Immigrant Healthcare Workers Are Critical in the Fight Against Covid-19

As the coronavirus outbreak affects more states, demand for doctors, nurses, and other critical healthcare workers is soaring across the country. As 16.4 percent of all workers in the U.S. healthcare industry, 2.8 million immigrant healthcare professionals are playing a vital role on the front lines against the disease. In some states, immigrants make up an even more significant share of the healthcare workforce. In New York State, the epicenter of the U.S. coronavirus outbreak, more than 400,000 immigrants made up at least one in three healthcare workers in 2018.

Figure 1: Immigrant Healthcare Workers in the United States

State Number of Foreign-born Healthcare Workers Share of All Healthcare Workers, Foreign-born
United States 2,804,897 16.4%
New York 402,731 34.3%
New Jersey 154,508 30.6%
California 556,016 31.6%
Michigan 45,102 8.1%
Louisiana 7,389 3.0%
Massachusetts 108,984 22.6%
Florida 307,153 28.4%
Illinois 114,405 16.9%
Washington 62,684 16.9%
Pennsylvania 75,038 9.3%
Texas 249,280 18.6%
Virginia 57,234 14.5%
Georgia 50,121 10.7%
Arizona 47,087 14.3%
Maryland 85,522 24.9%
North Carolina 38,019 7.3%
Ohio 41,777 5.8%
Source: NAE Analysis of 1-year sample from the 2018 American Community Survey

Even before the Covid-19 crisis began, America faced a severe shortage of healthcare workers. In 2018, there were 27 open healthcare practitioner jobs—such as doctors, surgeons, registered nurses—for every available unemployed healthcare practitioner. Overall in the healthcare sector, there were 12.3 open job openings for every available unemployed worker.

In states hit the hardest by Covid-19, where the number of severe cases requiring intensive medical care has surged, acute shortages of healthcare professionals could significantly limit capacities to diagnose, treat, and assist patients quickly. There were 20.9 open jobs for every unemployed healthcare practitioner in New York, 26.8 in California, and 36.7 in Washington in 2018.

Figure 2: Shortage of Healthcare Workers in the United States

State Ratio of open healthcare practitioner jobs to unemployed healthcare practitioners, 2018 Ratio of open healthcare jobs to unemployed healthcare workers, 2018
United States 27.0 12.3
New York 20.9 7.1
New Jersey 22.3 11.0
California 26.8 12.7
Michigan 23.5 10.2
Massachusetts 31.6 14.6
Florida 19.0 10.4
Illinois 20.7 8.1
Louisiana 23.1 7.6
Washington 36.7 21.0
Pennsylvania 19.8 9.7
Texas 20.8 9.0
Virginia 33.0 13.8
Georgia 37.4 15.8
Arizona 35.2 16.9
Maryland 23.4 13.4
North Carolina 21.6 11.0
Ohio 32.5 11.0
Source: Burning Glass Labor Insights and NAE Analysis of 5-year sample from the 2018 American Community Survey

Data shows that to some extent, immigrants are helping to fill these critical personnel gaps. In 2018, more than 244,000 immigrants served as physicians and surgeons in the country, making up 28.2 percent of the workforce in these occupations. Meanwhile, immigrants made up one-fourth of all health aides, including home health aides, personal care aides, and nursing assistants, and 15.3 percent of all nurses. In other healthcare occupations that are particularly important in the Covid-19 crisis, immigrants also made up significant shares of the workforce, including about one in five lab technicians, more than one in eight respiratory therapists, and one in 20 emergency medical technicians.

Figure 3: Select Occupations in the Healthcare Industry in the United States

Occupation Number of Immigrant Workers Immigrants’ Share of Workforce
Physicians and Surgeons 244,249 28.2%
Health Aides 578,270 25.3%
Lab Technicians 58,013 19.6%
Nurses 597,426 15.3%
Respiratory Therapists 14,593 13.6%
Emergency Medical Technicians 8,543 5.1%
Source: NAE Analysis of 1-year sample from the 2018 American Community Survey

Again, in the states that are struggling with some of the sharpest increases in new infections, immigrant healthcare workers prove to be even more vital. In New Jersey, which has the second-largest number of confirmed cases in the country, immigrants made up two in five physicians and surgeons, three in ten nurses, and one in two health aides in 2018.

Figure 4: Immigrants’ Share of Healthcare Workforce in Select State

State Physicians and Surgeons Nurses Health Aides
New York 36.4% 30.9% 60.7%
New Jersey 40.3% 29.5% 53.7%
California 33.1% 35.2% 44.3%
Michigan 27.1% 7.0% 4.8%
Massachusetts 34.5% 17.1% 39.8%
Florida 36.5% 25.8% 45.6%
Illinois 30.6% 17.5% 20.9%
Washington 24.1% 15.9% 29.0%
Pennsylvania 23.7% 7.9% 11.7%
Texas 31.7% 20.6% 24.5%
Virginia 32.4% 12.7% 17.3%
Georgia 27.8% 11.1% 17.5%
Arizona 28.8% 13.0% 21.4%
Maryland 31.0% 26.6% 40.9%
North Carolina 16.7% 6.8% 4.4%
Ohio 27.1% 3.7% 7.8%
Source: NAE Analysis of 1-year sample from the 2018 American Community Survey

Many immigrant healthcare workers also speak multiple languages, making them a valuable asset to reach vulnerable communities who may have limited English language proficiency. In a medical emergency like Covid-19, it is critical that healthcare professionals can communicate clearly with each and every patient, regardless of language.

The vast majority of immigrant healthcare workers, about 69 percent in the country, spoke both English and at least another language in 2018. Bilingual skills are even more common among immigrant physicians and surgeons, nurses, and lab technicians, with more than 70 percent of them speaking more than one language.

Figure 5: Bilingual Immigrants Healthcare Workers in the United States

Share of Immigrant Workforce, Bilingual
All Healthcare Workers 68.9%
Physicians and Surgeons 74.9%
Nurses 72.3%
Health Aides 56.2%
Lab Technicians 78.9%
Respiratory Therapists 68.5%
Source: NAE Analysis of 1-year sample from the 2018 American Community Survey

The shares of immigrant healthcare workers with bilingual skills are higher than the national average in some states like California, Michigan, Illinois, and Washington, where more than 70 percent of all immigrant healthcare workers spoke another language in addition to English in 2018.

Figure 6: Bilingual Immigrant Healthcare Workers in Select States

State Share of Immigrant Healthcare Workers, Bilingual
New York 53.1%
New Jersey 66.5%
California 77.5%
Michigan 74.8%
Massachusetts 69.7%
Florida 67.1%
Illinois 78.0%
Washington 75.0%
Pennsylvania 67.8%
Texas 71.1%
Virginia 74.0%
Georgia 60.1%
Arizona 71.1%
Maryland 71.0%
North Carolina 63.2%
Ohio 68.1%
Source: NAE Analysis of 1-year sample from the 2018 American Community Survey

In this unprecedented war against a global pandemic, immigrant healthcare workers are fighting side by side with their U.S.-born counterparts to save lives and keep our communities safe. Among them, Dr. Tarig Elhakim, a doctor from Sudan, is working on the front line in a Miami hospital. He says the country needs more healthcare professionals like himself to contain the virus.

If you want to explore how immigrants often disproportionately serve in some of the most at-risk jobs in the Covid-19 crisis, including the healthcare occupations featured in this brief, click the image below to explore our data visualization.

Finally, check out our research portal of Immigration and Covid-19. If you have any specific questions about our data, please reach out to us at

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