Immigrant Health-Care Workers in the United States

The COVID-19 pandemic has shone a bright light on the U.S. health-care system like no other recent crisis. Doctors, nurses, and other health-care professionals were praised for stepping up to confront the major public-health challenge. While the waning of the pandemic has relieved some pressure on the U.S. health-care system, longstanding challenges remain, including the aging of both the overall U.S. population and health-care workers, geographic mismatches between health providers and vulnerable populations, and the persistent under-representation of racial and ethnic minorities.

Immigrants account for disproportionately high shares of essential workers across the U.S. economy and were on the front lines as part of the U.S. response to the pandemic. If recent immigration, education, and health-care trends continue, immigrants’ presence in the health-care sector will only increase going forward.

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. This was slightly higher than immigrants’ share of the overall U.S. civilian workforce (17 percent) and the foreign born were especially over-represented among certain health-care occupations such as physicians and surgeons (26 percent) as well as home health aides (almost 40 percent). Approximately 1.6 million immigrants were working as doctors, registered nurses, dentists, pharmacists, or dental hygienists.

Immigrants in the health-care sector hold a variety of legal statuses; among them are naturalized citizens, legal permanent residents, temporary workers, and recipients of Temporary Protected Status (TPS) and the Deferred Action for Childhood Arrivals (DACA) program. Female immigrants were more likely than U.S.-born women to work in direct health-care support occupations known for low wages, such as home health aides and nursing assistants. In contrast, immigrant men were more likely than their U.S.-born counterparts to be physicians and surgeons, occupations that are well compensated. Compared to all immigrant workers, those employed in the health-care field were more likely to speak English fluently, be naturalized citizens, and hold health insurance coverage.

While immigrants play a vital role at all levels of health care, the Migration Policy Institute (MPI) estimates that 270,000 immigrants with a college degree in medical and health sciences and services were on the sidelines of the pandemic because of skill underutilization—that is, because they were working in lower-skilled jobs, such as registered nurses working as health aides—or were out of work. Like immigrants employed in health care overall, most of these underemployed immigrant health-care professionals are bilingual. They speak a variety of non-English languages (such as Spanish, Tagalog, Chinese, Arabic, Korean, Hindi, and Russian) also spoken by U.S. residents who are Limited English Proficient (LEP) and who may receive health-care services of lower quality because of language and cultural barriers.

This Spotlight provides a demographic and socioeconomic profile of foreign-born health-care workers residing in the United States. The data come primarily from the U.S. Census Bureau’s 2021 American Community Survey (ACS) and the U.S. Bureau of Labor Statistics (BLS). All data refer to civilian, employed workers ages 16 and older, unless otherwise noted.