BIRMINGHAM, Alabama (June 4, 2019)—Curtailing immigration to the United States threatens the availability and quality of care for elderly and disabled Americans, according to a new study published in the current issue of the journal Health Affairs.

Almost one-third of caregivers in U.S. home health agencies, or 31.1%, are immigrants, according to the data, which is based on 2017 government research. The study also found that roughly a quarter of employees working directly with clients in nursing homes and the informal sector are foreign-born, and those playing indirect roles such as janitorial and maintenance workers at nursing homes also make up a large percent of the long-term care workforce.

“In light of current shortages, high turnover rates, low retention rates, growing demand for direct care workers, and immigrants’ already disproportionate role in filling such jobs, policies that curtail immigration are likely to compromise the availability of care,” the study concludes. “Moreover, the anti-immigrant rhetoric and policies that restrict immigration threaten the health and well-being of immigrants, who are entrusted with the care of the nation’s elderly and disabled people.”

Altogether, the study found that almost a quarter, or 23.4%, of U.S. long-term care workers working in homecare, nursing homes, and less formal care environments—a total of more than 1 million people—are immigrants. The data did not include immigration status. The researchers, who are from the Harvard Medical School, Hunter College, and the Institute for Community Health, used a previously published method to estimate status and determined that 13.9% of direct care workers are naturalized citizens and 9% are legal noncitizen immigrants.

The study also found that 18.3% of all health care workers, or about 3.3 million people, are immigrants, slightly higher than the overall U.S. population, which is 15.5% non-native-born. Nearly one in three of them were employed in long-term care settings.

While there have been other looks at immigrant workers providing care at home or in senior housing, prior analyses have not included workers hired directly by patients and their families—“a workforce that is believed to be growing”—the study claims. The report was based on data from the federal government’s Annual Social and Economic Supplement of the 2018 Current Population Survey, which collected information from 180,084 people in March of 2017.