This is the fourth blog in a series detailing the panels and discussions that took place at the recent 2024 Care Conference hosted by the Institute for Women’s Policy Research (IWPR) and American University’s Program on Gender Analysis in Economics (PGAE). 

The immigrant population in the United States is growing rapidly, bringing with it a diverse set of skills. However, a large portion of immigrants find themselves in care work positions, regardless of the education and experience they gained in their countries of origin. During the workshop “Care, Immigration, and Job Quality,” moderated by Maria Caballero, assistant professor of economics at American University, panelists discussed the multifaceted roles this diverse community plays in the care economy. 

Andrea Velasquez, associate professor of economics at the University of Colorado Denver, discussed the consequences of Secure Communities, a national police-led initiative that targeted undocumented immigrants, on the availability of child care and mothers’ labor force participation. Secure Communities claimed to target violent crime, yet only a small percentage of those deported had convictions related to violent crime. Instead, the initiative was correlated with a significant decline in the employment of lower-skilled non-citizens as well as an increase in the price of child care, suggesting that the enforcement action led to the deportation of workers—most of whom were women—who previously had provided child care. Further analysis then found a decline in the labor supply of college-educated US-born mothers, and this effect was strongest for mothers of young children.

Two panelists focused specifically on international nurse migration. Roy A. Thompson, a postdoctoral fellow at the University of Missouri’s Sinclair School of Nursing, studied the experience of foreign-born nurses working in long-term care facilities in the United States. Many of these nurses had migrated from English-speaking countries in Asia, sub-Saharan Africa, and the Caribbean; a higher share of immigrant nurses were men, and they often had higher levels of educational attainment and experience than their US counterparts. His research highlighted the discrimination and racism faced by many in this community, including their concentration in undesirable shifts and the communication barriers they wrestle with.

Paolo Abarcar, a senior researcher at Mathematica, used a human capital lens on nurse migration and noted two perspectives: a ‘brain drain,’ where lower-income origin countries lose educated workers to higher-income countries, which could lead to poor health outcomes in less affluent nations; and a ‘brain gain,’ where there are high prospective returns and opportunities for skill development for those who migrate. He studied the impact of the expansion and contraction of US nursing visas on nursing education enrollment in the Philippines. When visa availability expanded, nursing degree enrollment increased by 129 percent and nursing graduation by 247 percent, suggesting migration may be a powerful incentive for people to invest in their skills. Abarcar suggested that there is a need for more bilateral agreements to provide financial and technological support to origin countries in recognition of the training they provide to health care workers who then work in high-income countries such as the United States.

Julia Gelatt, an associate director at the Migration Policy Institute, more broadly highlighted the crucial contribution of immigrant workers to the US care workforce. Immigrants were 17 percent of the total US labor workforce in 2022, but they were 32 percent of all adult care workers and 39 percent of home health aides. The large majority—88 percent—are women. Unlike immigrant nurses, a substantial proportion of immigrant care workers (57 percent) do not have education beyond high school. Bureau of Labor Statistics projections predict a need for more than 800,000 additional home health and personal care aides to meet the needs of an aging population. She stressed that it will not be possible to meet this demand without immigrant workers and that proactive strategies are needed to ensure that workers receive training and education to provide high-quality care.

This issue was further discussed by Faith Wiggins, the director of long term care at the 1199SEIU Training and Employment Funds (TEF). The goal of TEF services is to create equity and opportunities for historically marginalized health care workers and to work with union and employer partners to ensure the health care industry has a well-trained workforce. TEF supports its many migrant and immigrant members through assistance with getting recognition for non-US educational credentials, help pursuing US citizenship, English as a second language classes, and courses to reach high school equivalencies. It also provides Spanish language classes for medical professionals. She stressed the importance of language services because caregiving is so intimate; language competency improves the patient’s outcomes because dialogue is more honest.

This workshop reminded everyone of the large contribution made by immigrants to the care industry and their need for long-term career pathways and supports. Beyond that, it is important to foster partnerships to exchange skills and resources between host countries and those countries sending care workers beyond their borders.  

Noura Hassouna is a research associate at IWPR and Cristy Mendoza is a research assistant at IWPR.  

Watch the full workshop here and download the presentations here.