Department of Health Care Policy, Harvard Medical School, Boston, MA, 02115, USA.
Department of Health Care Policy, Harvard Medical School, Boston, MA, 02115, USA.
Soc Sci Med. 2024 Jun;351:116978. doi: 10.1016/j.socscimed.2024.116978. Epub 2024 May 15.
One-fourth of nursing home residents are diagnosed with anxiety disorders and approximately half live with depression. Nursing homes have long struggled with staffing shortages, and the lack of care has further heightened the risk of poor mental health. A key solution to both problems could be immigration. Prior studies have documented how immigrant labor could strengthen the long-term care workforce. We add to this picture by exploring the impact of immigrant inflows on the mental health outcomes of nursing home residents. Using a nationally representative dataset and a shift-share instrumental variable approach, we find empirical evidence that immigration reduces diagnoses of depression and anxiety, the use of antidepressant and antianxiety drugs, and self-assessed symptoms of depression. The results are robust to several sensitivity tests. We further find that the effect is more substantial in facilities with lower direct care staff hours per resident and with likely more immigrants without citizenship. Language barriers tend to be a minor issue when providing essential care. The findings suggest that creating a policy framework that directs immigrant labor to the long-term care sector can mutually benefit job-seeking immigrants and nursing home residents.
四分之一的养老院居民被诊断患有焦虑症，大约一半的人患有抑郁症。养老院长期面临人员短缺的问题，护理的缺乏进一步加剧了心理健康状况不佳的风险。解决这两个问题的一个关键办法可能是移民。先前的研究已经记录了移民劳动力如何能够加强长期护理人员队伍。我们通过探索移民流入对养老院居民心理健康结果的影响，进一步丰富了这一图景。我们使用全国代表性数据集和转移份额工具变量方法，发现了移民减少抑郁症和焦虑症诊断、使用抗抑郁药和抗焦虑药以及自我评估抑郁症状的经验证据。这些结果在经过几次敏感性测试后仍然成立。我们还发现，在直接护理员工每居民小时较少的设施和可能有更多没有公民身份的移民的设施中，效果更为显著。在提供基本护理时，语言障碍往往不是一个大问题。研究结果表明，制定一个将移民劳动力引导到长期护理部门的政策框架，可以使寻求移民的人和养老院居民互惠互利。
