Foreign-Born Health Care Workers in the United States
Today, immigrants make up a sizeable proportion of the US health care workforce. In 2010, the foreign born accounted for 16 percent of all civilians employed in health care occupations in the United States. In some health care professions, this share was larger. More than one-quarter of physicians and surgeons (27 percent) were foreign born, as were more than one out of every five (22 percent) persons working in health care support jobs as nursing, psychiatric, and home health aides.
Although the characteristics of health care workers varied across occupational categories, as a group foreign-born health care workers were more likely than their native-born counterparts to have obtained a college degree and more likely than employed immigrants overall to speak English fluently or be naturalized US citizens.
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 US Census Bureau's 2010 American Community Survey (ACS) and the US Bureau of Labor Statistics. All data refer to employed civilians age 16 and older unless otherwise noted.
Health care occupations are projected to account for about one in every six newly created jobs in the United States between 2010 and 2020.
Health care occupations are projected to be among the fastest-growing professions from 2010 to 2020, adding 3.5 million jobs. This represents 17 percent of the 20.5 million total jobs predicted to be added to US employment during this period. In addition, among all occupational groups, health care support occupations are projected to grow at the fastest rate (34.5 percent), and health care practitioners and technical occupations the third fastest (25.9 percent).
Note: The BLS estimates and projections described above provide a measure of jobs rather than individuals. For example, one individual who holds two jobs will be counted twice in the BLS estimates. The ACS estimates included in this article provide a measure of individuals rather than jobs. For more information on the methodology used to derive the BLS estimates and projections, click here. For more information on the methodology used to derive the ACS estimates, click here.
Foreign-born health care workers are admitted to the United States under a variety of temporary and permanent visa categories.
Doctors with foreign degrees often apply for a J-1 visa to complete a medical residency in the United States, which is required of most foreign-educated doctors. Doctors may also apply for a temporary visa, such as an H-1B, to complete residency training or to work in the medical field after completing their US residency program.
As is the case with other immigrants, foreign-born health care workers can be admitted through permanent immigration channels based on family or employment connections and through humanitarian and other routes.
Two temporary work visa categories designated for nurses have been discontinued. The H-1A visa category, created exclusively for temporary employment of foreign-born nurses under the 1989 Immigration Nursing Relief Act, expired in 1995. The other was the H-1C visa program, which ended in 2009. Established through the Nursing Relief for Disadvantaged Areas Act of 1999, only hospitals in designated "health professional shortage areas" serving a minimum share of Medicaid and Medicare patients were eligible to petition for H-1C nurses.
In 2010, 16 percent of US health care workers were foreign born.
The number of foreign-born workers employed in health care occupations has risen slightly in recent years; in 2006, immigrants accounted for 15 percent (1.5 million) of the 10 million total US workers employed in health care occupations.
The foreign born accounted for more than one in four US doctors (physicians and surgeons) in 2010.
Nearly one-third of foreign-born women employed in health care occupations in 2010 worked as nursing, psychiatric, or home health aides.
Native-born women employed in health care occupations were most likely to work as registered nurses (28 percent), and technologists and technicians (23 percent). Native-born men were most likely to work as technologists and technicians (24 percent), and physicians and surgeons (22 percent). (See Table 2.)
Foreign-born health care workers, regardless of gender, were more likely to be physicians and surgeons than their native-born peers.
Foreign-born health care workers overall were also more likely than their native-born peers to work as nursing, psychiatric, or home health aides: 32 percent of foreign-born women worked in this occupational group (compared to 20 percent of native-born women) and 13 percent of foreign-born men (compared to 11 percent of native-born men).
In 2010, women accounted for three out of every four foreign-born health care workers.
Regardless of nativity, women accounted for the majority in each of the seven health care occupational groups except for one: physicians and surgeons. One-third of native-born physicians and surgeons (33 percent) were women compared to 37 percent of the foreign born. In contrast, women represented a substantial share of both foreign-born (87 percent) and native-born registered nurses (92 percent). Health care support professionals - including those working as nursing, psychiatric, and home health aides and in other support roles - were also particularly likely to be women.
About 40 percent of all foreign-born health care workers residing in the United States in 2010 were born in Asia.
Asian-born health care workers and those from northern America, Europe, and Oceania were more likely than their counterparts from other regions to be employed as physicians and surgeons and, along with those born in Africa, were more likely to be employed as registered nurses (see Figure 1). The Caribbean born were more likely than immigrant health care workers born in other regions to work as nursing, psychiatric, or home health aides: 52 percent of the Caribbean born reported working in this profession. More than one-third of African immigrants (39 percent) and Latin American immigrants (37 percent) also reported working as nursing, psychiatric, or home health aides.
Note: The northern America, Europe, and Oceania group also includes foreign-born persons for whom birthplace information was not available.
About one-third of foreign-born workers employed as registered nurses in 2010 were born in the Philippines.
Persons born in India, the Philippines, and China accounted for 34 percent of employed foreign-born physicians and surgeons. One-third (33 percent) of nursing, psychiatric, and home health aides were born in Mexico, Haiti, and Jamaica.
Foreign-born health care workers were more likely to have a college education than their native-born counterparts in 2010.
Regardless of nativity, virtually all physicians and surgeons had college degrees or higher. More than 90 percent of both native and foreign-born workers in the occupational group "other health care practitioners and technical occupations" - which includes dentists and physicians assistants, among others - possessed a bachelor's degree or higher.
Among all civilian employed workers age 25 and older, 35 percent of the native born and 31 percent of the foreign born had obtained a bachelor's degree or higher educational credential.
The majority of immigrants employed in health care occupations in 2010 had naturalized as US citizens.
A majority of foreign-born workers in each of the seven health care occupational groups reported having acquired US citizenship, with naturalization rates ranging from 55 percent for those working as nursing, psychiatric, or home health aides to 78 percent for "other" health care practitioners and technical occupations. Physicians and surgeons, registered nurses, and technologists and technicians also had naturalization rates of 70 percent or higher.
In 2010, almost three-quarters of foreign-born health care workers reported speaking English fluently.
A majority of immigrants reported speaking English proficiently in the health care occupational groups examined in this Spotlight, with rates of English proficiency ranging from 91 percent for physicians and surgeons to 55 percent for nursing, psychiatric, and home health aides.
In 2010, almost one-quarter of foreign-born workers employed as nursing, psychiatric, or home health aides lacked health insurance.
Health care coverage rates were 88 percent or higher for native-born and foreign-born workers employed in most health care occupational groups, and coverage was close to universal for physicians and surgeons regardless of nativity. Nursing, psychiatric, and home health aides and other health care support professionals were the exception: almost one-quarter of foreign-born (23 percent) and native-born (24 percent) persons employed as nursing, psychiatric, or home health care aides lacked health insurance. Among other health care support professionals, 16 percent of the native born and 24 percent of the foreign born lacked health insurance.
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For information about ACS methodology, sampling error, and nonsampling error, please click here.
For more information about BLS employment projections methodology, please click here.
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