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
Jeroen J. A. Spijker, Centre d’Estudis Demogràfics (CED), UAB
Iñaki Permanyer, Centre for Demographic Studies and ICREA

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