Immigrants Play Large Role in Combating Home Health Caregiver Shortage

A large proportion of home health workers in the U.S. are immigrants, according to a new study compiled with census data. But stricter immigration policies proposed by the Trump administration could reduce the number of foreign-born health care workers and further fuel the nationwide caregiver shortage, some experts say.

More than 23% of home health, psychiatric and nursing aides were born outside the U.S., while almost 9% — and maybe more — were not citizens as of 2016, according to the report.

The data confirms similar research put out by the Paraprofessional Healthcare Institute (PHI), an organization centered on improving the direct care workforce, last year. The report said 860,000 of 4.4 million direct care workers are immigrants.


The most recent findings, published in the Journal of the American Medical Association (JAMA), come from analyzation of 2016 census data on 164,000 health care professionals, which also included doctors, nurses, dentists and pharmacists. In total, nearly 17% of all health care professionals were immigrants, and almost five percent were not U.S. citizens, according to the data.

The majority of those professionals come from Asia, followed by Mexico, Central America and the Caribbean, according to the report.

Although data shows about 9 % of home health workers were not citizens, the authors of the study, who spoke to Reuters, hypothesize there figure could be higher, as some surveyed chose not to disclose citizenship status. Similarly, the 2017 PHI report reads “more research is needed to understand the relationship between direct care and undocumented immigrants.”


As the JAMA study used census data, immigration status was also discretionary and may be underestimated, according to the authors.

With the need for caregivers growing rapidly, immigrants are an increasingly important members of the home health workforce, experts say. Some have even advocated for federal policies that help immigrant workers.

“We have a caregiver shortage and implementing policies like [immigration reform is] just going to exacerbate that shortage even more,” Carelinx CEO Sherwin Sheik said at a HHCN summit in September. “We have to recognize who is taking care of our seniors and embrace them, rather than close the door.”

Written by Bailey Bryant

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