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 As of 2017, immigrants accounted for more than 18% of U.S.
healthcare workers, researchers report in the journal Health
Affairs. In nursing homes, nearly one in four workers who directly
care for patients are immigrants, as are nearly one in three
housekeeping and maintenance workers.
"We rely heavily on immigrants to care for the elderly and disabled,
particularly in their everyday care," said the study's lead author,
Dr. Leah Zallman, an assistant professor of medicine at the Harvard
Medical School and director of research for the Institute for
Community Health at the Cambridge Health Alliance. "Therefore, any
policies trying to reduce immigration are likely to make what is
already a workforce shortage worse."
Currently, Zallman said, "there are not enough people willing to do
these jobs and we are going to need a lot more people in the future.
This is an industry that needs people round the clock. And
immigrants disproportionately take the night shifts. They are really
filling the gaps."
The issue becomes increasingly important as the elderly population
grows, with experts predicting it will double by 2050, Zallman and
her colleagues noted.
To take a closer look at the role of immigrants in healthcare, the
researchers turned to the Annual Social and Economic Supplement of
the 2018 Current Population Survey, a nationally representative
survey conducted by the Census Bureau and the Bureau of Labor
Statistics, which collected data on 180,084 people in March of 2017.
Compared to U.S born healthcare workers immigrant workers were
older; 51.6% were older than 44, compared to 43.8% of U.S. born
healthcare workers. Immigrant workers were also more likely to have
completed a four year college degree and more likely to be Hispanic,
non-Hispanic Asian or non-Hispanic Black.
Nearly one in three immigrant healthcare workers - 30.4% - were
employed in long term care settings, compared to 22% of U.S. born
workers. Overall, 1 million workers, or 23.5%, in the formal and
non-formal long term care sector were immigrants.
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Among unauthorized immigrant healthcare workers, 43.2% were employed
in these types of settings.
Immigrant workers were also more likely than those born in the U.S.
to be employed with home health agencies (13.1% versus 7.9%) - and
in the non-formal sector (6.8% versus 4.6%).
The new study is "very important and timely," said Dr. Albert Wu, an
internist and professor of health policy and management at the Johns
Hopkins School of Public Health. "I hope it will encourage us to be
more thoughtful about political decisions as they have an impact on
all of us. The current proposal to restrict immigration to more
skilled or professional applicants runs directly counter to the need
for this category of worker."
Those proposals are coming at a time when the U.S. birthrate is
falling, Wu said. "Looking 10 years ahead, there's a huge projected
shortfall in people who do hands-on face-to-face caregiving for
older and disabled adults."
That's exactly what's already happening in Japan, said Dr. John W.
Rowe, a professor in the Mailman School of Public Health at Columbia
University. "Immigration has been limited by Japan's preference for
an ethnically homogeneous society," Rowe said in an email. "With the
rapid aging of the Japanese, who have the longest life expectancy in
the world, this shrinking population has yielded major shortages in
the elder care workforce and in manufacturing."
In response, "the Japanese government in December 2018 relaxed the
long-standing immigration restriction and established a program of
five-year visas for several hundred thousand workers, Rowe said.
"This was seen as a major social change in traditionally xenophobic
Japan."
SOURCE: http://bit.ly/31ach9O Health Affairs, online June 3, 2019.
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