Mallorca is home to a thriving international community. Whether you’ve made the island your permanent base or are here for a few years of adventure, living abroad brings unique experiences and health considerations. Official statistics group us as “foreign-born residents,” yet our backgrounds, reasons for moving, and day-to-day realities can be very different. One thing we have in common is that, regardless of how long we plan to stay, we all face challenges when it comes to looking after our health in a new country.
From a public health perspective, this group cannot be ignored: Spain has almost 7 million foreign-born residents, more than the population of Denmark. In the Balearics, nearly 28% of the population was born abroad, making it the region with the highest proportion of foreign residents in Spain.
Terminology is important here, and can be useful in thinking about different groups and their needs. An immigrant is someone who moves to a new country intending to settle permanently, while an expat is often seen as someone living abroad for a limited or undecided period. The reality is more nuanced. The words “immigrant” and “expat” carry connotations about wealth, privilege, and lifestyle. People may move fluidly between these categories, or self-identify as one when others might see them as the other.
The “Healthy Immigrant Effect”
Research shows that people who immigrate to a new country often arrive in better health than those born there. This is known as the “healthy immigrant effect”, a well-documented phenomenon in Spain and internationally.
Immigrants are often younger and healthier to begin with, and the process of migration itself can be a self-selection for resilience and good health. This doesn’t mean every immigrant is healthier than every local but, on average, newcomers start out with a health advantage.
However, this doesn’t always last. Over time, the health of immigrants tends to converge with-or even fall below-that of the local population. The reasons are complex: adapting to a new culture, changes in lifestyle, and, for some, social isolation or economic insecurity all play a part. In Spain, where many foreign-born residents are pensioners, difficulties accessing the health service and challenges integrating with the local population can compound this effect.
Barriers to healthcare access
Spain has a universal healthcare system and, in theory, everyone living here should be able to access medical care regardless of nationality or immigration status. In practice, however, things can be more complicated. For many, the biggest hurdle is paperwork: registering with the local health centre (centro de salud), obtaining a health card (tarjeta sanitaria), and understanding which services are available can be daunting, especially if your Spanish is still a work in progress.
Language is an obvious barrier. Even those who speak conversational Spanish may find medical and bureaucratic terms confusing, and misunderstandings can delay diagnosis or treatment. Some regions, including the Balearics, have made efforts to provide interpreters or multilingual information, but coverage can be variable.
Expats sometimes face different challenges compared to immigrants, even though many are financially comfortable. Many must purchase private health insurance to meet residency requirements. Others may travel back to their home countries for medical treatment. While this approach can seem practical, it often disrupts continuity of care, as people see multiple providers, sometimes in different countries. This can result in slower diagnosis, difficulties accessing treatment, and, for those with complex health needs, important details being missed.
Health service use and outcomes
Immigrants and expats in Spain use healthcare differently than locals. Studies show that some groups of foreign-born residents make fewer visits to GPs and specialists initially, but are more likely to end up in hospital or A&E (emergency) departments. This pattern raises the concern that barriers to preventive care may lead to more serious problems down the line. Women, in particular, may miss out on preventive services like cancer screening.
What can you do about it?
The most important thing is to be proactive about your health, and it’s never too late to start.
- If you are eligible to register for state healthcare services, make it a priority.
- Try to see the same doctors consistently where possible, whether in the public or private sector. Continuity of care brings real benefits, including a reduced risk of mortality.
- Stay on top of routine care. Do you need screening? Should you be having regular health checks for your medical conditions? Make a note and make it happen
- Work on your Spanish – it’s the best way to communicate with your health team. In the meantime, bring a friend or use a translation app for appointments, and ask for help.
- Do your best to integrate into local society. Join clubs, attend social events and get to know your neighbours
Living abroad brings both opportunities and challenges for your health. With a bit of planning and a willingness to reach out, you can make the most of all the island has to offer while ensuring that your health remains a priority.