Andorra – Health Issues

What are the most common health issues and diseases in Andorra?

The diseases causing the greatest harm in Andorra are overwhelmingly non-communicable. Cardiovascular conditions, cancer, and neurological disorders sit at the top of the list, mirroring the disease profile seen across other prosperous Western European nations.

Heart disease stands as the single largest cause of death in the principality, responsible for roughly 27% of all fatalities — a figure that aligns with trends seen throughout the developed world. Ischaemic heart disease (IHD) affects around 22% of the population and represents the foremost preventable cause of mortality; growing affluence and increasingly sedentary day-to-day routines have steadily intensified this burden over time.

Cancer accounts for approximately 23% of all deaths, making it the second most deadly condition. The types most frequently diagnosed include breast, lung, and colorectal cancers. Tobacco, alcohol, and poor dietary habits are significant contributing risk factors. Deaths from tracheal, bronchus, and lung cancers are particularly notable, and overall cancer mortality has been climbing — respiratory cancer death rates have risen by around 18% since 1990.

When measured by overall disease burden, cardiovascular conditions account for roughly 40.1% of the total, cancers for 31.6%, and neurological disorders — chiefly Alzheimer’s disease, other dementias, and Parkinson’s disease — for approximately 11.9%. These neurological conditions represent a significant and growing proportion of Andorra’s health challenge.

Diabetes affects around 3% of the population. As with other preventable conditions, a gap persists between awareness of risk and the adoption of protective behaviours. Taken together, tumours, cardiovascular disease, and respiratory conditions make up the dominant causes of mortality, underscoring how heavily Andorra’s health burden falls on non-communicable diseases affecting adults.

Is Andorra considered a healthy country? How do health outcomes compare internationally?

By virtually every meaningful measure, Andorra is one of the healthiest places in the world to live. Life expectancy at birth increased from 83.4 years in 2016 to 84.6 years in 2023, placing the principality at the very top of the WHO European Region. Disaggregated by sex, women can expect to live to approximately 86.9 years and men to 82.1 years.

The Lancet’s Healthcare Access and Quality Index — which evaluated the healthcare systems of 195 countries between 1990 and 2015 — awarded Andorra a score of 95 out of 100, the highest recorded globally. This remarkable result reflects the exceptional performance of the country’s public health infrastructure relative to its compact size and population.

Vaccination coverage stood at 94–99% across all age groups as of 2023. Infant mortality was recorded at just 1.5 per 1,000 live births in the same year, and no maternal deaths were registered during that period — outcomes that favourably rival those of much larger and better-resourced European nations.

Household out-of-pocket health expenditure represented only 11% of total health spending in 2023, placing Andorra among the most equitable systems in the WHO European Region. Just 2.1% of households faced catastrophic health costs — a testament to the strength of the country’s financial protection mechanisms.

The absence of heavy industry keeps Andorra’s air notably clean, and residents of all generations naturally incorporate movement into their daily lives by navigating the country’s hilly terrain. Both factors contribute meaningfully to its exceptional longevity figures. That said, lifestyle-related non-communicable diseases are a genuine and expanding concern. For the latest statistics, consult the WHO Andorra country data page and the Andorran national statistics agency (Estadística).

What infectious diseases or environmental health risks should expats be aware of in Andorra?

Infectious diseases play a relatively minor role in Andorra’s overall health burden. Tuberculosis rates have dropped dramatically, falling to just 4 cases per 100,000 people according to the 2025 WHO/European Observatory review. Serious vector-borne or tropical illnesses pose no meaningful public health threat, though a handful of practical points deserve attention for anyone planning to settle in the country.

Insect bites can transmit disease even in an industrialised setting such as Andorra. When outdoors or in wooded terrain, covering exposed skin with long-sleeved clothing, full-length trousers, and hats is a sensible precaution. Tick-borne illnesses are a realistic, if not widespread, concern in rural and forested areas of the Pyrenees, particularly during the warmer months of the year.

Drinking water quality is not a cause for concern for the vast majority of residents. Andorra’s tap water meets European safety standards. Nevertheless, the level of risk from food and water can vary depending on circumstance — day-to-day life in the capital carries different considerations from extended hiking trips in remote mountain areas.

