25% increase in US immigration may save 5,000 senior deaths: Study explains

NBER research says a 25% rise in immigration could prevent about 5,000 deaths annually among older Americans by strengthening the healthcare workforce

Is immigration good for the health of older Americans? Yes. A study from the National Bureau of Economic Research (NBER) found that a 25 per cent increase in the flow of immigrants into the US would prevent 5,000 deaths among older Americans.

 

The February 2026 study by David C Grabowski, Jonathan Gruber and Brian E McGarry found that immigration expanded the US healthcare workforce and was linked to measurable declines in mortality among seniors.

 

The findings come at a time when immigration has tightened under the Trump administration, with policymakers weighing labour market concerns against broader economic and social effects.

   

How immigration affects older Americans’ health

 

The researchers estimated that every 1,000 additional immigrants leads to 9.8 fewer deaths annually among older adults in the average metropolitan area studied.

 

At the national level, modelling suggested that increasing annual immigrant inflows by 25 per cent — roughly 325,000 additional people — would prevent about 5,000 deaths among seniors each year.

 

The study focused on Americans aged 65 and older, who are the heaviest users of healthcare and long-term care services in the United States.

Immigrants in the US

 

The United States remains home to the world’s largest immigrant population. About 47.8 million immigrants lived in the country in 2023, accounting for 14.3 per cent of the total population, according to Census-based estimates.

 

Most immigrants are legally present as citizens, permanent residents or temporary visa holders, though roughly one in four are estimated to lack authorised status.

 

The NBER paper noted that immigrants already play an outsized role in the labour market and especially in healthcare.

 

Visa pathways feeding the care workforce

 

The study highlighted several immigration channels that supply healthcare workers to the US:

 

> H-1B visas for specialised workers, including physicians

> J-1 exchange visas used by foreign medical graduates during training

> TN visas for eligible Canadian and Mexican health professionals

> Conrad 30 waiver programme, which allows foreign doctors to work in underserved areas

> Employment-based green cards such as EB-2 and EB-3, which give preference to licensed healthcare workers

 

These pathways are particularly important because many care roles face chronic shortages.

 

The workforce channel: Where immigrants fit in

 

A central mechanism identified by the researchers was the role immigrants play in filling healthcare workforce gaps.

 

The paper found that admitting 1,000 new immigrants results in 173 additional healthcare workers overall, including both foreign-born and domestic staff.

 

Of these:

 

> 142 are foreign-born healthcare workers

> The rest reflect modest increases among domestic workers

> There is no evidence of crowd-out of native healthcare workers

 

The expansion spans key frontline roles. An additional 1,000 immigrants is associated with:

 

> 28 more aides

> 49 more nurses

> 19 more doctors (of any origin)

 

The study also found a small “crowd-in” effect for domestic physicians, suggesting that more support staff allows health systems to expand capacity.

 

Why older Americans benefit

 

Older adults account for nearly $1 trillion in healthcare spending and over $230 billion in formal long-term care spending in the US, making them highly dependent on care labour.

 

Immigrants are deeply embedded in this system:

 

> Roughly 1 in 5 frontline nursing home workers are immigrants

> Nearly 1 in 3 home care workers are immigrants

> About 18 per cent of all healthcare workers are immigrants

 

Because many care roles face chronic vacancies and relatively low pay, the researchers argue immigration helps ease persistent staffing shortages.

 

Fewer nursing home stays

 

The clearest pathway identified in the paper was reduced reliance on nursing homes.

 

The authors estimated that 1,000 additional immigrants lead to 17.3 fewer seniors using skilled nursing facilities in a typical metro area.

 

This shift matters because:

 

> Many older adults prefer ageing at home

> Nursing homes carry infection and quality risks

> More home-based support may improve survival

 

The study found that mortality improvements appear closely linked to this decline in institutional care.

 

No major increase in Medicare spending

 

Despite the workforce expansion and health gains, the researchers did not find meaningful increases in overall Medicare spending.

 

Their analysis suggested reductions in some areas, such as nursing home use, were likely offset by increases elsewhere, resulting in little net fiscal impact.

 

The study analysed:

 

> 18.0 million Medicare beneficiaries aged 65+

> Data from 276 state-level metropolitan areas

> Immigration and labour data from the American Community Survey (2000–2019)

> Medicare outcomes from 2008–2019

 

To address concerns that immigrants may simply move to healthier regions, the researchers used a shift-share instrument and tracked a fixed cohort of seniors over time.

 

Tightening immigration debate

 

The paper arrives amid renewed scrutiny of immigration policy in the United States. The authors noted that expanding immigration for healthcare workers has been proposed as one way to address workforce shortages, even as broader political pressures have pushed toward stricter controls.

 

What the study suggests

 

The researchers concluded that immigration under age 55 produces “meaningful declines in the mortality rates of older adults” and boosts the care workforce.

 

They added that targeted immigration policies tied to healthcare employment could potentially deliver even larger health gains.