Beyond the migration label: structural racialisation and mental health inequalities in Elche, Spain

Background

Racialised and migrant populations report poorer mental health, yet research overlooks intersecting vulnerabilities of legal status and racial identity, and the protective role of social capital often remains underexplored. We examine mental health inequalities across migration profiles and the role of assistance-related social capital.

Methods

Cross-sectional study in Elche, Spain (n = 602), among adults from a socioeconomically vulnerable neighbourhood. Mental health was assessed with the VR-12 questionnaire. Social capital was measured with 10 items assessing support across daily activities. Four migratory profiles were created: non-racialised nationals (reference group), racialised nationals, regularised migrants, and irregularised migrants. Multivariable linear regression with robust standard errors was used. Employment status and years in the neighbourhood were examined in a sensitivity analysis as adjustment variables.

Results

Compared to non-racialised nationals, racialised nationals had poorer mental health (β = −4.87; 95%CI:−8.24,−1.51; p = 0.005), unattenuated by assistance-related social capital or employment adjustment. Irregularised migrants initially showed poorer mental health (β = −3.59; p = 0.007), but this was no longer significant after adjusting for employment (β = −1.62; p = 0.294). Regularised migrants did not differ from the reference group. Assistance-related social capital was independently protective (β = 0.52; p = 0.043), while being a woman and unemployment predicted poorer mental health.

Conclusions

Mental health inequalities vary across migratory profiles defined by legal status and racial identity, reflecting distinct structural mechanisms: racialisation operates independently of employment, while poorer mental health among irregularised migrants is largely driven by employment constraints. These findings call for differentiated interventions, including anti-racist policies and pathways to administrative regularisation.

Key messages

• Racialisation is linked to poorer mental health beyond employment and social capital, pointing to the need for policies tackling discrimination and structural inequities.

• Employment exclusion largely explains poorer mental health among irregularised migrants, highlighting legal regularisation as central to reducing inequities.