Indian immigrants among top untapped pool of healthcare workers

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A leading Washington-based think tank on immigration says the United States is wasting the healthcare talent in its pool of immigrants who could provide support during this COVID-19 pandemic when the country has a shortfall in terms of medical personnel. Thousands among these underemployed undergraduates hail from India.

“As hospitals in hotspots across the United States are strained by COVID-19 cases, an estimated 263,000 high-skilled immigrants and refugees with health-related undergraduate degrees are either employed in low-skilled jobs requiring no more than a high school diploma or are out of work,” notes the Migration Policy Institute.

India is among the top three countries of origin for this underutilized cohort of 263,000, who have at least a four-year degree in a health field, and who have been sidelined, Jeanne Batalova, senior policy analyst at MPI and one of the authors, told News India Times.

“We estimate about 27,000 immigrants from India who are underutilized and with a Bachelor degree in health care … That amounts to one in ten, of the total 263,000, making India second after Philippines with 1 in 5, followed by China in 3rd place,” Batalova said.

The report is entitled “Brain Waste Among U.S. Immigrants With Health Degrees: A Multi-State Profile.”

The MPI has provided a fact sheet that gives estimates state-wise of underemployed workers, who are found all over the country, not just in traditional immigrant-gateway states. The fact sheet uses data from the U.S. Census Bureau and the U.S. Department of Labor to offer a profile of where these immigrant professionals live, the languages they speak, their English proficiency, college degree majors and legal status.

Most surprising in all the data is that the overwhelming majority of these  underutilized healthcare workers, are in the United States legally, with more than 80 percent of them being naturalized U.S. citizens, legal permanent residents, humanitarian migrants and holders of temporary non-immigrant visas.

“These 263,000 immigrants and refugees, who majored in a health-related field (nearly half of them in nursing) as undergraduates, have been largely sidelined as a result of barriers including difficulty getting their academic credentials recognized and limited professional networks,” MPI says.

Top 5 Countries of Origin of Underutilized Immigrant Adults (ages 25 and 64) with Health-Related Undergraduate Degrees, 2017

Source: Migration Policy Institute (MPI) tabulation of U.S. Census Bureau 2017 American Community Survey (ACS) data.

As this relates to India, Batalova indicated, they are hampered by virtue of being family members coming in through reunification; others are spouses of H-1B workers and may have long gaps in employment history, and they still have to get the credentials for working here, which is an extremely arduous process. And, many have visa conditions that do not allow them to be employed.

These hurdles are keeping many from joining the 12.1 million U.S. born and more than 2.6 million immigrants employed in the health care field before the coronavirus outbreak began, the independent, non-partisan, non-profit think tank contends.

“What MPI is saying is – we have a health emergency and we have to think outside the box in terms of how to boost the strength of health professionals,” Batalova said. “There is this pool and they could be used in other capacities till they get their credentials, like contact tracers since they would have linguistic and cultural capabilities; they could be public health workers spreading awareness about the virus and how to prevent its spread and what to do if a family member contracts it.” They would be a great community resource and the local governments could think of ways to use these talents, she says.

The fact sheet also offers an overview of policies in the eight states (Colorado, Idaho, Massachusetts, Michigan, Nevada, New Jersey, New York and Pennsylvania) where governors have used their executive authority to temporarily suspend or adjust licensing requirements for certain health professions, including for internationally trained health care professionals.

“So in these 8 states, even if a person has to go through a process, at least there is an effort by governments to engage this populace. It is a good start,” Batalova says, but with a qualifier. “Not many were actually able to get approval for a variety of reasons.” In New Jersey for example, the state government received about a thousand applications from internationally trained doctors and others, but only 32 were able to obtain the license under this executive order, Batalova says. They could work in hospitals, clinics or thought telemedicine.

Idaho is very interesting and unique in this regard, according to Batalova. It has a rule where in case of emergencies the state could temporarily waive regulations, and employ those from other states or other countries, if their licences from other states and countries are valid, and they could begin practicing right away.

Obviously, there is no uniformity in policy nationwide. “Our suggestion is that states need to put laws on the books that would make them more nimble in a crisis situation,” Batalova said.

The MPI researchers found that the 263,000 foreign-born health professionals experiencing skill underutilization (which it calls “brain waste”),  are widely distributed across the United States.

Beyond the traditional top immigrant destinations of California, Florida, Texas, New York and New Jersey, sizeable numbers of these health care professionals can be found in states such as Georgia and Washington (8,000 apiece); North Carolina and Michigan (6,000 each); and Tennessee and Connecticut (3,000 apiece).

This cohort of potential healthcare worker, speak languages that “overlap substantially” with those spoken by Limited English Proficient (LEP) populations in the states where they live, making them a “potentially valuable resource” in providing linguistically and culturally competent care in those communities, the report says.

“These highly educated immigrants offer both language and cultural skills that are not replicated in the current health care labor force,” write authors Jeanne Batalova, Michael Fix and Sarah Pierce.

“What’s so important right now is to be able to convey information about a complicated disease,” Batalova  told this writer. By speaking the language of the local population, these underutilized workers could be that path to reaching out to these LEP populations.

Citing New Jersey as an example, a state which has a significant Indian-origin population, Batalova et al’s Fact Sheet shows that 22 percent of underemployed immigrants with undergraduate healthcare degrees are from India. Eight percent of them speaks Gujarati, and another 4 percent speaks Hindi. And if you look at all the LEP population in New Jersey, 3 percent speak Gujarati,” Batalova points out.

With the disease spreading particularly fast among immigrant and minority communities, “broad demand for the kind (of) skills that many underutilized immigrants with health degrees offer should be high not just in tracing networks, but in other emergency and nonemergency settings,” the authors recommend.

The fact sheet is available at: www.migrationpolicy.org/research/brain-waste-immigrants-health-degrees-multi-state-profile.