Immigration, the Long-Term Care Workforce, and Elder Outcomes in the U.S

61 Pages Posted: 20 Feb 2023 Last revised: 3 Feb 2025

See all articles by David C. Grabowski

David C. Grabowski

Harvard University - Department of Health Care Policy

Jonathan Gruber

Massachusetts Institute of Technology (MIT) - Department of Economics

Brian McGarry

University of Rochester

Date Written: February 2023

Abstract

Although debates over immigration remain contentious, one important sector served heavily by immigrants faces a critical labor shortage: nursing homes. We merge a variety of data sets on immigration and nursing homes and use a shift-share instrumental variables analysis to assess the impact of increased immigration on nursing home staffing and care quality. We show that increased immigration significantly raises the staffing levels of nursing homes in the U.S., particularly in full time positions. We then show that this has an associated very positive effect on patient outcomes, particularly for those who are short stayers at nursing homes, and particularly for immigration of Hispanic staff.

Suggested Citation

Grabowski, David C. and Gruber, Jonathan and McGarry, Brian, Immigration, the Long-Term Care Workforce, and Elder Outcomes in the U.S (February 2023). NBER Working Paper No. w30960, Available at SSRN: https://ssrn.com/abstract=4364708

David C. Grabowski (Contact Author)

Harvard University - Department of Health Care Policy ( email )

25 Shattuck Street
Boston, MA 02115
United States

Jonathan Gruber

Massachusetts Institute of Technology (MIT) - Department of Economics ( email )

50 Memorial Drive
E52-391
Cambridge, MA 02142
United States

Brian McGarry

University of Rochester ( email )

300 Crittenden Blvd.
Rochester, NY 14627
United States

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