Sick immigrant workers more likely to go to work

Foreign workers in Spain are more likely than Spanish ones to turn up for work if they are unwell, a study has concluded. A study by the Institute for Work, Environment and Health (ISTAS) compared sickness presenteeism levels between Spanish-born and foreign-born workers. It found that presenteeism is higher among foreign-born workers, particularly among those who haven’t been in Spain long. This difference might be explained by immigrants’ precarious employment.

Background and methodology

The Institute for Work, Environment and Health (ISTAS), an independent body founded by Trade Union Confederation of Workers’ Commissions (CCOO), has recently published a report (215Kb PDF) on sickness presenteeism among immigrant workers. The term ‘presenteeism’ is understood as ‘going to work despite feeling sick or having some health problems’.

Immigration in Spain has significantly increased over the last 10 years, with many people coming from developing countries where there is a low average income. Many of these immigrants have no documents.

Previous research (see the Spanish national contribution to the study on employment and working conditions of migrant workers) shows that immigrant workers suffer from precarious employment, low salaries and difficulty in accessing social benefits. These are all conditions which might put these people at a higher risk of experiencing health and safety problems. However, it seems that the proportion of immigrants who turn up for work despite illness is greater than that of Spanish workers.

The ISTAS study took into account variables such as personal and employment characteristics, and the amount of time the immigrants have been living in Spain. It is based on a large cross-sectional study conducted over a representative sample of foreign-born workers (2,434) and a sample of Spanish-born workers (509) created specifically to resemble the foreign-born sample according to gender, age and area of residence. The study was carried out in different Spanish cities during 2008 and 2009.


The main results of the study can be summarised as follows:

  • Sickness presenteeism is higher among foreign-born workers, particularly among those with a shorter time of residence in Spain. More precisely, foreign-born workers living in Spain for less than two years report sickness presenteeism in 56.3% of cases, whereas the percentage is lower for immigrants who have spent two or more years in Spain (51.6%) and even lower for Spanish-born workers (42%).
  • Broadly speaking, social and economic variables show a general trend where, as salaries increase, presenteeism levels are lower. At the same time, sickness presenteeism is higher for workers who do not have a contract of employment (in comparison to those who have a temporary or permanent contract).
  • The results also show higher presenteeism levels among immigrants with temporary contracts, than among immigrants with permanent contracts. However, the situation observed among Spanish workers is just the opposite: presenteeism levels are 35.5% for employees with a temporary contract and 44.4% for those with a permanent contract.
  • However, although sickness presenteeism for immigrant workers is higher than that for Spanish workers, those Spanish interviewees with a monthly income of €750 or less (the lowest-income group), show higher presenteeism than the average of immigrant workers who have spent less than two years in the country (60.3% versus 56.3%).


The study shows that social and economic conditions have an effect on sickness presenteeism levels. Higher presenteeism levels among immigrants might be a consequence of the fact that they experience more precarious employment. Moreover, the inequalities faced by immigrants mean that many immigrant workers feel unprotected and vulnerable to exploitation, either because they find it more difficult to demand their labour rights or because they do not know what social protection they can claim.

Jessica Durán, IKEI Research & Consultancy

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