title: Restricting Access to Health Care to Immigrants in Barcelona: A Mixed-Methods Study With Immigrants Who Have Experienced an Infectious Disease.
abstract: Austerity policies implemented in Spain in response to the ongoing economic crisis may have detrimental consequences for the health of immigrant populations and for public health in general. A mixed-methods study by the Public Health Agency of Barcelona and the University of Michigan indicates that the Real Decreto-ley 16/2012 (RDL) threatens the health of individuals and the population, especially in the case of infectious diseases. The study sought to determine the percentage of foreign-born persons with an infectious disease who had an Individual Health Card (IHC) prior to the RDL and to determine whether foreign-born persons with an infectious disease in Barcelona encountered problems accessing health care after the RDL. Results indicate that immigrants used the IHC to seek medical attention for infectious diseases and chronic conditions. Results also show that 66% of respondents, including 54% of unemployed respondents, 3% of respondents working without contracts, and those in informal employment (9%), may be at risk of losing at least part of their health coverage. Universal health care access in Spain has been crucial for the control of communicable diseases among immigrant populations. Reducing access to a significant percentage of the total population may have deleterious effects on public health.
authors.affiliation: University of Michigan, School of Public Health, USA jcastano@umich.edu.
authors.forename: Jenny
authors.initials: J
authors.lastname: Castano
authors.affiliation: University of Michigan, School of Public Health, USA.
authors.forename: Jesús E
authors.initials: JE
authors.lastname: Ospina
authors.affiliation: University of Michigan, School of Public Health, USA.
authors.forename: Joan A
authors.initials: JA
authors.lastname: Caylà
authors.affiliation: University of Michigan, School of Public Health, USA.
authors.forename: Scott L
authors.initials: SL
authors.lastname: Greer
mesh_terms: D000293:Adolescent; D000328:Adult; D003141:Communicable Diseases / Q000628:therapy*; D057172:Economic Recession; D054242:Emigrants and Immigrants; D005260:Female; D006291:Health Policy; D006297:Health Services Accessibility / Q000331:legislation & jurisprudence*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011634:Public Health; D013030:Spain; D011795:Surveys and Questionnaires
keywords: Individual Health Card; Public Health Agency of Barcelona; Real Decreto-ley 16/2012; austerity policies in Spain; health; health care access; health policy; immigrant health; infectious diseases; universal health care