In early December last year, my mother fell and sustained multiple injuries to her pelvis. In due course, she recovered from the injury, but the experience exacted a steep toll. From a fully functioning 86-year-old, she became a dependent 87-year-old. Her physical compass had to re-orient and she had to relearn simple everyday activities she had given no thought to earlier.
During her recovery and rehabilitation, she was at a nursing home in the bay area, where I was rather astonished to discover that over 80 percent of the staff were immigrants. From doctors, nurses and certified nursing assistants to physical therapists, occupational therapists and the cleaning crew, I encountered people from different countries and continents, with the hallways echoing the intonations of a dozen different accents. It seemed to me like a thriving United Nations hub.
According to research from New American Economy (NAE), immigrants make up 16.4 percent of all health care workers nationally, and in metros like San Francisco, New York, Los Angeles and Miami that number more than doubles. In these four metros alone, there are close to a million immigrant health care workers.
In The City, 60 percent of all health aides, 40 percent of nurses, and 30 percent of physicians and surgeons are immigrants. “During an ongoing health crisis, such as COVID-19, the ability to communicate with each patient is crucial — especially in large urban areas with diverse populations. We find that immigrant health care workers are especially well-suited to this challenge. We find that the majority of them are bilingual, speaking both English and at least one more language,” the NAE analysis elaborated.
Many immigrants come from cultures where families take care of their old and sick. As the noted writer and surgeon Atul Gawande describes in his book “Being Mortal,” grandparents in India are typically cared for in multi-generational homes. “There was no need to save up for a spot in a nursing home or arrange for meals-on-wheels. It was understood that parents would just keep living in their home assisted by one or more of the children they raised.” Living in such homes and being exposed to the vulnerabilities of the sick and elderly builds capacity for patience and tolerance. Out of this experience emerges the ability to react appropriately to the fears and anxieties of patients.
That’s why it’s no surprise to discover that 29,000 Dreamers — Deferred Action for Childhood Arrivals program recipients — work as health care aides and nurses nationwide.
In 2017, a KQED news report asked the important question, “Are California Dreamers snatching health care jobs from citizens?” The answer was unequivocally negative. The article quoted Joanne Spetz, a health care workforce expert at UC San Francisco, as saying that “We need more health professionals. It’s been hard for some employers to even fill the openings they have now.”
In the two years since, that remark is still valid. According to NAE analysis, in 2018, there was an average of “12.3 open health care jobs per unemployed health care worker” and for specialized jobs, including physicians, surgeons and registered nurses, that ratio was even higher, “with 27 open health care practitioner jobs for each unemployed health care practitioner.”
In San Francisco, the shortfall is even more acute, with 15 open health care jobs for every unemployed health care worker, and 28 open health care practitioner jobs for every unemployed health care practitioner. That means that for every specialist or physician in San Francisco, there’s a choice of 28 job opportunities, which means that 27 of them will go unfilled.
In light of these health care job vacancies, President Trump’s announcement to halt immigration to the country to shore up the economy and protect American jobs in the wake of the COVID-19 pandemic doesn’t appear to have the support of data.
“Foreign nationals are critical to the U.S. economy, especially the health care industry,” said Richard Burke, CEO of Envoy Global, a global workforce management firm. He added that “immigrants represent 24% of direct-care workers, including the nurses and assistants who have been on the frontlines of the COVID-19 pandemic.”
In January, my mother was discharged from the nursing home. I signed up on Care.com to interview caregivers to assist her at home. It proved to be a tough task, with some candidates not responding, some not finding availability, some declaring that distance was an issue and some referring me to others. I finally settled on a lovely immigrant woman who brings a smile to my mother’s face every morning she appears. They don’t speak the same language.
Jaya Padmanabhan can be reached at email@example.com. Twitter: @jayapadmanabhan. She is a guest columnist and her point of view is not necessarily that of The Examiner.