Critical Care: The Role of Immigrant Workers in U.S. Healthcare
As the public debate over healthcare reform continues to rage, mention is seldom made of the vital role that immigrants play in the healthcare workforce of the United States. If immigrants are mentioned at all, it is usually in the context of heated discussions about whether or not unauthorized immigrants will, or should, be included in any of the healthcare bills now circulating in Congress. Lost in this debate is the simple demographic fact that immigrants are a critical component of the healthcare workforce at both the high-skilled and less-skilled ends of the occupational spectrum. Most notably, immigrants comprise more than one-quarter of all Physicians and Surgeons in the United States, and roughly one-fifth of all Nursing, Psychiatric, and Home Health Aides.
Immigrant healthcare workers are employed in occupations that are not only expected to experience relatively high labor demand over the coming decade, but in which there are already pronounced worker shortages in many parts of the country. Even if more native-born workers are drawn into healthcare professions in the future, the role that immigrants play in providing healthcare services is likely to increase as the U.S. population continues to age and the growing population of senior citizens requires more medical care. In the case of doctors and nurses, recent projections indicate that even if medical-school and nursing-school graduation rates rise among the native-born, this will not be sufficient to prevent shortages, at least in the near term.
Immigrants are a critical component of the workforce at all skill levels in the nation’s largest healthcare occupations:
· Immigrants accounted for more than one-in-four (27.3 percent) of all Physicians and Surgeons in 2006.
· Immigrants accounted for one-in-five (20.1 percent) of all Nursing, Psychiatric, and Home Health Aides in 2006.
· Immigrants accounted accounted in 2006 for more than one-in-six of all Dentists, Pharmacists, and Clinical Laboratory Technicians.
Imaginary Lines: Border Enforcement and the Origins of Undocumented Immigration, 1882-1930 by Patrick Ettinger (Univeristy of Texas Press)
Although popularly conceived as a relatively recent phenomenon, patterns of immigrant smuggling and undocumented entry across American land borders first emerged in the late nineteenth century. Ingenious smugglers and immigrants, long and remote boundary lines, and strong push-and-pull factors created porous borders then, much as they do now.
Historian Patrick Ettinger offers the first comprehensive historical study of evolving border enforcement efforts on American land borders at the turn of the twentieth century. He traces the origins of widespread immigrant smuggling and illicit entry on the northern and southern United States borders at a time when English, Irish, Chinese, Italian, Russian, Lebanese, Japanese, Greek, and, later, Mexican migrants created various "backdoors" into the United States. No other work looks so closely at the sweeping, if often ineffectual, innovations in federal border enforcement practices designed to stem these flows.
From upstate Maine to Puget Sound, from San Diego to the Lower Rio Grande Valley in Texas, federal officials struggled to adapt national immigration policies to challenging local conditions, all the while battling wits with resourceful smugglers and determined immigrants. In effect, the period saw the simultaneous "drawing" and "erasing" of the official border, and its gradual articulation and elaboration in the midst of consistently successful efforts to undermine it.
Patrick Ettinger is Associate Professor at California State University, Sacramento
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Disclaimer: The information contained in this newsletter is analysis and commentary of a general nature. Nothing in this newsletter applies to a specific case nor does it constitute legal advice.
Schedule appointment: For legal advice on your case, please schedule an appointment with Curtis Pierce, Certified Specialist, Immigration & Nationality Law, The State Bar of California Board of Legal Specialization.
“The only title in our democracy superior to that of President (is) the title of citizen”.
Former Supreme Court Justice Louis Brandeis. (In the case Ng Fung Ho v. White, 259 U.S. 276, 284 (1922), Justice Brandeis wrote that deportation can deprive an individual of "life, or of all that makes life worth living.")
In the words of President Kennedy,
the United States is a "nation of immigrants."
IMMIGRATION LAW E-NEWSLETTER Curtis F. Pierce
Attorney At Law
Certified Specialist, Immigration & Nationality Law
The State Bar of California Board of Legal Specialization
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