The impact of discrimination in immigrant workers' health in Spain (ITSAL Project)

Background: Discrimination is considered an important social determinant of health, affecting vulnerable populations such as immigrants. The objective is to analyse the relationship between discrimination and self- perceived health in a group of immigrant workers in Spain.

Methods: A cross-sectional survey was conducted in 2008 amongst a non-random sample of immigrants from Ecuador, Morocco, Romania and Colombia in four Spanish cities: Barcelona, Huelva, Madrid and Valencia. The survey examined the demographic, working and health conditions of participants. Questions about self-perceived discrimination (Yes/No) and general health (Good/Poor), mental health (General Health Questionnaire GHQ-12), muscular diseases, headache, stress, insomnia and anxiety were analysed establishing associations by means of Odds Ratios. Logistic regression was used adjusted for sex, legal status, occupation, origin country, age, and education level.

Results: The total sample was 2,434 immigrants (42.7% females). 1,972 cases reported self-perceived discrimination (57.9% males).  Those reporting discrimination were more likely to report poor general health (OR 2.11 CI95% 1.53-2.90), mental health problems (OR 2.99 CI95% 2.24- 3.99), muscular diseases (OR 2.10 CI 95% 1.61- 2.74), headache (OR 1.64 CI95% 1.30- 2.07), stress (OR 2.35 CI95% 1.83- 3.01), insomnia (OR 2.22 CI95% 1.57- 3.13) and anxiety (OR 2.75 CI95% 1.94- 3.91).  With respect to general health and people reporting self-perceived discrimination, men (OR 2.72 CI95% 1.61- 4.61), undocumented (OR 2.54 CI95% 1.19- 5.44), non-manual occupations (OR 2.25 CI95% 1.30- 3.90) and Ecuadorians (OR 2.47 CI95% 1.39- 4.39) were more likely to report poor health.  In the other cases, differences were observed according to sex, legal status, occupation and origin country.

Conclusion: Self-perceived discrimination may constitute a risk factor for immigrants’ health relative to people in the host society. Additional research is required to explicate the relationship between working conditions, immigrants’ health and discrimination in the workplace.

Sponsors: Healthcare Research Fund- Spain: (PI050497, PI052202, PI052334, PI061701)