Chapter 1: The Impact of Immigrant Workforce in the Senior Care Economy

Dominique Elmadi

CAPS 621

Oonah JaJa Wachuku

Research Paper | Part 1 03/07/2023

Table of Contents Chapter 1 : Introduction 1 Overview 3 Background of Study 3 Problem Statement 6 Statement of Purpose 6 Research Question(s) 7 Significance 9 Assumptions 11 Limitations 11 Definition of Terms 12 Organization of the Remaining Chapters 1 14 References 16

Over the years, there has been a significant increase in the number of the aged population leading to an expansion of the senior care economy. Contextually, since 2019 the aged population has grown by 36% compared to the young population (65 years and below), which has only grown by 3%. As ACL (2020) puts it, the increased life expectancy has been as a result to the improved living conditions. A person born in 2019 has a higher life expectancy than one born in 1990. This shows that with time, life expectancy is increasing and more people will reach the age of 65 years and above (Kilduff, 2021). As it were, there was a low life expectancy in the 1990s due to the lower number of children born during the Great Depression, which was characterized by tough economic conditions. However, after the Great Depression, the quality of life increased, increasing life expectancy and leading to a more aged population. The baby boomers were the first generation to have an increased life expectancy, and in the near future, all boomers will be over 65 years hence contributing to an increase in US aged population. As ACL(2020) posit, "In the US, the number of people aged 85 and up will more than double to 14.4 million by the year 2040". This means that out of every 5 Americans, one will be of retirement age. The increased access to healthcare advantages like the Medicare and Medicaid programs have contributed to increased life expectancy for baby boomers and to the trend of aging in the country (Costs. Medicare, n.d; Robin Rudowitz et al., 2021, ). The racial and ethnic groups in the US also contribute to the rise of older populations in the US. The predicted rise in the aged population means that there will be more demand for senior care in the upcoming years, and it is essential to navigate the economic options available for them while at the same time analyzing the impact of these options on the economy.

The increased demand for senior care has made facility-care workers a fast-growing occupation in the US. Immigrant workers are increasingly filling the positions of facility-care health workers in the US to help care for the increasing aged population. Since the 1990s, the number of immigrants in the United States has grown dramatically. Immigrants make up a significant share of the US workforce, and their impact is especially evident in the senior care economy. Immigrants work in healthcare occupations, including health assistants, registered nurses, and primary care providers, primarily needed in rural areas. According to research by Butcher et al. 2021, immigrant workers are more likely than native-Americans to work in the senior care economy. The educational backgrounds of immigrants are essential as most are highly skilled healthcare workers aged 25 and above. 35% of registered nurses and 36% of state physicians were born in foreign countries (Butcher et. al., 2021). However, most foreign healthcare professionals receive training abroad, and those not trained enroll in programs that guide them through the steps required to join the state's healthcare workforce. The programs support the roles in health that take four years to attain a college degree. Hence, these programs encourage low-skilled workers to join the health workforce as they can enroll in health programs and get the skills required to start working. Also, most immigrants work in the senior care economy because they help provide effective care to immigrant patients in the US. California, Texas, and Florida are the biggest states in the US, with a high population of immigrants. Immigrants in the US fall under the low-income earning group, and thus using immigrants to provide senior care helps make them a resource for the low-income earning group. Immigrant care workers are bilinguals and thus can help address the language barrier when caring for aged immigrant patients. In California, 77.5% of immigrant healthcare workers are bilingual (Zallman et al., 2019). This can help break the communication barrier and make the patient feel more comfortable with their caregiver, as they can communicate easily regarding their wants and needs. For example, in California, a community of immigrants based in Oakland provides personal support to the aging population.

In the recent past, there has been a significant rise in the aged population and it is estimated to rise gradually with time. The number of people aged 65 years and above is becoming more in the US, and by 2030, all the baby boomers generation will be 65 years and above, resulting in more population increase. As the aged population in the US continues to grow, the demand for facility senior caregivers is also growing (Hoyt, 2022). Immigrants supply a great share of senior care labor in California, Texas, and Florida (New American Economy Research Fund, 2020). However, little work concerns the impact of the senior care economy comprising the immigrant workforce in the US economy. Thus, the specific problem in this study is to investigate the impact of the immigrant workforce in the senior care economy on the US GDP and the supply of jobs and demand for senior care.

This quantitative research study aims at investigating the impact of the immigrant workforce in the senior care economy on the US economy. The study will determine if there has been an increase or decrease in GDP over the recent years based on legal immigrant work in the senior care economy. It will also establish the impacts by determining whether the supply of jobs and demand for senior care has increased or decreased with the increase in the senior care economy. The study will be conducted using a case study approach with the US economy as the dependent variable and the legal immigrants in the aging care workforce as the independent variable. The case study will involve collecting various pieces of evidence about the US senior care economy and the immigrant workforce in the senior care sector. The case study will also involve a comprehensive analysis of research works from different researchers on the US senior care economy and senior care immigrant workforce.

