Open Access Open Badges Research article

The effect of perceived discrimination on the health of immigrant workers in Spain

Andrés A Agudelo-Suárez123*, Elena Ronda-Pérez234, Diana Gil-González245, Carmen Vives-Cases24, Ana M García467, Carlos Ruiz-Frutos8, Emily Felt3 and Fernando G Benavides34

Author Affiliations

1 Faculty of Dentistry, University of Antioquia, Calle 64 N° 52-59. Medellin, Antioquia, Colombia

2 Preventive Medicine and Public Health Area, University of Alicante, Campus de San Vicente del Raspeig s/n, Alicante, 03690, Spain

3 Centre for Research in Occupational Health, Parc de Recerca Biomèdica de Barcelona (PRBB), C/Dr. Aiguader 88, Barcelona 08003, Spain

4 CIBER Epidemiology and Public Health, Spain

5 Observatory of Health Policies and Health, University of Alicante, Campus de San Vicente del Raspeig s/n, Alicante, 03690, Spain

6 Department of Preventive Medicine and Public Health, University of Valencia. Av. Tarongers s/n, Valencia, 46022, Spain

7 Trade Union Institute for Work, Environment and Health (ISTAS), C/Ramon Gordillo 7-1, Valencia 46010, Spain

8 Department of Environmental Biology and Public Health, University of Huelva. Avenida de las Fuerzas Armadas, S/N. Huelva, 21071, Spain

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BMC Public Health 2011, 11:652  doi:10.1186/1471-2458-11-652

Published: 17 August 2011



Discrimination is an important determinant of health inequalities, and immigrants may be more vulnerable to certain types of discrimination than the native-born. This study analyses the relationship between immigrants' perceived discrimination and various self-reported health indicators.


A cross-sectional survey was conducted (2008) amongst a non-random sample of 2434 immigrants from Ecuador, Morocco, Romania and Colombia in four Spanish cities: Barcelona, Huelva, Madrid and Valencia. A factorial analysis of variables revealed three dimensions of perceived discrimination (due to immigrant status, due to physical appearance, and workplace-related). The association of these dimensions with self-rated health, mental health (GHQ-12), change in self-rated health between origin and host country, and other self-reported health outcomes was analysed. Logistic regression was used adjusting for potential confounders (aOR-95%CI). Subjects with worsening self-reported health status potentially attributable to perceived discrimination was estimated (population attributable proportion, PAP %).


73.3% of men and 69.3% of women immigrants reported discrimination due to immigrant status. Moroccans showed the highest prevalence of perceived discrimination. Immigrants reporting discrimination were at significantly higher risk of reporting health problems than those not reporting discrimination. Workplace-related discrimination was associated with poor mental health (aOR 2.97 95%CI 2.45-3.60), and the worsening of self-rated health (aOR 2.20 95%CI 1.73- 2.80). 40% (95% CI 24-53) PAP of those reporting worse self-rated health could be attributable to discrimination due to immigrant status.


Discrimination may constitute a risk factor for health in immigrant workers in Spain and could explain some health inequalities among immigrant populations in Spanish society.