Most Common US Occupation at Risk From Immigration Crackdown

A recent Senate hearing has brought into sharp focus the ascendance of the healthcare sector as the largest employer in rural America. 

This shift, revealed during a tense exchange between Treasury Secretary Scott Bessent and Senator Ron Wyden, underscores the sector's growing importance and its increasing vulnerability amid evolving immigration policies. Initially assuming agriculture held the top spot, Secretary Bessent was swiftly corrected by Senator Wyden, highlighting the critical role healthcare now plays in sustaining rural economies. 

This revelation comes at a time when healthcare is experiencing rapid growth nationwide, driven by an aging population and an escalating demand for home health and personal care aides. Over the past few years, healthcare job growth has outpaced other sectors, marking a fundamental change in the labor market. Notably, home health aides and personal care assistants have surpassed retail employees as the most common occupation in the United States. This surge reflects the growing preference among elderly citizens to age at home, rather than in assisted living facilities, thereby intensifying the need for in-home care professionals.

The Looming Workforce Shortage

However, this burgeoning sector faces significant challenges, particularly in maintaining an adequate workforce. Historically, home healthcare roles have been heavily reliant on immigrant labor, both documented and undocumented. Data indicates that immigrants constitute over 40% of home health aides and nearly 30% of personal care workers, substantially higher than the broader labor force, where approximately one in five workers is foreign-born.

This dependence on immigrant labor renders the healthcare sector particularly susceptible to shifts in US immigration policy. The tightening of immigration policies under the Trump administration has raised considerable concerns among healthcare industry leaders, who fear that a more restrictive approach could exacerbate existing worker shortages.

The work is physically demanding and often low-paid, leading to significant turnover. Approximately two-thirds of home health workers leave their jobs within the first year of employment. Experts warn that without a steady influx of workers willing to take on these roles, the supply of caregivers may drastically diminish, leaving families and individuals without essential services.

Ripple Effects Across Industries

The potential consequences of this labor shortage extend beyond healthcare. Similar workforce gaps are emerging across industries that rely on immigrant labor, including agriculture, construction, and meatpacking.