COVID-19 Confirms Immigrants Are Vital to the Healthcare Workforce

According to the New American Economy Research Fund, states across the country have faced critical healthcare worker shortages for years, and the coronavirus pandemic has only exacerbated these needs. In 2015, there were about 10 open healthcare jobs for every unemployed worker in the United States. By 2018, even before the current outbreak, this number had risen by more than 30 percent, with 13 open jobs for every unemployed healthcare worker. As states brace for a second wave of coronavirus infections, addressing these shortages will become even more critical. Given these growing shortages and the imminent need for healthcare workers during the COVID-19 crisis, the role of immigrants in the healthcare industry plays a key role in the fight against the disease and to a successful recovery in its aftermath. Immigrants are vital to the healthcare workforce.

Using the most recent data available from the American Community Survey, the Philippines was the most popular country of birth for immigrant healthcare workers overall, with more than 357,000 Filipino immigrants working in healthcare. This includes almost 143,000 Filipino immigrant registered nurses, making the Philippines also the most common country of birth for foreign-born registered nurses in the United States. Together, Filipino immigrants made up almost 1 out of 20 registered nurses.

Country of BirthNumber of WorkersShare of All Immigrant RNsShare of All RNs
Philippines142,80029.3%4.5%
India32,4006.7%1.0%
Nigeria21,2004.4%0.7%
Jamaica21,2004.3%0.7%
Mexico18,9003.9%0.6%
Top Countries of Birth for Immigrant Registered Nurses

Separate research conducted by the Migration Information Source found that overall, immigrants ranging from naturalized citizens, legal permanent residents, and temporary workers to recipients of Temporary Protected Status (TPS) and the Deferred Action for Childhood Arrivals (DACA) program accounted for nearly 18 percent of the 14.7 million people in the United States working in a health-care occupation in 2018. As a group, immigrant health-care workers are more likely than their U.S.-born counterparts to have obtained a university-level education. Immigrant women in the industry were more likely than natives to work in direct health-care support, the occupations known for low wages. In contrast, immigrant men were more likely than the U.S. born to be physicians and surgeons, occupations that are well compensated.

Even before the COVID-19 pandemic, a number of health-care occupations were among the fastest-growing occupations, as projected by the U.S. Bureau of Labor Statistics (BLS) for the 2018-28 period. The more immediate trends now are less clear. Like other parts of the U.S. economy, the health-care sector has suffered job losses since February 2020, however this trend has quickly reversed in June and July. Nonetheless, the main drivers for a greater demand for healthcare services—population aging and longevity—remain valid. As in the past and present, immigrants are vital to the healthcare workforce and can be expected to play a significant role in the future of U.S. healthcare.

Immigrants, Diversity and Quality

Diversity in healthcare goes far beyond an ethnic backgrounds and languages spoken. Diversity is about understanding the mindset of a patient within a larger context of culture, gender, religious beliefs, and socioeconomic reality. In a healthcare age where quality is everything, diversity in nursing is extremely important. The Joint Commission has been pushing hospitals since 2008 to adopt policies and practices to demonstrate that they can care for diverse population. In August 2015 The Joint Commission’s medical director observed that the lack of diversity among healthcare professionals is resulting in health inequities. He urged schools, health systems and accrediting bodies to: “re-double their efforts to increase awareness of disparities and enhance diversity in the health professions.”

Policy Makers Recognize Fragility of Healthcare Workforce

As the number and intensity of coronavirus cases has ebbed and flowed, the shortage of nurses and doctors has been exposed for all to see. In late March, despite the worldwide suspension of routine visa services, the U.S. State Department confirmed that U.S. embassies and consulates would continue to provide emergency and mission critical visa services. Medical professionals with an approved visa petition were instructed to contact their nearest U.S. embassy or consulate for procedures to request an emergency visa appointment. This policy initiative has had a limited impact thus far as local travel restrictions, regulations and laws made accessing U.S. embassies and consulates almost impossible as the coronavirus spread around the world.

Most recently in May, Senator David Perdue (R-GA) introduced the Healthcare Workforce Resilience Act. This bill makes previously unused immigrant visas available to nurses and physicians who petition for such a visa before the date that is 90 days after the end of the declared national emergency relating to the COVID-19 outbreak. To date this legislation has gained broad bi-partisan support with a total of 33 co-sponsors in the Senate. Parallel legislation has been introduced in the House of Representative where it has also been embraced on a bi-partisan basis.

Preparing for a Post-pandemic World

“The nurse and doctor shortages that existed prior to the coronavirus, will return and be even greater when the pandemic passes,” said Ron Hoppe, CEO of WorldWide HealthStaff Solutions Ltd. “The stress of providing healthcare in the midst of a pandemic is significant and it will bring long term ramifications.”

Research has found that nurses have always been at some risk for developing PTSD symptoms because of their exposure to traumatic situations in the course of caring for their patients. Research conducted during and after the Coronavirus Middle East Respiratory Syndrome (MERS) outbreak that started in 2012 and lasted through 2018 validated a significant and positive relationship between PTSD and turnover intention among nurses who were involved with the care during the MERS outbreak. This is a factor that has not been accounted for in current workforce planning models. The supply and demand imbalance in the availability of experienced nurses and doctors will be exacerbated by the current pandemic.

Immigrants are vital to the healthcare workforce and to the future demand of healthcare in the U.S. In spite of changes and controversy with immigration laws, organizations are increasingly seeking opportunities to recruit globally as part of their overall staffing strategies. As the immigration process becomes more streamlined, professional nurses can continue to contribute to the provision of high-quality care and cultural diversity in our workforce and our communities.

If you are a hospital or healthcare employer interested in learning more about the benefits of international nurse recruitment, click here to download the USA Guide to Direct Hire International Recruitment.