Challenging the Immigrant Health Burden Myth: A Comorbidity Analysis in Navarra, Spain - APNA Study

BACKGROUND: Anti-immigrant arguments often claim that immigrants burden healthcare systems due to increased health problems and healthcare utilization. This study challenges this assumption by comparing the health status of immigrants and native inhabitants using the Charlson comorbidity index, aiming to demonstrate that immigrants are healthier and will use fewer healthcare services. METHODS: The APNA cohort study includes all inhabitants of Navarra, Spain, with a population of 661,023. A cross-sectional observational study was conducted on 503,392 adults. The Charlson Index was computed as a comorbidity measure. The Mann-Whitney U test compared the index between immigrants and native Spaniards, and quantile regression examined the relationship between immigrant status and Charlson Index, adjusting for age, sex, and socioeconomic status. RESULTS: Of the population, 18.4% were born abroad. The average Charlson index was higher in Spaniards (1.55, SD = 1.89) than in immigrants (0.45, SD = 0.93; U-Mann-Whitney p < 0.001). The quantile regression showed that, after adjustment, the Charlson Index was higher in Spaniards than in immigrants by -0.071 (95%CI 0.066-0.077). CONCLUSIONS: This study contradicts the myth that immigrants burden healthcare systems. Immigrants in Navarra, Spain, are healthier and have lower comorbidity indexes than native inhabitants. Public health policies should consider these findings to promote evidence-based approaches and challenge misconceptions about immigrants’ healthcare utilization. Immigrants in Navarra, Spain, are healthier than native inhabitants, debunking the myth that they burden healthcare systems. Public health policies should consider these findings for evidence-based approaches and challenge misconceptions about immigrants’ healthcare utilization. KEY MESSAGES: • Immigrants in Navarra, Spain, are healthier than native inhabitants, debunking the myth that they burden healthcare systems. • Public health policies should consider these findings for evidence-based approaches and challenge misconceptions about immigrants’ healthcare utilization.