This research study focuses on creating an understanding of the impact of legal immigrants in the senior care sector on the US economy in terms of GDP and labor demand and supply from the states of California, Texas, and Florida. The study will focus on answering two research questions to help determine the impacts. The first one is, "has GDP increased or decreased over the recent years based on the legal immigrant workforce in the senior care economy?" and the second question is, "has the amount of jobs supply and senior care demand increased or decreased over the recent years?" With these two research questions, it will be possible to come up with a concise conclusion about the impact of the senior care immigrant workforce on the US economy. The paper seeks to tell whether US GDP has declined or increased with the rise in the immigrant workforce in the senior care economy. There are two possible outcomes from this research study. One is that the senior care economy's immigrant workforce has no impact on the US economy. The other alternative is a decline or rises in GDP due to legal immigrant work in senior care. Undeniably, the growing senior economy has several impacts on the overall US economy. It must be assumed that the rise of the immigrant workforce will not impact the senior care economy and the overall US economy. There will be either a decline or rise in GDP and jobs supply and demand for senior care will either decrease or increase. To come up with concise answers to the research questions, the study focuses on California, Florida, and Texas since they have the highest contribution to the US economy and have the highest populations with both immigrants and old aged population.

As seen beforehand, the aging population in America is increasing at a high rate necessitating facility-based senior care. This has translated into an increased demand for senior care workers. And as Zhang and others (2020) explains, the demand for senior care is high than the supply of workers. As a result, immigrant workers are increasingly being hired as senior caregivers in various US states. According to research by Zhang et al. (2020), the immigrant population accounts for about 18.2 percent of senior caregivers in the US. In a state like California, the highest percentage of the aged population relies on immigrant labor for facility-based care services. Also, immigrants who are primarily women, represent 70% of paid caregivers in California (60%), 60% in Texas, and 50% in Florida (Eckstein & Peri, 2018). Yet, even with the increased immigrant workers in senior care, there is still a shortage of healthcare workers. Numerous pieces of research in the issue of immigrant workers and the US aging population prompts the need to develop an evidence-based answer on the impact of the legal immigrant workforce in the senior care sector on the US economy. Has the GDP increased or decreased due to an increase in the legal immigrant workforce providing senior care? Has the demand for senior care and job supply increased or decreased? This research study will help establish clear answers to these questions and eliminate future incorrect predictions concerning the research questions. It will help the general population understand the relationship between the legal immigrant workforce in the senior care sector and the US economy. The research questions will be a guiding tool to facilitate a smooth pathway to the result.

The wider significance of this research study lies in its ability to serve as a potential creative bridge in quantitative research. The research study will help come up with a concise conclusion regarding the impact of the legal immigrant workforce in the senior care economy on the US economy. The findings will help create advancing knowledge in economics and healthcare. One of the ways through which the research findings will benefit the healthcare sector is that it will help understand the trends in the senior care economy. Senior care falls under the healthcare sector. Thus, when relevant authorities are updated with the existing trends in the senior care economy, they can make informed decisions that are in accordance with the existing trends.

The study is conducted using a case study approach which means that different data sources will be analyzed to deduce the current and future trends in the senior care economy. The aging population in California, Texas, and America is increasing at an alarming rate, which raises the need for senior care. The increased rate of the aged population in America has increased the demand for senior care. Increased demand for senior care impacted the healthcare sector and necessitated employing more healthcare providers to provide senior care to the aging population. The healthcare sector must employ more healthcare givers to cope with the increasing demand for senior caregivers. Thus, with this study, relevant stakeholders in the healthcare sector, including policymakers, will thus have a clear picture of how the decrease or increase affects the overall healthcare sector.

Understandably, the study findings will play a significant role in economics. The economic field is concerned with human beings and helps explain a country's economic status. The research findings in this paper will equip people with vast knowledge of the economic status of the US. The study seeks to determine whether the legal immigrant workforce will increase or decrease GDP. The GDP Of a country is a key economic indicator since the size of a country's economy is determined by GDP. The gross domestic product of a country is affected by many factors including what is happening in the healthcare sector. Almost all economic sectors help determine a country's economic status. Thus, with the finding of this research, economic experts will have relevant knowledge on how the legal immigrant workforce in the senior economy is affecting US GDP. The study will investigate how the legal immigrant workforce in the senior care economy is affecting the US economy. From this research question, it will be possible for economic experts to get clear pictures of the economic status from the healthcare sector's viewpoint.

Additionally, the research findings focus on addressing the existing gaps in the literature concerning the US economy and the legal immigrant workforce in the senior care economy. Several researchers have explained the stipulated rise in the aging population in the US and the rise of the immigrant workforce in the senior care economy. However, they have failed to address the impacts of these factors on the US economy. They have not touched on whether GDP will increase or decrease due to legal immigrant senior caregivers. Also, there have been controversies concerning the supply of jobs and demand for senior care. Some argue that the demand for senior care will rise while the supply of jobs will decrease. In contrast, others argue that the increased use of immigrant labor in senior care will create a balance between the demand for senior care and the supply of jobs. The findings of this study will thus help address this dilemma which acts as a gap in the literature concerning the senior legal immigrant workforce and the US economy.

