Immigrants find a haven in health care

By Tanya DeJesus

Health care is the largest employment sector for immigrants in the Bay State. A 2008 study by the Immigrant Learning Center (ILC) called, "Immigrant Workers in the Massachusetts Health Care Industry" showed health care employs almost half a million workers and immigrant workers comprised almost 15 percent of the state's health care labor force.

The 2008 study was the first ILC-sponsored research about immigrant workers. Marcia Hohn, the ILC's Director of Public Education who contributed in the study, said they expected the study would show immigrants working in health care but they didn't know the extent of their involvement. She also said the study's findings of a strong immigrant work force in health care is due in part because many Americans are not willing to do certain jobs.

"Immigrants are filling critical vacancies, not taking jobs away from other people. They are filling in where there were not enough people. They are bringing skills that some Americans, native-born workers don't have, especially in the medical science area," said Hohn.

Click below to listen to Marcia Hohn talk about the "Immigrant workers in the Massachusetts Health Care industry" study. 

The study showed that more than half of all workers in the medical science field were foreigners. Immigrants comprised 40 percent of pharmacists, 28 percent of all physician assistants, 28 percent of all physicians/surgeons and 10 percent of all nurses.

Nursing is an employment sector that has been having trouble finding employees. Hohn said that although the nursing sector talks constantly about the crisis it's going through, nothing has come out of it."They talk about the coming retirements and the need for culturally competent health care but they haven't moved forward very well on trying to increase those numbers of foreign-born nurses or nurses that come from different cultures and backgrounds," Hohn said.

These job vacancies in the nursing industry have opened the doors to immigrants who are struggling to find jobs elsewhere. Marie, a woman born in Haiti who cites privacy issues for not revealing her last name, studies English at the ILC and works as a nurse assistant. Before coming to the US four years ago, Marie worked as a manager at a factory in France, where she grew up. She said finding a job as a nurse assistant was easier than finding a job as a manager, regardless of her experience. Still, she thinks is difficult for immigrants to find jobs in health care because of the language barrier but that doesn't stop them for applying.

"I asked for job because I knew many Haitians prefer working in hospitals and nursing homes because it's less difficult," Marie said.

The ILC study found that the health care establishments with the highest immigrant employment base (at least 20 employers or more) are hospitals, followed by nursing facilities and personal care establishments. The aging Baby Boomer generation was listed in the study as one of the primary reasons job vacancies in the health care sector will continue to grow. The study showed that Massachusetts ranked 12th out of 50 states in the percent of population 65 years and older. Therefore, a lot of people in the working population are starting to retire. This is also the reason why the demand for registered nurses and home health aides will increase dramatically, as the elderly start lacking the ability to take care of themselves.

"Improving human health, that often opens up a whole number of other jobs," Hohn said. "Clearly, the need for people who are in home health care and are taking care of people because of age or illness, that's a huge and important service that many immigrants play in."

Click below to hear  Hohn talk about what contributions immigrants are making in health care.

Working in elderly facilities or nursing homes has opened the doors for immigrants to step up the health care ladder and aspire for better positions. When Margaret Namaganda came to the US from Uganda,  she had a diploma in accounting from Kyambogo University. After she applied for accounting positions and was unsuccessful, she decided to go back to college and get her bachelor's degree in management with the hope of finding a good job after earning that degree. She immediately started working in a nursing home to make money to pay for her tuition because it was one of the few jobs available for her. Namaganda was able to pay her way through college but still couldn't find a job in her related field.

"After not finding a job I decided to go to Middlesex Community College for prerequisites for the nursing program because health care was the only field that would take me and they needed my labor," said Namaganda.  Namaganda now works at the Seven Hills Foundation as a direct support care staff. She said getting that job was very easy.

"I took a one-month training course and received two certificates as a home-health aide and as a nursing assistant. I did a Red Cross state examination that has three parts - written, oral, and practical - and then I got a license that I just have to renew when it expires," Namaganda said.

Namaganda is not surprised that health care is such a large employment sector in Massachusetts. She said she believes other employment sectors have become very selective and discriminating.

"Because immigrants have accents that business professions find hard to understand,  nobody wants to employee them," Namaganda said. "Also, with our education certificates from home, the American standard believes our education systems to be so low that it doesn't equate to their requirements," she said.

However, the ILC study shows that  the health care sector seeks out those cultural differences The study noted that  public health officials at the highest levels have called on the health care industry to improve cultural competence. They have suggested a number of strategies that would help improve it such as the ibetter language skills by staff members, training in cultural competence and hiring of more immigrants. Dr. Karen Wallace, who works at Massachusetts General Hospital, said having different ethnic and cultural groups in her workplace have given patients from other ethnicities a sense of ease.

"Not all our patients speak English and the hospital, it's not an environment where anybody feels completely comfortable," Wallace said. "So having nurses and doctors who can help a patient understand an illness that they might be suffering from and make them feel secure is vital in health care," she said.

Hohn is hoping that the ILC study will increase recognition of the important role immigrants play in health care and that more attention is paid to the workforce development programs that take people from the lower levels of health care employments and bring them to higher positions.