📊 What the data cover

Eleven rounds of the European Social Survey (2002–2023) are analyzed, totaling 222,989 respondents from 30 European countries. The analysis tests whether personal health is an overlooked driver of anti-immigrant attitudes.

🔍 How the relationship was tested

• Four distinct measures of ill health are used to capture health status variation.
• Propensity score matching is applied to reduce selection bias.
• Extensive robustness checks are conducted to confirm the stability of results.

🧭 Key findings and mechanisms

• Poor health is consistently associated with stronger anti-immigration attitudes across countries and survey waves.
• Three mediating pathways explain this link:
• Belief that immigrants drain public services (resource competition/welfare chauvinism).
• Lower interpersonal trust.
• Distrust in political institutions.
• The association holds across all four measures of ill health and remains robust after matching and sensitivity tests.

📝 Why this matters

Health shapes immigration attitudes not only through concerns about welfare competition but also by eroding faith in others and in the political system. Bad health intensifies fear of losing access to crucial health services, which translates into hostility toward immigrants. These findings point to health insecurity and declining trust as important, and often overlooked, drivers of anti-immigrant sentiment in Europe.