US immigration boosts healthcare staffing, elder care, says new study

MIT, Harvard and University of Rochester researchers found immigration growth improved healthcare staffing and elder care outcomes in US nursing homes

As immigration faces renewed scrutiny under US President Donald Trump, a new study by researchers from Massachusetts Institute of Technology, Harvard Medical School, and the University of Rochester has found that higher immigration levels are linked to a larger healthcare workforce and better outcomes for elderly patients in nursing homes.

 

The paper, titled Immigration, the Long-Term Care Workforce, and Elder Outcomes in the US, was authored by Jonathan Gruber, David C Grabowski, and Brian E. McGarry.

 

The findings come as immigration remains one of the most politically charged issues in the US, with the Trump administration pushing stricter enforcement measures and tighter controls on both legal and illegal immigration.

   

At the same time, the country continues to face staffing shortages in elder care facilities following the Covid-19 pandemic.

 

Staff levels at nursing homes dropped by 10 per cent after the pandemic began in early 2020, worsening shortages in a sector already under pressure from a rapidly ageing population.

 

“We have an aging population, care for them is labour-intensive, and there are shortages everywhere in that supply chain,” said Gruber, who also heads the economics department at Massachusetts Institute of Technology.

 

What did the researchers find?

 

The researchers found that immigrants account for around one-fifth of healthcare support workers in the US. Using data from metropolitan areas across the country, they examined how changes in immigration levels affected staffing patterns and patient care in nursing homes.

 

“When immigration rises in a city, it significantly increases the health care workforce,” said Gruber.

 

The study found that a 10 per cent increase in female immigrants in a metro area led to a 1.1 per cent rise in the number of hours registered nurses spent with elderly patients. Hours worked by certified nursing assistants also increased by 0.7 per cent.

 

Researchers said these increases happened without displacing existing caregivers.

 

How did patient outcomes change?

 

The paper also linked higher immigration levels with improved patient outcomes. Hospitalisations among patients staying in nursing homes for short-term care, usually up to one month, fell by 0.6 per cent in areas that saw higher immigration.

 

The researchers also recorded lower use of physical restraints, fewer psychiatric medication prescriptions, and fewer urinary tract infections among elderly patients receiving care in nursing homes with larger immigrant workforces.

 

“Even if immigration actually increases labor supply to the medical sector, it was an open question if that would improve outcomes, and it does,” said Gruber. 

 

What data did the study use?

 

The study drew on immigration data collected between 2000 and 2018 from the United States Census Bureau’s American Community Survey. Researchers also used nursing home staffing and patient records submitted for Medicare and Medicaid compliance.

 

The analysis covered more than 16 million Medicare beneficiaries across over 13,000 nursing homes in metropolitan areas across the US.

 

“One of the key groups that’s taking care of our nation’s elders is immigrants,” said Gruber. “So I thought it would be fascinating to understand how much does immigration actually matter for elder care.”   

 

Why does the study matter in the immigration debate?

 

Researchers said the findings add another dimension to the wider immigration debate in the US, which has often focused on jobs, wages, crime, and taxes.

 

“I think it provides a new lens on the debate over immigration,” said Gruber. “The debate over immigration has been solely about what will it do to native workers, what will it do to the crime rate, what will it do to tax collection. This adds a new element, which is: What will it do to our citizens’ care? By having more immigration, we provide more care.”

 

The researchers are continuing to examine the issue. In a separate working paper released in February, they found that increased immigration was also linked to lower mortality rates among elderly Americans, partly because more seniors were able to receive care at home.

 

The newly published paper said the findings “paint a consistent picture of improved quality of care resulting from increased immigration.”