They take our healthcare: health and attitudes towards immigration in Europe

In this study, we extend the research on anti-immigrant attitudes by analyzing an overlooked factor: health. We develop a framework explaining why residents perceive competition for health services with immigrants. Using data from eleven rounds of the European Social Survey, covering 222,989 respondents in 30 European countries (2002–2023), we find a consistent association between poor health and anti-immigration attitudes. Three pathways—the belief that immigrants drain public services, diminished interpersonal trust, and distrust in political institutions—mediate this effect. The association holds across four measures of ill health, with propensity score matching to reduce selection bias and extensive robustness tests. We conclude that health is crucial for attitudes about immigration not only because of welfare chauvinism and resource competition but also because bad health makes people lose faith in each other and the system, intensifying their fear of losing access to vital health services, translating into hostility toward immigrants.