This study is perhaps the most significant headline for our chronically low-staffed healthcare.

Note that the researchers cast a very wide net for this study. Dubiously wide, given the nature of the administration's deportation policies. 

"...16.7 million were U.S.-born citizens, 2.3 million naturalized citizens, nearly 700,000 documented noncitizens, and over 366,500 undocumented immigrants..."

Undocumented aliens are the group most likely to be deported, and represent a relatively small number in the scope of US healthcare.

https://www.medpagetoday.com/publichealthpolicy/workforce/114947

Over 350K Health Workers Face Deportation Risk

— Survey study quantifies the role of immigrants, both documented and undocumented, in healthcare

by Nicole Lou     |   April 3, 2025

Key Takeaways

• In the U.S., over 350,000 undocumented immigrants and nearly 700,000 documented immigrants work in healthcare, researchers estimated.
• Noncitizen immigrants, both documented and undocumented, made up some 4% of personnel in hospitals and outpatient settings.
• Worker shortages due to deportations could reverberate through emergency departments and hospitals, the study authors suggested.

More than 350,000 noncitizen healthcare workers in the U.S. may be at risk of deportation as part of the Trump administration's immigration crackdown, researchers estimated.

Based on the Current Population Survey (CPS) from March 2024, there were over 20 million individuals making up the workforce across formal and informal healthcare settings nationwide, of whom an estimated 16.7 million were U.S.-born citizens, 2.3 million naturalized citizens, nearly 700,000 documented noncitizens, and over 366,500 undocumented immigrants.

"More than 1 million noncitizen immigrants (one-third of them undocumented) work in healthcare in the U.S. Their ranks include skilled personnel who would be difficult to replace, especially if legal immigration is further restricted," according to a group led by Lenore Azaroff, MD, ScD, of Edward M. Kennedy Community Health Center in Worcester, Massachusetts, writing in JAMA.

Azaroff and colleagues reported that noncitizen immigrants, both documented and undocumented, made up some 4% of personnel in hospitals and outpatient settings, 7% of nursing home workers, and at least 10% of personnel in home care agencies and nonformal settings in their study. In particular, the bulk of the undocumented healthcare workforce were working as nursing aides and assistants at the time of the survey.

If these healthcare workers without U.S. citizenship are deported, the consequences would be felt by America as a whole, they suggested. "Deportations could especially compromise long-term care, where immigrants play a large role. The resulting shortages could reverberate through emergency departments and hospitals, leading to the inability to discharge patients and tying up nurses and other staff."

Outside the study, a report showed that in the first 6 full weeks of the second Trump administration, there were 27,772 immigrants removed from the country, according to data published by Immigration and Customs Enforcement and analyzed by the nonpartisan Transactional Records Access Clearinghouse.

Despite this pace of deportations being lower than it had been under President Biden, healthcare workers now find themselves newly exposed to an immigration crackdown.

Before President Trump returned to office this year, federal law enforcement agents had been told to honor a longstanding humanitarian parole program that exempts sensitive locations such as schools, hospitals, and health centers from immigration raids. This was ended as one of the new Trump administration's earliest actions.

"The Trump administration's plans to deport undocumented immigrants and some with temporary protected status -- which allows some migrants from countries with unsafe conditions to live and work in the U.S. -- and increase legal barriers even for skilled immigrants, could worsen workforce shortages," they warned. "A (currently stayed) court ruling ending DACA (Deferred Action for Childhood Arrivals) could affect additional personnel, including some physicians and nurses."

Study authors estimated that in formal healthcare settings in the country, there were 607,713 documented and 328,470 undocumented workers. Documented noncitizens accounted for 6.1% of physicians, whereas they made up 4.3% of registered nurses.

Informal healthcare settings were said to have 89,871 documented noncitizens and 38,093 undocumented noncitizens employed.

Azaroff's group acknowledged the limitations of basing their study on a survey administered by the Census Bureau, through both personal and telephone interviews, using a probability selected sample of about 60,000 occupied households.

"The CPS is known to undercount undocumented immigrants and nonformal workers, and the CPS-supplied weights may not fully adjust for sampling of persons with different immigration statuses. The algorithm used to impute documentation status yields estimates of the overall undocumented population that are consistent with official estimates, but may be imprecise for subpopulations," the authors cautioned.

More wild cards in the April 7 headlines by MedPage.

https://www.medpagetoday.com/pediatrics/vaccines/114988

Calling Robert F. Kennedy Jr.'s early tenure as HHS secretary "very scary," recently ousted top FDA vaccine regulator Peter Marks, MD, PhD, said Kennedy's team specifically asked for data to show that vaccines are not safe. (Wall Street Journal)

Meanwhile, the longtime vaccine critic Kennedy said that vaccination is "the most effective way to prevent the spread of measles" after a second unvaccinated Texas child died of measles. (STAT, AP)

Amid the growing measles outbreaks, HHS announced that Kennedy will embark on a multistate tour to celebrate "Make America Healthy Again" initiatives.

Five scientists who helped develop the blockbuster diabetes and weight-loss drug semaglutide (Ozempic, Wegovy) are among recipients of the 2025 $3 million Breakthrough Prizes. (Nature)

Mexico confirmed its first human case of bird flu in a 3-year old girl. (AP via ABC News)

Lawyers for a Texas family deported to Mexico have appealed to the Department of Homeland Security for a temporary parole to return to Texas while their 10-year-old daughter -- a legal resident -- receives follow-up care for brain surgery. (USA Today)

Drug prices have been excluded from the Trump administration tariffs, but prices still could go up. (The Hill)

The non-profit Undue Medical Debt struck a deal with a Virginia-based medical debt trader to pay off $30 billion in unpaid medical debt. (KFF Health News)

Workers say unsanitary practices persist at the nation's largest baby formula facility, whose shutdown in early 2022 led to nationwide shortages. (ProPublica)

Maryland joined a multistate lawsuit against the Trump administration's "illegal" NIH funding cuts, claiming the cuts will delay medical and public health research.

The Association of Public Health Laboratories has appealed to HHS to reinstate two CDC laboratories that did testing for rare forms of hepatitis and drug-resistant sexually transmitted diseases. (Reuters)

Despite Kennedy's statement that rehiring some fired HHS employees "was always the plan," the department has no plan to bring back any of the terminated workers, and even more layoffs at NIH are expected. (Politico, CBS News)

Legal experts say the Trump administration is on shaky legal ground with the mass layoffs at HHS. (New York Times)

Kennedy claims the mass firings were necessary because Americans are getting sicker. Is that true? (ABC News)

NIH is launching a research initiative into the causes of autism, a Trump administration priority. (Washington Post)

Five nurses who work on the same floor at Mass General Brigham Newton-Wellesley Hospital in suburban Boston have developed brain tumors, which hospital officials say has not been linked to an environmental risk. (NBC News)

Johnsonville has recalled 22,000 pounds of cheddar bratwurst because of potential contamination with hard plastic. (WTMJ)

Former child actor Jay North, 73, best known for his portrayal of the titular role in the "Dennis the Menace" sitcom, has died of colon cancer. (NPR)