign-born nationals report better perceived good health and mental health and are less likely to report having chronic illnesses. On the contrary, the foreign-born without Spanish nationality have better reproductive health outcomes - elucidating the 'healthy' migrant effect for the outcomes of pap-smear and mammogram. Yet, multivariate logit pre-law; post-law comparisons indicate that the timing of the law coincided with worse health outcomes among migrants relative to pap-smear, mammogram and mental health but with better perceived health and chronic illness outcomes. Employing a difference-in-difference design to test the true effects of the law on migrant’s health, we find that the implementation of the law had marginal effects– increasing the likelihood of reporting a chronic illness by about 1 % in the regions where the law was fully implemented, decreasing by 1 % the likelihood of reporting good health and by approximately 5 % the odds of doing a pap-smear albeit the latter was not statistically significant.

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 Presented in Session 73. Immigrant Health and Mortality