Spain – Health Issues

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

Non-infectious conditions, chiefly heart disease and cancer, sit at the top of both the mortality and morbidity tables in Spain. This largely mirrors the pattern observed across Western Europe, yet Spain’s relatively elevated rates of certain lifestyle-linked risk factors give these illnesses particular weight. WHO data puts Spain’s total population at roughly 46.7 million, with 387,300 deaths from non-communicable diseases each year. Figures from the National Institute of Statistics (INE) show that 26.4% of deaths stemmed from diseases of the circulatory system, 25.2% from tumours, and 10.2% from infectious diseases.

Spain’s 2023 National Health Survey found that 57.7% of the population aged 15 and over reported at least one chronic health condition — a figure higher among women (62.3%) than men (52.8%). The three most frequently reported chronic problems in 2023 were high blood pressure (20.2%), chronic lower back pain (19.8%), and high cholesterol (18.3%).

Among widespread chronic illnesses, those carrying the strongest link to mortality included cancer, chronic lung diseases such as COPD, bronchitis, and emphysema, acute myocardial infarction, and diabetes. Back pain and depression also contribute substantially to the total disease burden, with women disproportionately affected by both.

In children under 15, the most common chronic conditions were chronic allergy (8.3%), asthma (4.6%), and behavioural disorders (2.7%). Because Spain operates a decentralised health system, disease rates and the availability of specialist services can differ between autonomous communities; wealthier regions such as Madrid and Catalonia tend to offer a wider network of specialist facilities.

The principal risk factors driving death and disease in Spain have been identified as smoking, elevated body mass index, and high blood glucose. These align with broader European trends, but they are worth highlighting for expats who may not have previously encountered Spain’s public health messaging on these issues.

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

By virtually every international benchmark, Spain achieves outstanding results on population health. According to the OECD, Spain recorded the highest life expectancy among EU member states in 2023 at 84.0 years, compared with an EU-wide average of 81.5 years — a margin of 2.5 years. This places Spain alongside Switzerland and ahead of Germany, France, and Sweden on this particular measure.

The OECD’s Health at a Glance 2025 report confirms life expectancy in Spain at 84 years, which exceeds the OECD average by 2.9 years. Preventable mortality stood at 92 per 100,000 in Spain — well below the OECD average of 145 — while treatable mortality was recorded at 50 per 100,000 against an OECD average of 77. Taken together, these figures point to a healthcare system that is effective both at averting illness and at managing it once it arises.

The gender gap in life expectancy, in favour of women, was 5.3 years as of 2024. Women in Spain could expect to live to 86.53 years on average, and men to 81.38 years — a gap broadly comparable to the EU average.

Spain operates one of Europe’s most comprehensive and cost-efficient healthcare systems, covering 99.5% of the population through the public health network. Despite this strong performance, per capita health spending in Spain runs approximately one fifth below the EU average — a notable achievement that underscores the efficiency of the country’s tax-funded national health system, the Sistema Nacional de Salud (SNS).

For the most current data, readers are encouraged to consult the WHO Spain country profile, the Spanish National Statistics Institute (INE), and the OECD Health at a Glance reports, all of which are updated on a regular basis.

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

For the vast majority of serious infectious diseases, Spain represents a low-risk environment. Preventable communicable illnesses such as measles occur at a rate of just 0.6 cases per 100,000 inhabitants — considerably below the EU average of 5 per 100,000. Spain achieves a high level of vaccination coverage, and for most people arriving from countries with comparable immunisation programmes, no unusual vaccination requirements apply simply by virtue of residing in Spain.

That said, anyone relocating should confirm that their routine vaccinations are current before the move. Generally recommended immunisations for new residents include diphtheria, tetanus, polio, measles-mumps-rubella (MMR), and hepatitis B. Up-to-date guidance can be found through your home country’s travel health authority — such as the UK’s NHS Travel Health or the US CDC Traveler’s Health pages — as well as Spain’s Ministry of Health (Ministerio de Sanidad).

Vector-borne diseases warrant some attention, especially in warmer southern and coastal parts of the country. Tick-borne encephalitis and Lyme disease may occur in forested and rural areas, and mosquito-transmitted West Nile virus has been reported sporadically across southern Spain, including Andalusia. Those who plan to spend extended time outdoors or in rural settings should use appropriate insect repellent and carry out tick checks after walking in the countryside.

Tap water quality across Spain is generally high and safe to drink in most urban locations, though some rural areas and parts of the Canary or Balearic Islands may produce water with a noticeably different mineral taste. Food safety standards are governed by EU regulations and are broadly on a par with those found elsewhere in Western Europe.

