Purpose: 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. Design/methodology/approach: 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. Findings: 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. Originality/value: 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. © 2018, Emerald Publishing Limited.

qualitative research Therapeutic itineraries Access to health services immigrants Social exclusion healthcare use

perception ethnographic research immigrant social exclusion witness Wuchiapingian comprehension human qualitative research hygiene male Spain female Article health care utilization adult human experiment health care system quantitative analysis attention Fear medical care