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Foreign nurse importation and the supply of native nurses

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  • Cortés, Patricia
  • Pan, Jessica

Abstract

The importation of foreign registered nurses has been used as a strategy to ease nursing shortages in the United States. The effectiveness of this policy depends critically on the long-run response of native nurses. We examine the effects of immigration of foreign-born registered nurses on the long-run employment and occupational choice of native nurses. Using a variety of empirical strategies that exploit the geographical distribution of immigrant nurses across US cities, we find evidence of large displacement effects – over a ten-year period, for every foreign nurse that migrates to a city, between 1 and 2 fewer native nurses are employed in the city. We find similar results using data on nursing board exam-takers at the state level – an increase in the flow of foreign nurses significantly reduces the number of natives sitting for licensure exams in more dependent states relative to less dependent states. Using data on self-reported workplace satisfaction among a sample of California nurses, we find suggestive evidence that part of the displacement effects could be driven by a decline in the perceived quality of the workplace environment.

Suggested Citation

  • Cortés, Patricia & Pan, Jessica, 2014. "Foreign nurse importation and the supply of native nurses," Journal of Health Economics, Elsevier, vol. 37(C), pages 164-180.
  • Handle: RePEc:eee:jhecon:v:37:y:2014:i:c:p:164-180
    DOI: 10.1016/j.jhealeco.2014.06.008
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    2. Chung Hyeran & Arends-Kuenning Mary, 2020. "Do foreign-educated nurses displace native-educated nurses?," IZA Journal of Labor Policy, Sciendo & Forschungsinstitut zur Zukunft der Arbeit GmbH (IZA), vol. 10(1), pages 1-28, March.
    3. Xie, Bin, 2017. "The Effects of Immigration Quotas on Wages, the Great Black Migration, and Industrial Development," IZA Discussion Papers 11214, Institute of Labor Economics (IZA).
    4. Paolo Abarcar & Caroline Theoharides, 2024. "Medical Worker Migration and Origin-Country Human Capital: Evidence from U.S. Visa Policy," The Review of Economics and Statistics, MIT Press, vol. 106(1), pages 20-35, January.
    5. Christian Dustmann & Giovanni Facchini & Cora Signorotto, 2015. "Population, Migration, Ageing and Health: A Survey," RF Berlin - CReAM Discussion Paper Series 1518, Rockwool Foundation Berlin (RF Berlin) - Centre for Research and Analysis of Migration (CReAM).
    6. Elizabeth Munnich & Abigail Wozniak, 2020. "What Explains the Rising Share of US Men in Registered Nursing?," ILR Review, Cornell University, ILR School, vol. 73(1), pages 91-123, January.
    7. Stuhler, Jan & Jaeger, David & Ruist, Joakim, 2018. "Shift-Share Instruments and the Impact of Immigration," CEPR Discussion Papers 12701, C.E.P.R. Discussion Papers.
    8. Ortega, Francesc & Hsin, Amy, 2022. "Occupational barriers and the productivity penalty from lack of legal status," Labour Economics, Elsevier, vol. 76(C).
    9. Ariel Burstein & Gordon Hanson & Lin Tian & Jonathan Vogel, 2020. "Tradability and the Labor‐Market Impact of Immigration: Theory and Evidence From the United States," Econometrica, Econometric Society, vol. 88(3), pages 1071-1112, May.
    10. Hanson, Gordon & Liu, Chen, 2023. "Immigration and occupational comparative advantage," Journal of International Economics, Elsevier, vol. 145(C).
    11. Kai Fischer, 2023. "Skilled Labour Migration and Firm Performance: Evidence from English Hospitals and Brexit," CESifo Working Paper Series 10747, CESifo.
    12. Haan, Peter & Wnuk, Izabela, 2024. "The Effect of Migration on Careers of Natives: Evidence from Long-Term Care," IZA Discussion Papers 16749, Institute of Labor Economics (IZA).
    13. Furtado, Delia & Ortega, Francesc, 2020. "Does Immigration Improve Quality of Care in Nursing Homes?," IZA Discussion Papers 13552, Institute of Labor Economics (IZA).
    14. Peter Haan & Izabela Wnuk, 2024. "The Effect of Migration on Careers of Natives: Evidence from Long-term Care," Discussion Papers of DIW Berlin 2070, DIW Berlin, German Institute for Economic Research.
    15. Christine Dauth & Julia Lang, 2019. "Can the unemployed be trained to care for the elderly? The effects of subsidized training in elderly care," Health Economics, John Wiley & Sons, Ltd., vol. 28(4), pages 543-555, April.
    16. Fabrizio Patriarca & Rama Dasi Mariani & Eugenio Levi, 2017. "Hate at First Sight? Dynamic Aspects of the Electoral Impact of Migrations: The Case of the UK and Brexit," SPRU Working Paper Series 2017-21, SPRU - Science Policy Research Unit, University of Sussex Business School.

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    More about this item

    Keywords

    Foreign nurses; Immigration; Displacement;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • J44 - Labor and Demographic Economics - - Particular Labor Markets - - - Professional Labor Markets and Occupations
    • J61 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - Geographic Labor Mobility; Immigrant Workers

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