‘Mass deportations’ of immigrants may further compromise US health care workforce
Key takeaways:
- Of the 55,802 noncitizen physicians included in analysis, more than three-fourths worked in hospitals.
- Access to health care could worsen as a result of immigrant deportations, according to a researcher.
The deportation of immigrant workers and restrictions on immigration could negatively affect health care in the United States, according to study results published in JAMA.
“Mass deportations and scaring away new immigrants will harm American’s medical care,” Steffie Woolhandler, MD, MPH, distinguished professor of public health at City University of New York’s Hunter College and lecturer at Harvard Medical School, told Healio. “Everyone has an interest in assuring that immigrants to the U.S. are treated fairly.
“The health care system is experiencing shortages of personnel, which have forced hospitals to operate below full capacity. Hospitals face a double whammy — they face shortages of staff to care for acute problems, but the limited availability of nursing-home or home care means they also are often unable to discharge frail patients after their acute problems improve,” she continued. “Mass deportations of immigrants — many of whom work in health care — will lengthen delays in admissions and discharges, worsening access to care for all Americans.”
To estimate the number of immigrants in health care who could be affected by deportation or immigration restrictions, Woolhandler and colleagues pooled data from the March 2024 Current Population Survey (CPS), a source for U.S. workforce statistics.
The researchers assessed person-level data on occupation, industry, demographics, citizenship, country of origin and receipt of public benefits among 144,265 CPS respondents, of whom 8,587 were health care workers — representing a weighted 20,050,162 individuals. This included 2,319,224 naturalized citizen immigrants and 1,064,147 noncitizens who worked in health care (697,584 documented; 366,563 undocumented).
Overall, 161,405 noncitizens qualified for temporary protected status.
The researchers found that 936,183 noncitizens worked in formal health care settings and 127,964 noncitizens worked in nonformal settings.
Among the 55,802 noncitizen physicians included in the study, more than three-fourths worked in hospitals and accounted for 8.8% of all physicians. Moreover, 148,445 noncitizens worked as registered nurses and 443,958 as nursing aides or assistants, according to the researchers.
Both documented and undocumented noncitizen immigrants accounted for at least 10% of personnel in home care agencies and nonformal settings, 7% of nursing home workers and nearly 4% of personnel in hospitals and outpatient settings.
The researchers acknowledged study limitations, including the potential that CPS may undercount undocumented immigrants and nonformal workers.
“Health professionals need to raise awareness that most immigrants are not criminals or freeloaders, but people who want to live here safely and to work,” Woolhandler said. “The 3.4 million immigrants, including naturalized citizens, working in American health care include not only highly skilled professionals, like physicians, medical researchers and registered nurses, but also many direct care workers, like nursing assistants and orderlies, who provide day-to-day care for frail patients.”
For more information:
Steffie Woolhandler, MD, MPH, can be reach at swoolhan@hunter.cuny.edu.
Perspective
Back to TopThis study underscores the essential role that immigrants play in the U.S. health care workforce, with findings that have direct implications in oncology, particularly as cancer care delivery continues its increasing shift away from inpatient and hospital-based settings to outpatient care and home-based settings.
In this context, direct patient caregivers, including home health aides, will be indispensable for delivering consistent, compassionate cancer care — particularly for older adults, patients nearing end of life and those managing treatment-related disabilities.
With that said, ongoing threats to immigrants, with and without legal status, risk exacerbating existing workforce shortages in oncology. These policies also destabilize the training pipeline, particularly for international medical graduates and researchers who form a key segment of the oncology trainee population.
Ultimately these findings present an important call to action: Oncology leaders must advocate for immigration policies that support workforce sustainability, patient care continuity and equity across the cancer care continuum.
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Azaroff LS, et al. JAMA. 2025;doi:10.1001/jama.2025.3544.
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