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wesentliche Säulen des US-amerikanischen Gesundheitssystems

von NFI Redaktion

A study by the Baker Institute for Public Policy, led by Prof. Shishir Shakya of the Appalachian State University and a Visiting Research Fellow at the West Virginia University, delved into the trends of immigrant healthcare professionals in the United States (USA) to emphasize their contribution to the US healthcare system. While examining legal mechanisms available to medical experts, such as the J-1 Visa Exchange Visitor Program and the Conrad 30 Waiver Program, his focus was on addressing the shortage of healthcare personnel.

Study: Understanding the Role of Immigrants in the US Healthcare Sector: Employment Trends from 2007 to 2021. Image credit: PeopleImages.com – Yuri A / Shutterstock

Healthcare professionals in the USA face challenges such as an aging population, labor shortages, and underrepresentation of minorities, which limit their ability to address future healthcare issues and provide essential treatments. Policymakers must reconcile the need for better access to healthcare, improved quality, and reduced costs without compromising compassionate care. Immigrants could serve as a feasible solution to these challenges.

About the Study

The study provided long-term trends in subsectors of the healthcare industry using annual estimates from microdata on population usage sourced from the American Community Survey (ACS) of the United States Census Bureau.

The researcher examined patterns in population growth and immigrant shares in the United States. Individuals born in Guam, Puerto Rico, the Northern Mariana Islands, and the Virgin Islands were classified as native and non-US citizens, including legally admitted refugees, immigrants, undocumented immigrants, and foreign-born individuals with temporary residence status.

The definitions of the native and foreign population align with those of the ACS and the Bureau of Labor Statistics (BLS). The researcher calculated the total number of employed civilian US citizens aged ≥ 16 and the immigrant share. This population group includes civilians employed, unemployed, and on temporary leave at the time of the survey data collection.

From the number of civilian individuals aged 16 and above working in the United States, the researcher excluded unemployed persons, members of the US Armed Forces (including those on temporary leave), and individuals not in the labor force. The North American Industry Classification System and the Bureau of Labor Statistics classify healthcare workers into ambulatory healthcare services, hospitals, residential and nursing care facilities, and social assistance.

Nursing and residential care facilities provide medical and nursing care for patients requiring more than just home care. The subsector of social assistance comprises establishments providing social assistance directly to needy individuals and families. Healthcare technical and practitioner occupations, such as registered nurses, physicians, surgeons, and licensed practical and vocational nurses, perform a wide range of healthcare tasks and duties. Examples of healthcare occupations include nursing, psychiatry, home health care, and medical assistance.


In 2021, the population of the United States was 331 million, with approximately 45 million immigrants. The immigrant share of the total population reached an all-time high, with 15% being the highest percentage reported among Americans in 1890. From the beginning to the end of the 19th century, the United States experienced a substantial increase in its proportion of foreign-born individuals, predominantly those from Northern Europe. However, at the beginning of the 20th century, there was a significant influx of immigrants, mainly from Poland, Italy, and other Eastern and Southern European regions.

Between 2007 and 2018, the immigrant share in the labor force aged ≥16 years increased from 16% to 17%. Between 2007 and 2021, the share of immigrants in the US population increased from 13% to 14%. Five of the 20 industry categories expected to experience rapid growth between 2019 and 2029 are in the healthcare and social assistance sector, which includes businesses offering medical treatment in clinics, hospitals, physician offices, residential and nursing care facilities, and social assistance.

The number of employed individuals increased from 15 million to 19 million between 2007 and 2021, while the share of immigrants working in healthcare increased from 14% to 17%. The number of employees in nursing care facilities increased from 1.7 million (2007) with an immigrant share of 15.5% to 1.9 million (2013) with an immigrant share of 16%. However, this trend reverses, with the subsector having 1.50 million jobs by 2021, with an immigrant share of 18%.

The number of trained nurses in the United States increased from 2.7 million in 2010 to 3.4 million in 2021, while the proportion of immigrant-trained nurses increased marginally between 2007 and 2021. By 2034, there could be a shortage of 37,800 to 124,000 physicians in the USA, with general and specialty care gaps. The demand for home health aides has dramatically increased due to the aging baby boomer generation and the expansion of Medicare coverage for home health care in 2017. The typical annual wage for home health and personal care aides was $29,430 in 2021, representing a 25% increase from 2021 to 2031.


The findings show that immigrants are essential to the US healthcare industry as the share of foreign-born individuals in the civilian workforce increases. While certain industries are experiencing declines, immigrants fill several healthcare and social assistance occupations. Programs such as the Conrad 30 Waiver Program and laws like Tennessee HB 1312 aim to minimize labor shortages and improve access to healthcare in rural and underserved areas. However, visa processing times are too long and costly to meet the needs of international physicians. Eliminating these barriers and integrating immigrant healthcare professionals should be part of a comprehensive strategy to address the challenges of the US healthcare system.

Article Revisions

  • 8th January 2024 – The position of the main article image was raised on the page, and an active hyperlink to the research report was added.

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