title: The healthy migrant effect in primary care.
abstract: OBJECTIVE
  To compare the morbidity burden of immigrants and natives residing in Aragón, Spain, based on patient registries in primary care, which represents individuals' first contact with the health system.
  
  
  METHODS
  A retrospective observational study was carried out, based on linking electronic primary care medical records to patients' health insurance cards. The study population consisted of the entire population assigned to general practices in Aragón, Spain (1,251,540 individuals, of whom 12% were immigrants). We studied the morbidity profiles of both the immigrant and native populations using the Adjusted Clinical Group System. Logistic regressions were conducted to compare the morbidity burden of immigrants and natives after adjustment for age and gender.
  
  
  RESULTS
  Our study confirmed the "healthy immigrant effect", particularly for immigrant men. Relative to the native population, the prevalence rates of the most frequent diseases were lower among immigrants. The percentage of the population showing a moderate to very high morbidity burden was higher among natives (52%) than among Latin Americans (33%), Africans (29%), western Europeans (27%), eastern Europeans and North Americans (26%) and/or Asians (20%). Differences were smaller for immigrants who had lived in the country for 5 years or longer.
  
  
  CONCLUSIONS
  Length of stay in the host country had a decisive influence on the morbidity burden represented by immigrants, although the health status of both men and women worsened with longer stay in the host country.
authors.affiliation: EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Paseo Isabel La Católica 1-3 50009 Zaragoza, Spain; San Pablo Health Centre, C/Aguadores 7 50003 Zaragoza, Spain; Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, C/Domingo Miral s/n 50009 Zaragoza, Spain. Electronic address: lugifel@gmail.com.
authors.forename: Luis A
authors.initials: LA
authors.lastname: Gimeno-Feliu
authors.affiliation: EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Paseo Isabel La Católica 1-3 50009 Zaragoza, Spain; Department of Microbiology, Preventive Medicine and Public Health, University of Zaragoza, C/Domingo Miral s/n 50009 Zaragoza, Spain; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Carlos III Health Institute, C/Sinesio Delgado 4 28029 Madrid, Spain.
authors.forename: Amaia
authors.initials: A
authors.lastname: Calderón-Larrañaga
authors.affiliation: Department of Public Health and Primary Health Care, University of Bergen, Kalfarveien 31 NO-5020 Bergen, Norway.
authors.forename: Esperanza
authors.initials: E
authors.lastname: Diaz
authors.affiliation: EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Paseo Isabel La Católica 1-3 50009 Zaragoza, Spain; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Carlos III Health Institute, C/Sinesio Delgado 4 28029 Madrid, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Poblador-Plou
authors.affiliation: San Pablo Health Centre, C/Aguadores 7 50003 Zaragoza, Spain.
authors.forename: Rosa
authors.initials: R
authors.lastname: Macipe-Costa
authors.affiliation: EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Paseo Isabel La Católica 1-3 50009 Zaragoza, Spain; Department of Microbiology, Preventive Medicine and Public Health, University of Zaragoza, C/Domingo Miral s/n 50009 Zaragoza, Spain; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Carlos III Health Institute, C/Sinesio Delgado 4 28029 Madrid, Spain.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Prados-Torres
mesh_terms: D000293:Adolescent; D000328:Adult; D000349:Africa / Q000208:ethnology; D000368:Aged; D001208:Asia / Q000208:ethnology; D002648:Child; D002675:Child, Preschool; D057286:Electronic Health Records; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005060:Europe / Q000208:ethnology; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007843:Latin America / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
keywords: Immigrants; Inmigrantes; atención primaria; electronic health records; health policy; historia clínica informatizada; morbidity; morbilidad; política sanitaria; primary health care