Air pollution represents a meaningful environmental health concern. In addition to lifestyle risk factors such as smoking and diet, environmental elements including air quality and extreme temperatures play a role in Spain’s overall health picture. Major cities — Madrid, Barcelona, and Valencia in particular — experience periodic episodes of elevated pollution, largely attributable to traffic. Those with asthma or chronic respiratory conditions should consult publicly available air quality indices, which regional health authorities make accessible online.

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

Smoking rates in Spain have been on a downward trajectory since 2006. Approximately 27.9% of the adult population are current smokers — down from 34% in 2006 — representing around 11.1 million individuals. The INE’s 2023 National Health Survey provides a more granular daily-smoker figure: 16.6% of those aged 15 and over reported smoking every day in 2023, a fall of 3.2 percentage points compared with 2020. A further 2.6% described themselves as occasional smokers, and 20.7% identified as former smokers. Breaking this down by sex, 20.2% of men smoked daily compared with 13.3% of women. Differences in methodology account for some variation between sources, and consulting INE or WHO figures directly is advisable for the most standardised current statistics.

Spain introduced comprehensive indoor smoking restrictions through Law 28/2005, which prohibited smoking in all enclosed workplaces and public spaces. A 2011 strengthening of that legislation extended the ban to bars, restaurants, and hospitality venues, bringing Spain broadly into alignment with similar measures already operating in countries such as Ireland and France. Smoking is currently forbidden in all enclosed public spaces, on public transport, and within healthcare and educational settings.

Ongoing legislative developments are reinforcing restrictions on alcohol sales and consumption for those under 18, curtailing advertising near schools, and tightening tobacco regulation — including widening smoke-free zones, introducing controls on vaping products, and raising tobacco taxes. The reform of the existing anti-tobacco law cleared its first legislative hurdle in September 2024 and was continuing through parliament into 2025–2026.

Nicotine vapes (e-cigarettes) are lawful in Spain, with an adult vaping prevalence of roughly 1.33%. Sales of vaping devices are restricted to those aged 18 and over, and their use in public spaces is subject to legal constraints. A further bill that would ban vaping across many outdoor public areas — including terraces and beaches — was scheduled for final parliamentary debate, with enforcement potentially commencing by spring 2026 if passed, which could position Spain as a leader in outdoor smoke-free policy. Expats should keep abreast of regulatory changes as they develop.

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

According to Spain’s 2023 National Health Survey, 55.0% of the population aged 18 and over were overweight — a figure more prevalent among men (62.2%) than women (48.0%). Among children aged 2–17, the equivalent rate stood at 23.3%. Obesity specifically affected 15.2% of adults and 7.1% of children, while excess weight excluding obesity was recorded in 39.8% of adults.

Adult obesity rates have climbed only marginally since 2017 and were broadly in line with the EU average according to the most recent OECD data. While the picture is less severe than in several comparable countries, the upward direction of travel remains a public health priority.

Spain is internationally associated with the Mediterranean diet — an eating pattern centred on olive oil, vegetables, legumes, fish, and whole grains, accompanied by moderate wine consumption. This dietary tradition is widely considered to underpin Spain’s strong health outcomes and notably low rates of cardiovascular mortality. However, as in many European nations, the consumption of ultra-processed foods has grown — especially among younger age groups — and this shift represents an increasing concern for public health policymakers.

Active policy responses include the Obesity Action Plan 2024–27 and the National Strategic Plan for the Reduction of Childhood Obesity. The School Meals Reform Law (2025) mandates daily provision of fruit and vegetables and weekly fish, restricts processed foods, bans sugary drinks, and requires school menus to incorporate 45% locally sourced or seasonal produce in order to address childhood obesity.

Annual agreements between the Ministry of Health and the Spanish Federation of Municipalities and Provinces encourage local initiatives promoting physical activity, expanded provision of spaces for walking and cycling, healthy and sustainable eating habits, reduced tobacco and alcohol consumption, and prevention of chronic conditions. Expats settling in Spain may find that the cultural emphasis on outdoor living, structured mealtimes, and access to fresh local produce naturally supports healthier daily routines.

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

Spain’s 2023 National Health Survey found that 14.6% of the population aged 15 and over experienced depression in the fortnight preceding the interview, with 8.0% classified as severely depressed. The prevalence of depressive symptoms rose compared with 2020, with severe depression increasing by 5.5 percentage points. Mental health has become an ever more prominent topic within Spanish public health debates.