No vaccinations are mandatory for entry into Andorra, but keeping routine immunisations current — including measles-mumps-rubella (MMR), tetanus-diphtheria-pertussis, and annual seasonal influenza — is strongly recommended. Andorra’s own immunisation programme achieves coverage of 94–99%, reflecting a robust national commitment to preventive health. Always consult your home country’s travel health authority ahead of relocating, as guidance can be updated at short notice. The US CDC Andorra traveller page and the UK government’s Andorra health advice both provide reliable, current guidance.

Air quality across Andorra is generally high. Without heavy industrial activity, the principality avoids the chronic pollution levels typical of many European urban centres. Traffic congestion in and around the capital, Andorra la Vella, can occasionally produce localised spikes in pollution. Altitude sickness is a recognised hazard in higher-lying parts of the country, particularly for those arriving from sea-level environments who then engage in vigorous physical activity before fully acclimatising.

Is smoking common in Andorra, and what are the laws around it?

Tobacco use is strikingly common in Andorra when measured against Western European norms. As of 2022, 33.6% of the adult population smoked — a figure that is notably similar for men (33.3%) and women (33.8%) alike. For comparison, the EU-wide average adult smoking rate sits well below 25%, making Andorra’s prevalence markedly higher than most of its neighbours.

There has, however, been a gradual downward trend over recent decades. Overall tobacco use declined from 36% in 2000 to around 30.5% by 2015, with projections pointing to a continued fall. Male prevalence dropped from 43% to 36% between 2000 and 2015, while female prevalence fell from 28% to 25% over the same period.

The health consequences of this elevated tobacco use are substantial. Tobacco was responsible for 25.2% of all deaths in 2021 and was identified as the single greatest risk factor driving combined deaths and disability in that year. Among the top causes of death, ischaemic heart disease ranked first, stroke fourth, lung cancer fifth, and chronic obstructive pulmonary disease sixth — all conditions with strong links to tobacco use.

Andorra became a party to the WHO Framework Convention on Tobacco Control in 2006, committing to a range of measures aimed at curbing tobacco consumption. The government subsequently introduced a ban on smoking in public spaces, including bars and restaurants. As of 2022, these bans are enforced with full compliance requirements, and the sale of tobacco products and e-cigarettes to anyone under 18 is prohibited.

Andorra formally ratified the WHO Framework Convention on Tobacco Control (FCTC) in 2020. There is presently no specific legislation covering e-cigarettes as a distinct category, and heated tobacco products (HTPs) are legally available on the market. Compared with countries such as the UK or Ireland — where regulations for novel nicotine products are comprehensive — Andorra’s framework in this area remains comparatively underdeveloped. Expats who use these products are advised to verify the latest rules with the Andorran Ministry of Health (Salut) before moving.

Social attitudes towards smoking are shifting. Smoking is increasingly viewed unfavourably in Andorran society, and is considered inappropriate in many workplaces, where restrictions are commonly enforced.

Is obesity or poor diet a significant health concern in Andorra?

Obesity represents a growing public health challenge in Andorra. Figures from 2016 show that roughly 28% of adults were classified as overweight and 16% as obese — a notable rise compared to earlier data, most likely reflecting shifts in both lifestyle patterns and dietary habits. These proportions are broadly in line with trends seen across much of Western Europe, where sedentary behaviour and energy-dense diets are similarly fuelling chronic disease.

Andorra’s traditional cuisine is rooted in hearty, home-prepared mountain cooking, often featuring substantial quantities of fat and calories. Signature dishes such as trinxat (a combination of potato, cabbage, and bacon), escudella (a warming stew of meat and vegetables), and a range of cured meats all reflect the Pyrenean heritage of the country — food designed to sustain people through physically demanding, cold-climate lives. When those same dietary patterns persist alongside increasingly sedentary modern routines, however, the health implications become more pronounced.

The connection between growing prosperity and rising rates of lifestyle-related disease is clearly visible in Andorra’s health data. Ischaemic heart disease has increased by 43% over the past two decades, a trend consistent with wealthier, tourism-dependent economies where the nature of work and daily activity has shifted considerably. Risk factors for heart disease — including smoking, elevated blood pressure, high cholesterol, and physical inactivity — remain prevalent.

In response, the Andorran government has launched public health initiatives targeting both dietary habits and physical activity levels. A National Pact for sustainability has been developed, and the PISMA programme is redirecting mental and broader health services towards community-based models of care. For current national health promotion campaigns, consult the Ministry of Health website.

What are the mental health attitudes and services like in Andorra?

