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This paper describes the level of self‐perceived health (SPH) in immigrant and native populations resident in Madrid and the demographic and socioeconomic factors associated with negative self‐perceived health status, from a gender perspective. A population‐based home survey (2005 Madrid Health Survey) was carried out. Subjects were selected by random sampling of bistage clusters. The study was limited to 5704 adults (16 to 64 years). SPH was considered the dependent variable. The independent variables included migration status, social class, age, sex, marital status, level of education, area of residence, work precariousness, family burden and perception of environmental quality. The association was assessed by odds ratios and their 95% confidence intervals obtained by multivariate logistic regression models disaggregated by gender and migration status. Results showed that poor/fair health status was perceived more by natives and by women. The variables associated with fair/poor SPH in immigrant men were the influence of working conditions perceived as negative and perception of the quality of the environment as poor, and in immigrant women, older age, low educational level and the influence of working conditions perceived as negative. Gender inequalities in self‐perceived health exist, and different factors are associated with immigrant and native populations. The results of the study support the need for a health intervention that would diminish gender inequalities in health, which are more accentuated in immigrants.

The purpose of this paper is to analyze the relationship between Latin American migrants and the Spanish healthcare system, from the users’ perspective, in order to examine the socio-cultural determinants for access and attention, as well as the possible difficulties faced when attending institutional facilities.

This work is based on qualitative ethnographic research with the Latin American community established in the region of Castile and León, Spain. Analysis was established through a thematic approach and illustrated with the testimonies of participants involved, to inspect personal meanings and interpretations, as well as specific practices regarding healthcare.

The encounter between foreigners and health services is frequently expressed with negative emotions, such as feelings of fear facing a system that is perceived as designed “for others.” For many Latin American immigrants in Spain, institutional healthcare is not considered their first choice for treating illness. This has been related to economic, bureaucratic, ideological and emotional factors.

Most of the existing literature about immigrant healthcare in Spain has focused on sanitary conditions or patterns of service use from an institutional perspective and a quantitative approach. This paper highlights the perceptions of users to enrich comprehension of the rapport between migrants and medical care.