Culturally, attitudes towards mental health have been shifting in Spain, most noticeably among younger generations. While stigma historically deterred many from seeking help — as in much of Europe — awareness campaigns and growing media attention to psychological wellbeing have progressively altered public attitudes. Cities such as Madrid and Barcelona tend to have a more open discourse around mental health, whereas more traditional perspectives may persist in certain rural areas.

Within the public health system (SNS), mental health care is accessible but frequently under strain. The availability of public psychiatrists and psychologists differs considerably from one region to another, and waiting times for non-urgent referrals can stretch to several months in some parts of the country. This stands in contrast to systems such as England’s NHS Improving Access to Psychological Therapies (IAPT) programme, which provides structured self-referral pathways not yet replicated at a national level in Spain.

Plans to strengthen provision are in motion: the Suicide Prevention Plan 2025–27 offers support for vulnerable individuals, while the Mental Health Action Plan 2025–27 targets the social determinants of poor mental health and includes concrete steps to widen access to services.

For expats, private mental health care is broadly available in urban areas, with many psychologists and therapists offering consultations in more than one language. Private health insurance complements — but does not substitute for — public coverage; as of 2024, around 28% of residents (12.4 million people) held private policies. Many expats find that private insurance substantially shortens waiting times for mental health assessments and therapy. Session fees with private therapists typically range from €50 to €100 per hour in city locations.

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

Expats relocating to Spain encounter relatively few acute health risks that are unique to the country, but a number of practical factors can influence wellbeing — particularly during the early months of settlement. Adapting to Spain’s climate is one of the more immediate challenges: the intense summer heat in southern and inland regions such as Andalusia, Extremadura, and Castile can pose a genuine health hazard for those who have not previously lived in such conditions. Heat-related illness, dehydration, and sunburn are real risks, and older residents as well as those with cardiovascular conditions should exercise particular caution during summer heatwaves.

Alcohol consumption among adults in Spain has risen since 2010, reaching 11.1 litres per adult in 2023 — approximately 10% above the EU average. The social context around drinking in Spain — including late evening meals, gathering in bars, and the everyday presence of wine at the dinner table — can feel markedly different to expats accustomed to other cultural norms, and it is worth staying mindful of gradual increases in personal alcohol intake following a move.

Allergy risks also deserve attention. Spain’s warm climate and high pollen counts — especially from olive trees in spring across southern regions — can trigger or exacerbate seasonal allergies and asthma. Chronic allergy is the most prevalent chronic condition among children in Spain, and a number of adults also develop symptoms for the first time, or find existing ones intensified, after moving to the country.

Practical steps every expat should take include:

1. Register with a local GP (médico de cabecera): Visit your local health centre (centro de salud) with proof of registration at your address (empadronamiento) and your health entitlement documentation (such as a social security number or European Health Insurance Card while transitioning). This is the gateway to the entire public health system.
2. Obtain your SIP or health card: In most autonomous communities, you will receive a Sistema de Información Poblacional (SIP) card or equivalent regional health card granting access to public care.
3. Review your vaccination record: Ensure routine vaccinations are up to date and ask your GP whether any additional vaccines are advisable based on where in Spain you are living.
4. Arrange health insurance: If you are not entitled to the public system (for example, on a non-lucrative visa), you will need private health insurance. Even those with public access often take out supplemental private cover for faster specialist appointments.
5. Get a dental and eye check: Dental and optical care are largely excluded from the public SNS and require private insurance or out-of-pocket payment — register with a private dentist early.
6. Be sun-safe: Use high-factor sunscreen year-round in coastal and southern areas, stay hydrated, and avoid prolonged outdoor activity during peak summer heat (typically 12:00–17:00).

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

Spain has well-established official health institutions that publish public health guidance, policy documents, and statistical information. The main source for national health policy is the Ministerio de Sanidad (Ministry of Health), which produces national health surveys, vaccination schedules, epidemiological bulletins, and public health strategies. The bulk of this material appears in Spanish, though key documents are occasionally translated into other languages.

For health statistics and demographic data, the Instituto Nacional de Estadística (INE) publishes regular national health surveys — the most recent being the 2023 Encuesta Nacional de Salud de España — containing detailed information on chronic conditions, mental health, lifestyle factors, and more. The INE makes summaries available in both Spanish and English.

At an international level, the WHO Spain country profile and the OECD’s Health at a Glance country notes offer comparative data on life expectancy, preventable mortality, and health system performance, and are useful for situating Spain’s health outcomes in a global context. These resources are updated regularly and freely accessible online.