Mental health is an area of growing importance in Andorra, as it is across much of the world. A degree of social stigma surrounding mental illness persists, which can discourage individuals from seeking professional support. This is by no means unique to Andorra — comparable cultural dynamics exist throughout Southern Europe — but it is worth bearing in mind, both for your own wellbeing and when considering the needs of family members.

Depression and anxiety are the mental health conditions most frequently encountered in Andorra, and both are often intertwined with other conditions such as obesity and cardiovascular disease. For expats in particular, the added pressures of social isolation, navigating a new language environment (Catalan is the official language), and the upheaval of relocation can amplify mental health difficulties during the early years of living abroad.

The PISMA programme is actively driving a shift in how mental health care is delivered in Andorra, moving away from a hospital-centred approach towards community-based provision. This trajectory mirrors reforms undertaken in France, Spain, and other European countries that have invested in deinstitutionalisation and the development of community psychiatry over recent decades.

Public mental health services are accessible through the national social security system, Caixa Andorrana de Seguretat Social (CASS), for all those registered within it. The system covers employed individuals and their dependants, with outpatient costs reimbursed at 75% and hospitalisation at 90%. Waiting times for specialist mental health appointments can, however, be considerably longer than for general medical consultations — a familiar constraint in many European public health systems. Private psychological and psychiatric practitioners operate in Andorra la Vella for those seeking faster access. Services are typically delivered in Catalan, Spanish, or French; expats requiring support in other languages may need to seek out private providers specifically.

The total number of doctors practising in Andorra reached 507 in 2023, supported by digital infrastructure including a shared electronic health record and the Andorra Salut app. Expats experiencing difficulties with their mental health are encouraged to speak first with their GP (metge de capçalera), who can initiate referrals within the public system.

Are there any health risks specific to expats living in Andorra?

Andorra is, in general terms, an exceptionally safe and healthy country in which to live. Even so, several health considerations tend to be of particular relevance to those moving there from abroad.

Altitude adjustment: Altitude sickness is a recognised hazard in parts of Andorra. The capital, Andorra la Vella, lies at approximately 1,023 metres above sea level, while many other parts of the country are considerably higher. People arriving from low-lying countries may experience headaches, fatigue, and shortness of breath during their first days or weeks. Anyone with a pre-existing cardiovascular or respiratory condition should consult a physician before relocating.

Climate and seasonal risks: Andorra’s climate is characterised as cold alpine, with significant snowfall each winter. Skiing, snowboarding, and hiking are deeply embedded in both daily life and the tourism economy. Winter sports-related injuries are among the more frequent causes of hospital admissions, making comprehensive health and accident insurance an essential rather than optional consideration. When engaging in outdoor activities, remain attentive to shifting weather conditions and carry appropriate clothing, sunscreen, and a basic first aid kit.

Healthcare registration: Employees working in Andorra are automatically enrolled in CASS, which provides healthcare coverage for workers and their families through the government-run social security system. Those who are self-employed, retired, or not in formal employment need to make their own arrangements to join CASS on a voluntary basis. Individuals who are not employed may opt into CASS by paying a monthly contribution of approximately €200 to €400 — verify the current rate directly with CASS, as this figure is subject to change. Securing registration before you require medical care is strongly advisable.

Language of healthcare: Medical consultations in Andorra are conducted primarily in Catalan, Spanish, or French. Expats who are not proficient in at least one of these languages may encounter difficulties, particularly in specialist or emergency situations. Acquiring a working knowledge of basic medical vocabulary in Catalan or Spanish before arrival is a practical and worthwhile investment.

Health screening on arrival: Shortly after registering with a local GP, arranging a general health check-up is advisable. This provides an opportunity to establish a baseline health record, discuss existing chronic conditions, and ensure any prescriptions you rely on can be managed within the Andorran healthcare system. Certain medications may be unavailable, harder to source, or marketed under different names or formulations in Andorra compared to your country of origin.

Insurance coverage: Andorran social security membership does not constitute comprehensive standalone health cover. CASS does extend coverage to accidents occurring in neighbouring France, Portugal, and Spain, but only when CASS is notified in advance of travel and invoices are submitted for subsequent reimbursement. Many expats choose to complement their CASS entitlement with private international health insurance to cover gaps — particularly for dental treatment, specialist appointments, and medical care sought abroad.

Where can expats find reliable health information and services in Andorra?

Andorra has made considerable investment in digital health infrastructure, making it easier than ever for residents to engage with official health information. A shared electronic health record system and the Andorra Salut app allow residents to view medical reports, referral documents, and vaccination histories in one place. The app is the government’s primary digital interface for health services and is available for download by all residents.

