Examining Immigrant Healthcare Access Inequalities in France: An Intersectional Approach

Julia Nicolas , Center for Research in Economics and Statistics (CREST) ENSAE Paris

Immigrants often arrive in better health than the native population of their host country, a phenomenon known as the ‘healthy immigrant effect’. However, this initial advantage tends to decline over time, partly due to unequal access to healthcare. This study examines disparities in healthcare access among immigrants in France, with a particular focus on women’s use of preventive services, specifically cervical cancer screening. These inequalities are often attributed to demographic and socioeconomic factors. While such determinants are frequently analyzed separately, I adopt an intersectional approach to explore how they interact and contribute to compounded disadvantages. Drawing on the recent Trajectoires et Origines 2 survey (N = 27,181), I apply the Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA), a recent quantitative advancement that enhances the study of intersectionality beyond conventional intercategorical models. This study examines how age, geographical origin, educational attainment, and social class intersect to shape inequalities in access to this form of preventive care among immigrant women in France. By identifying complex patterns of exclusion, this research underscores the need for frameworks that capture the multidimensional nature of healthcare access disparities. Using this approach, I reveal substantial heterogeneity between groups in their uptake of preventive care. Further analyses will identify which groups face the greatest barriers to healthcare access and will compare observed MAIHDA outcomes with additive predictions, highlighting the variability arising from complex interactions.

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 Presented in Session 101. Intersectional Approaches to Migrant Populations