A key assumption in this case study is that time will be enough to review different data sources to help establish the impact of the legal immigrant senior care workforce on the US economy. The research study assumes that the research study will take place within the allocated time and thus help come up with more accurate findings to the research questions. This assumption is necessary because time is important when conducting research using a case study approach. Another assumption in this study is that the Texas, Florida, and California states have the greatest contribution to the US economy, and this trend will remain the same during the period of this study. Usually, the economy is very volatile, and different factors in the economy keep changing depending on what is happening in the country. The three states that act as this study's background may not be among the highest contributors to the US economy. However, the study assumes they will remain the greatest contributors to help us develop contributors. The economic growth, inflation, unemployment percentage, and other factors that affect a country's economy will remain constant in all US states, making California, Texas, and Florida the biggest contributors to the US economy.

Additionally, the study assumes that the projected increase in the immigrant population in the US will remain the same. The trends that indicate a future rise in the aged population in the US will remain constant, and no factors will affect this trend. This assumption is necessary for this context since the study is concerned with the rising aged population and increased demand for legal immigrant senior care.

Another potential limitation is time constraints. Generally, case studies are time-consuming since they involve vigorous analysis of several data sources to help establish concise conclusions about the research topic. Thus, there is a possibility that more time will be needed to conduct intensive research on the issue being studied. Thus, time constraints will force the research to be conducted straightforwardly to avoid extra expenses that come along with an extended time in research. Another possibility resulting from time constraints is that the study may take longer than expected, failing to meet the deadline for each part of the study and the overall completion date.

Also, the complexity of the research topic may pose an eminent limitation to the study. The research topic is wide since it touches on different things, including the legal immigrant workforce, the senior care economy, the aged population in the US, and the US economy in terms of GDP. The complexity of this topic might make it difficult for a researcher to understand what they are expected to do and thus result in incorrect inferences and findings. The complexity may make a researcher fail to understand what is required of them, resulting o substandard research that does not substantially respond to the research questions.

Gross Domestic Product (GDP)

GDP refers to the monetary value of services and goods produced in a country within a specific period, usually one year. GDP provides an overview of a country's economy, helping determine its economic health. In most cases, GDP is calculated annually, though, at times, it is calculated quarterly.

Immigrants

Immigrants refer to individuals who move from their countries and go to another country to live there. In other words, immigrants live in a country where they were not born. Most of the immigrants in the US are from India, Mexico, Vietnam, and China. Immigrants always provide cheap labor since they need money to help them survive. People may move from their countries to a new country either legally or illegally.

Legal Immigrants

Legal immigrants are documented foreign-born individuals in the US. S A legal immigrant possess the necessary documents that allow them to stay in a country that is not theirs by birth. For instance, for one to be a legal immigrant in the US, they need to have a valid visa which shows that they are acceptable in the country. Also, one has to pass through an inspection before being allowed to live in the US as a legal immigrant.

Senior care

Senior care refers to services provided to the aging population to enable them to live a normal life that is less challenging. It can also be defined as healthcare assistance provided to aged individuals to help them with daily activities such as cleaning themselves, medication management, going to the toilet, bathing, and other self-care activities (Hoyt, 2022). Senior care primarily focuses on enabling the aged to live a comfortable lifestyle as they approach the end of life.

Chapter 2: Literature Review

This chapter will entail intensive research on existing knowledge about the topic of research in the study. The chapter will give a detailed analysis of the senior care economy in California, Texas, and Florida. It will also involve a broad explanation of the legal immigrant workforce in the senior care sector. The chapter will comprise four subsections, including an introduction, search description, theoretical or conceptual framework, and review of the research obtained.

Chapter 3: Methodology

This chapter will entail a detailed explanation of the research methods used in the study. In simple terms, the chapter will tell how the research study was conducted. Providing this information will allow readers to evaluate the validity and reliability of the research study and the topic under scrutiny. The chapter will comprise different subsections, including the introduction, research design, research questions, setting, participants, and data collection. The chapter will tell the research methods used, the people involved in the study, and where data was obtained from, that is, the study population.

Chapter 4: Results

This chapter describes what was obtained using different research methods applied throughout the study. The results are based on each of the findings and help confirm whether the hypothesis was refuted or confirmed. The results are shared through research conclusions, tables, and statistics to give readers a better overview of the research findings. This chapter is about explaining the results rather than presenting them. The chapter will comprise three subsections: introduction, findings, and conclusion.

Chapter 5: Discussion

This chapter will be all about discussing the findings obtained in chapter 5. It will give a detailed explanation of the obtained findings to enable readers to understand them easily. The chapter will comprise three key subsections: an introduction, a summary of findings, and a conclusion.

Chapter 6: Conclusion

This will be the last chapter of the research study. The chapter is all about summarizing the main points of the research study and putting them in language that is easy for all readers to understand. The conclusion section serves as a great tool in shaping the reader’s opinion concerning the research study. It is in this chapter that also suggestions for future research are made.