The Political Determinants of the Health of Undocumented Migrants

Background: The health of undocumented immigrants is an important concern in most societies. However, there is no conclusive evidence that inclusive health care policies lead to better outcomes for this group of the population. The aim of this study is to analyse whether there is an association between inclusive health care policies and the mortality patterns of undocumented migrants, or the distribution of diferent causes of death among those who have died.

Methods: We analyse individual data concerning the deceased in Switzerland between 2011 and 2017. We proceed in two steps. First, we estimate and compare the patterns of mortality of Swiss citizens, documented immigrants, and undocumented immigrants. Second, we test whether there is an association between cantonal authorities’ policies and difering mortality patterns. We use logistic regressions and multinomial regressions to estimate the relationship between legal status and mortality patterns both in Switzerland and across diferent cantons.

Results: We fnd a diference in the patterns of mortality between undocumented immigrants and the other groups of the population. Specifcally, death from circulatory system diseases is twice as frequent among undocumented immigrants compared to documented immigrants and Swiss citizens. However, this diference is smaller in the Swiss cantons that have more inclusive health care policies towards undocumented migrants.

Conclusions: We interpret these results as an indication that policies that expand access to health services lead to better outcomes for undocumented immigrants. This finding has implications for research on civic stratifcation and public health. Further analysis is needed to evaluate the efects of extending public health care for undocumented immigrants in diferent contexts.

Keywords: Undocumented immigrants, Access to health care, Cause of death, Mortality, Citizenship, Civic stratifcation, Irregular immigrants, Migration.

This is an abstract of an article by Lorenzo Piccoli and Philippe Wanner.