For expats in particular, Spain’s public health system is administered at the autonomous community level, so the most practical first port of call is your nearest centro de salud (health centre). Each region has its own health authority — such as the Consejería de Sanidad in Madrid or the Conselleria de Salut in the Balearic Islands — whose websites provide local service directories and appointment booking information.

Before relocating, travel health advice can be obtained from your home country’s official travel health body — such as the UK’s TravelHealthPro or the US CDC Spain Travel Health page — for current vaccine recommendations and health advisories specific to Spain. Always verify the latest guidance directly with official sources, as vaccination recommendations and public health alerts are subject to change.

A new national disease surveillance network launched in 2024 has strengthened disease monitoring across Spain, and the newly established State Public Health Agency formally incorporates extensive public health surveillance, monitoring, and health impact evaluation. As a result, expats can expect increasingly timely and accessible official public health communications in the coming years.

Frequently Asked Questions About Health Issues in Spain

Is Spain a safe and healthy country to live in as an expat?

Spain has one of the most inclusive and efficient healthcare systems in Europe, with 99.5% of the population covered by the public health system, and the country holds the highest life expectancy in the EU. For the great majority of expats, Spain is a very safe and healthy place to live, with a low risk of infectious disease, high food quality standards, and a climate that broadly encourages outdoor activity and a healthy lifestyle.

Do I need any vaccinations to move to Spain?

No vaccinations are compulsory for entry or residency in Spain. Nevertheless, it is strongly advisable to confirm that your routine immunisations are current before you move — particularly diphtheria, tetanus, polio, and MMR (measles, mumps, rubella). Consult your home country’s travel health authority and Spain’s Ministry of Health for the most up-to-date recommendations, as guidance can evolve over time.

What are the biggest health risks for expats in Spain?

The most significant health risks for expats tend to be sun and heat exposure — especially in southern Spain during the summer months — seasonal allergies driven by high pollen levels, the possibility of gradually consuming more alcohol within Spain’s social culture, and the importance of ensuring adequate health coverage, particularly for dental and optical care, which fall largely outside the public system. At a population level, chronic conditions such as cardiovascular disease and diabetes represent the greatest health burden.

How does Spain’s public health system deal with mental health?

Mental health services exist within Spain’s public SNS, but provision varies considerably by region and waiting times for non-urgent referrals can be substantial. The Mental Health Action Plan 2025–27 targets the social determinants of poor mental health and includes dedicated measures to broaden access to care. Many expats living in cities choose to supplement public services with private therapy, which is widely available and frequently offered in multiple languages.

Is the tap water safe to drink in Spain?

Across most Spanish cities and towns, tap water complies with EU safety standards and is perfectly safe to drink. That said, the taste and mineral composition of tap water can vary noticeably by location. In some areas — particularly on certain islands and in rural zones — many residents opt for bottled water on taste grounds even where tap water is technically safe. If you are uncertain about your specific location, your local health authority can provide clarification.

How common is smoking in Spain, and will it affect me in public?

Smoking rates in Spain are trending downward: the 2023 National Health Survey recorded 16.6% of those aged 15 and over as daily smokers, down 3.2 percentage points from 2020. Smoking is prohibited in all enclosed public spaces, restaurants, bars, and workplaces. Outdoor terraces have historically been areas where smoking was common, but legislation is becoming progressively stricter, with new laws extending smoke-free zones to outdoor settings advancing through parliament as of 2025–2026.

What should I do if I get sick and need to see a doctor in Spain?

If you are registered with the public health system, go to your nearest health centre (centro de salud) and request an appointment with your assigned GP (médico de cabecera). In an emergency, head to the nearest hospital emergency department (urgencias) or dial 112. If you are covered by private health insurance, contact your insurer’s helpline for a referral to an appropriate private clinic. Keeping your health card or insurance details on your person at all times is a sensible precaution.

Are allergies and asthma likely to get worse after moving to Spain?

This is a real possibility, particularly in spring and in areas with dense concentrations of allergenic plants such as olive trees — most notably Andalusia, Castile-La Mancha, and Extremadura. Spain has one of Europe’s most pronounced pollen seasons, and some people develop allergic symptoms for the first time, or find pre-existing ones more severe, following a move to the country. If you have a history of asthma or hay fever, discuss your situation with a GP both before and after relocating, ensure you have an adequate supply of any necessary medication, and track pollen forecasts during the peak season.