Welcome to the new face of multicultural America and the U.S. healthcare labor force.

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As we celebrate the Labor Day holiday weekend, most of us will enjoy packing up for the beach, firing up the grill and getting together with family and friends. When we return to work, something may seem different. Today's workforce is truly multigenerational, with Baby Boomers, Generation X and Millennials making up 93% of U.S. employees. Most Baby Boomers will have retired by 2030, and a majority of the remaining workforce will comprise 75 million millennials, a generation that will be responsible for Social Security and Medicare contributions and increasingly, the care of the young, the poor and the old.

Take notice. Millennials represent the most ethnically diverse generation in American history, more than a quarter of the total population, 40% Hispanic, Black, Asian, or Mixed race, 20 percent children of immigrants, 30% of the voting-age population, and 43% of the working-age population. Since the 1980s, the swell of immigration from Latin America and Asia, coupled with the aging of the non-Hispanic white population, has contributed to the new face of multicultural America and the U.S. healthcare labor force.

A visibly concerned senior citizen looking out a window.

Statistics aside, one issue that stands out and gaining a great deal of attention in the presidential election is the impact of immigration on healthcare for an aging population. Foreign-born professionals play a crucial role in filling severe shortages within the two largest health care occupations: physicians and nurses, including nursing aides. Nearly 2.8 million immigrants were employed as health-care workers in 2021, accounting for more than 18 percent of the 15.2 million people in the United States in a health-care occupation. Approximately 1.6 million immigrants were employed as physicians, registered nurses, dentists, pharmacists, or dental hygienists.

Since the 1950s, corporate America has turned to immigration policy to manage the health care workforce. Health care organizations generally favor relaxed immigration policies as a way to expand the labor supply of workers willing to accept low wages, although there has been little comprehensive research on the ability of immigrants to alleviate workforce shortages. Seventy percent of immigrant health care workers were citizens of the United States in 2021.

A debate continues as to whether immigrants do jobs that non-Hispanic white Americans choose not to do. Here’s the facts:

About one out of four physicians and surgeons are immigrants. International Medical Graduates (IMGs) after competing residency training practice in underserved small cities and towns where critical services are needed most for a minimum of three years. One out of three older adults living in rural areas, especially in the Midwestern states, count on IMGs for their care.

Like those used in the profession of medicine, the J1 visa program allows qualified nurses to enter the United States to meet immediate staffing needs and to provide much needed medical care in the hardest to reach areas. Immigrant nurses account for roughly 500,000 of the 3.2 million registered nurses.

What is also known is that, on average, many immigrants arriving in the United States have less education than earlier cohorts. As a result, they take jobs in the health service sector as home health aides that often barely cover the cost-of-living expenses, including health insurance. One out of four direct care workers are immigrants,

The future workforce consists of 27,000 health care workers who participate in the Deferred Action for Childhood Arrivals program. According to the American Medical Association, 200 medical students, medical residents and physicians depend on DACA for their eligibility to practice medicine, caring for thousands of patients a year. Together, over the course of their careers, they will make a positive difference in the lives of patients.

The effect of immigration on health care for older people should not be taken lightly. The increasing demand for health workers will invariably grow as a result of rapid population aging in coming decades. A reluctance to develop a comprehensive healthcare workforce policy will only exacerbate the shortages in the United States. The absence of immigrant health care workers affects critical access to services and supports in later life.

Jacqueline Angel is an expert on aging and healthcare and is a professor in the LBJ School of Public Affairs at the University of Texas.

This article originally appeared on Austin American-Statesman: Immigrant health care workers are central to the system

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Welcome to the new face of multicultural America and the U.S. healthcare labor force.

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