Immigration, work and health in Spain: the influence of legal status and employment contract on reported health indicators

OBJECTIVE: To analyze the relationship of legal status and employment conditions with health indicators in foreign-born and Spanish-born workers in Spain. METHODS: Cross-sectional study of 1,849 foreign-born and 509 Spanish-born workers (2008-2009, ITSAL Project). Considered employment conditions: permanent, temporary and no contract (foreign-born and Spanish-born); considered legal statuses: documented and undocumented (foreign-born). Joint relationships with self-rated health (SRH) and mental health (MH) were analyzed via logistical regression. RESULTS: When compared with male permanently contracted Spanish-born workers, worse health is seen in undocumented foreign-born, time in Spain ≤3 years (SRH aOR 2.68, 95% CI 1.09-6.56; MH aOR 2.26, 95% CI 1.15-4.42); in Spanish-born, temporary contracts (SRH aOR 2.40, 95% CI 1.04-5.53); and in foreign-born, temporary contracts, time in Spain >3 years (MH: aOR 1.96, 95% CI 1.13-3.38). In females, highest self-rated health risks are in foreign-born, temporary contracts (aOR 2.36, 95% CI 1.13-4.91) and without contracts, time in Spain >3 years (aOR 4.63, 95% CI 1.95-10.97). CONCLUSIONS: Contract type is a health determinant in both foreign-born and Spanish-born workers. This study offers an uncommon exploration of undocumented migration and raises methodological issues to consider in future research.