'Over 350K Health Workers Face Deportation Risk'

 

• In the U.S., over 350,000 undocumented immigrants and nearly 700,000 documented immigrants work in healthcare, researchers estimated.
• Noncitizen immigrants, both documented and undocumented, made up some 4% of personnel in hospitals and outpatient settings.
• Worker shortages due to deportations could reverberate through emergency departments and hospitals, the study authors suggested.

More than 350,000 noncitizen healthcare workers in the U.S. may be at risk of deportation as part of the Trump administration's immigration crackdown, researchers estimated.

Based on the Current Population Survey (CPS) from March 2024, there were over 20 million individuals making up the workforce across formal and informal healthcare settings nationwide, of whom an estimated 16.7 million were U.S.-born citizens, 2.3 million naturalized citizens, nearly 700,000 documented noncitizens, and over 366,500 undocumented immigrants.

"More than 1 million noncitizen immigrants (one-third of them undocumented) work in healthcare in the U.S. Their ranks include skilled personnel who would be difficult to replace, especially if legal immigration is further restricted," according to a group led by Lenore Azaroff, MD, ScD, of Edward M. Kennedy Community Health Center in Worcester, Massachusetts, writing in JAMAopens in a new tab or window.

Azaroff and colleagues reported that noncitizen immigrants, both documented and undocumented, made up some 4% of personnel in hospitals and outpatient settings, 7% of nursing home workers, and at least 10% of personnel in home care agencies and nonformal settings in their study. In particular, the bulk of the undocumented healthcare workforce were working as nursing aides and assistants at the time of the survey.

If these healthcare workers without U.S. citizenship are deported, the consequences would be felt by America as a whole, they suggested. "Deportations could especially compromise long-term care, where immigrants play a large role. The resulting shortages could reverberate through emergency departments and hospitals, leading to the inability to discharge patients and tying up nurses and other staff."

Outside the study, a report showed that in the first 6 full weeks of the second Trump administration, there were 27,772 immigrants removedopens in a new tab or window from the country, according to data published by Immigration and Customs Enforcement and analyzed by the nonpartisan Transactional Records Access Clearinghouse.

Despite this pace of deportations being lower than it had been under President Biden, healthcare workers now find themselves newly exposed to an immigration crackdown.

Before President Trump returned to office this year, federal law enforcement agents had been told to honor a longstanding humanitarian parole program that exempts sensitive locations such as schools, hospitals, and health centers from immigration raids. This was endedopens in a new tab or window as one of the new Trump administration's earliest actions.

"The Trump administration's plans to deport undocumented immigrants and some with temporary protected status -- which allows some migrants from countries with unsafe conditions to live and work in the U.S. -- and increase legal barriers even for skilled immigrants, could worsen workforce shortages," they warned. "A (currently stayed) court ruling ending DACA (Deferred Action for Childhood Arrivals) could affect additional personnel, including some physicians and nurses."

Study authors estimated that in formal healthcare settings in the country, there were 607,713 documented and 328,470 undocumented workers. Documented noncitizens accounted for 6.1% of physicians, whereas they made up 4.3% of registered nurses.

Informal healthcare settings were said to have 89,871 documented noncitizens and 38,093 undocumented noncitizens employed.

Azaroff's group acknowledged the limitations of basing their study on a survey administered by the Census Bureauopens in a new tab or window, through both personal and telephone interviews, using a probability selected sample of about 60,000 occupied households.

"The CPS is known to undercount undocumented immigrants and nonformal workers, and the CPS-supplied weights may not fully adjust for sampling of persons with different immigration statuses. The algorithm used to impute documentation status yields estimates of the overall undocumented population that are consistent with official estimates, but may be imprecise for subpopulations," the authors cautioned.

Disclosures

Azaroff's group had no disclosures.

Primary Source

JAMA

Source Reference: opens in a new tab or windowAzaroff LS, et al "Deporting immigrants may further shrink the health care workforce" JAMA 2025; DOI: 10.1001/jama.2025.3544.

https://www.medpagetoday.com/publichealthpolicy/workforce/114947