The following official and authoritative sources are recommended for expats:

• Ministeri de Salut (Ministry of Health): The definitive official source for public health policy, national vaccination schedules, and health awareness campaigns in Andorra. Content is predominantly in Catalan.
• Caixa Andorrana de Seguretat Social (CASS): The essential resource for understanding social security contributions, what healthcare coverage you are entitled to, and how to register as a resident.
• Servei Andorrà d’Atenció Sanitària (SAAS): The public health service operator responsible for managing primary care facilities and the principal hospital, Nostra Senyora de Meritxell.
• WHO European Region — Andorra country profile: A valuable source of international health data and comparative statistics for the principality.
• Departament d’Estadística (Statistics Andorra): The go-to source for national demographic and health statistics.
• Your home country’s travel health authority: For example, the US CDC or the UK government health advice for Andorra, for pre-departure health guidance and vaccination recommendations.

The European Observatory on Health Systems and Policies released a comprehensive review of Andorra’s health system in 2025, produced in collaboration with the Ministry of Health and the WHO Regional Office for Europe. This report provides an in-depth account of how the Andorran system is structured and functions, and is accessible through the European Observatory’s publications portal.

Health guidelines, vaccination requirements, fee structures, and available services are all subject to change over time. Always verify current information directly with official Andorran sources — particularly the Ministry of Health and CASS — both before and after your move. Older web content and expat community forums are not reliable substitutes for authoritative official guidance on medical or regulatory matters.

Frequently Asked Questions About Health Issues in Andorra

Is Andorra a safe country from a health perspective?

Yes — Andorra delivers near-universal healthcare coverage, a life expectancy of 84.6 years (as of 2023, the highest in the WHO European Region), and some of the lowest out-of-pocket health costs in Europe. Infectious disease risks are minimal, violent crime is rare, and the healthcare infrastructure is exceptional for a nation of Andorra’s scale.

Do I need any vaccinations before moving to Andorra?

No vaccinations are required as a condition of entry into Andorra. However, making sure your routine immunisations — including MMR, tetanus, and annual influenza — are current is strongly recommended. Review the latest guidance from your own country’s health authority as well as the Andorran Ministry of Health before making the move.

Is the tap water safe to drink in Andorra?

Yes. Tap water throughout Andorra is safe for consumption and complies with European quality standards. Water-borne illness is not a meaningful concern for residents or visitors under normal circumstances, though individuals undertaking remote mountain activities should exercise caution with natural water sources encountered in the field.

What is the biggest health risk for new arrivals in Andorra?

Altitude sickness is among the most recognised risks for people relocating to Andorra, particularly those arriving from countries at or near sea level. The capital itself sits above 1,000 metres, and many parts of the principality are significantly higher. Winter sports injuries are also common, making robust accident and health insurance a practical necessity rather than a luxury.

How does Andorra’s smoking rate compare to other European countries?

As of 2022, 33.6% of Andorra’s population used tobacco — one of the highest rates within the WHO European Region. Most EU member states report smoking prevalence closer to 20–23%. Expats accustomed to strict indoor smoking restrictions in their home countries may find attitudes and enforcement somewhat different in Andorra, though a ban on smoking in public areas, bars, and restaurants is in force.

Can expats access mental health services through the public system in Andorra?

Yes. Public mental health services are available to those registered with CASS. Andorra’s PISMA programme is actively transitioning mental health provision towards a community-based model of care. That said, waiting times for specialist referrals within the public system can be lengthy. Private psychological services are available in Andorra la Vella for those who need faster access or prefer multilingual support.

Are there any specific health concerns related to Andorra’s mountain environment?

Yes. Elevated altitude poses particular risks for individuals with pre-existing cardiovascular or respiratory conditions. UV radiation intensity increases with altitude, making sun protection important throughout the year — especially on the ski slopes. During the warmer months, tick exposure in forested and rural areas is a consideration for those spending time hiking or working outdoors.

How do I register with a doctor as a new expat in Andorra?

Once enrolled in CASS — a process that occurs automatically for employed residents — you can register with one of the primary care centres (centres de salut) operated by SAAS. The Servei Andorrà d’Atenció Sanitària runs 12 primary healthcare centres distributed across the principality. Contact your nearest centre to register with a GP. Those who are not in employment should first obtain CASS membership before seeking to register for primary care.