Legal status, employment contract and self-perceived health of immigrant workers in Spain

Background: Legal status and employment stability are central issues in immigrant integration in host societies. This study analyzes the relationship of self-perceived health with employment contract and legal status (ITSAL project).

Methods: 2,434 immigrant workers in Spain (Ecuadorian, Moroccan, Romanian, Colombian) were surveyed to asses self-perceived health, legal status, and employment contract type. Legal/contract situation was measured in 3 categories: undocumented, non-contracted (UDNC); documented, temporarily-contracted (DTC); and documented, permanently-contracted (DPC). The relationship of legal/contract situation with binary health status (very good/good, fair/poor/very poor) was analyzed via logistical regression, adjusting for sex, age, nationality, educational level, and years of residence in Spain (aOR).

Results: The distribution across legal/contract categories varies by nationality, with the largest percent of DPC workers among the Ecuadorians and the largest percent of UDNC workers among the Romanians. Poor health frequency also varies by nationality in each legal/contract category; Ecuadorians report the highest rates, Moroccans and Romanians report the lowest. Overall, UDNC workers reported worse health than DTC workers (aOR=1.49, 95%CI 1.07-2.09), and than DPC workers (aOR=1.43, 95%CI 1.05-1.96). By nationality, Ecuadorian, Romanian, and Colombian UDNC workers were more likely to report poor health than their DPC counterparts, although the difference was only statistically significant in Romanians. Stratified by gender, female UDNC workers show significantly higher risk of poor health than their DPC counterparts. Males exhibit the same trend, although significance is not achieved.

Conclusions: Self-perceived health is associated with legal status and employment contract type for immigrants in Spain. This relationship varies by country of origin.