How Do Social Determinants and Legal Status Affect the Health of Undocumented Migrants in France?
Abstract
BACKGROUND: The health of undocumented migrants (UMs) in France is poorly understood, especially outside of health care settings. This study aimed to (1) describe the health status of UMs in France, (2) to analyse the influence of the social determinants of health (SDoH) on four main reported conditions and self-perceived health and (3) to compare UMs with documented migrants (DMs) for those five outcomes. METHODS: The Premiers Pas study (PPS) is a cross-sectional survey that is representative of UMs aged 18 years or older living in France. The study was performed between February and April 2019 at sixty-three sites. The 2019 European Health Interview Survey (EHIS), representative of the French population, was subsequently used to compare UMs with DMs. Five outcomes were compared: diabetes, high blood pressure (HBP), asthma, depression (using the PHQ-9) and self-perceived health (SPH, using the Minimum European Health Module). Logistic regression models were used to explore associations between the five outcomes and (i) SDoH among UMs and (ii) administrative status (UMs vs DMs). RESULTS: Among UMs, 68.1% reported having a current health condition (n = 1188), and 33.5% reported having a chronic condition (n = 1189). Musculoskeletal (30.3%), mental (27.4%) and digestive (12.0%) conditions were among the most reported conditions. Several SDoH were risk factors for poor outcomes. For example, food insecurity was associated with a greater risk of depression ('often' aOR = 3.05 95% CI [1.58-5.89]). The prevalence of depression and poor SPH was significantly greater for UMs than for DMs for the same gender and age groups. After adjusting for age, gender, region of origin and job status, depression was higher (aOR = 2.35 95% CI [1.85-2.99], p < 0.001), and poor SPH was worse (aOR = 2.49 95% CI [1.89-3.29] p < 0.001) among UMs. CONCLUSION: This study showed that living conditions play an important role in the health of UMs. UMs had higher risks of poor SPH and depression than DMs. These inequalities persisted when stratifying by duration of residence and gender. Living conditions could be improved through targeted public policies that promote migrants' rights, social inclusion and legalization.
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BibTeX
@article{moussaoui2026social,
title = {{How Do Social Determinants and Legal Status Affect the Health of Undocumented Migrants in France?}},
author = {Sohela Moussaoui and Nicolas Vignier and Florence Jusot and Antoine Marsaudon and Jerôme Wittwer and Paul Dourgnon},
journal = {BMC Public Health},
year = {2026},
month = sep,
doi = {10.1186/s12889-026-27924-x},
url = {https://hal.science/hal-05736256v1},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - How Do Social Determinants and Legal Status Affect the Health of Undocumented Migrants in France?
AU - Sohela Moussaoui
AU - Nicolas Vignier
AU - Florence Jusot
AU - Antoine Marsaudon
AU - Jerôme Wittwer
AU - Paul Dourgnon
PY - 2026
DA - 2026/09/02
JO - BMC Public Health
DO - 10.1186/s12889-026-27924-x
UR - https://hal.science/hal-05736256v1
AB - BACKGROUND: The health of undocumented migrants (UMs) in France is poorly understood, especially outside of health care settings. This study aimed to (1) describe the health status of UMs in France, (2) to analyse the influence of the social determinants of health (SDoH) on four main reported conditions and self-perceived health and (3) to compare UMs with documented migrants (DMs) for those five outcomes. METHODS: The Premiers Pas study (PPS) is a cross-sectional survey that is representative of UMs aged 18 years or older living in France. The study was performed between February and April 2019 at sixty-three sites. The 2019 European Health Interview Survey (EHIS), representative of the French population, was subsequently used to compare UMs with DMs. Five outcomes were compared: diabetes, high blood pressure (HBP), asthma, depression (using the PHQ-9) and self-perceived health (SPH, using the Minimum European Health Module). Logistic regression models were used to explore associations between the five outcomes and (i) SDoH among UMs and (ii) administrative status (UMs vs DMs). RESULTS: Among UMs, 68.1% reported having a current health condition (n = 1188), and 33.5% reported having a chronic condition (n = 1189). Musculoskeletal (30.3%), mental (27.4%) and digestive (12.0%) conditions were among the most reported conditions. Several SDoH were risk factors for poor outcomes. For example, food insecurity was associated with a greater risk of depression ('often' aOR = 3.05 95% CI [1.58-5.89]). The prevalence of depression and poor SPH was significantly greater for UMs than for DMs for the same gender and age groups. After adjusting for age, gender, region of origin and job status, depression was higher (aOR = 2.35 95% CI [1.85-2.99], p < 0.001), and poor SPH was worse (aOR = 2.49 95% CI [1.89-3.29] p < 0.001) among UMs. CONCLUSION: This study showed that living conditions play an important role in the health of UMs. UMs had higher risks of poor SPH and depression than DMs. These inequalities persisted when stratifying by duration of residence and gender. Living conditions could be improved through targeted public policies that promote migrants' rights, social inclusion and legalization.
SN - 1471-2458
SN - 1471-2458
ER -