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Changes in immigration to the United States have a substantial impact on the health and death rates of older Americans, according to a study published by the National Bureau of Economic Research.

Immigrants provide a substantial percentage of the employees in the medical system. They are important to hospitals, medical offices, assisted living residences, nursing homes, and other providers to older Americans.

In many markets, especially rural areas, there are shortages of all types of medical workers.

Roughly 1 in 5 frontline nursing home workers are immigrants, nearly 1 in 3 home care workers are immigrants, and 18% of all health care workers are immigrants, according to the study.

The study sought to measure the impact changes in immigration could have on the mortality rates of older Americans and found a strong relationship between immigration changes and the health of retirees.

An increase of 1,000 immigrants to the United States would lead to 142 new health care workers with 88 of them being doctors, nurses and aides. The new health care workers would not displace native workers.

In addition, the study found that more foreign health care workers in any occupations would lead to an increase in the supply of domestic physicians and other health care workers.

The researchers speculated that having more support from immigrant workers makes domestic health care workers confident they can deliver better care to patients.

The researchers estimate that 1,000 new immigrants lead to a total of 173 more health care workers.

The increase in health care workers would lead to lower death rates among older Americans. The study estimates that a 25% increase in the steady flow of immigrants to the United States would result in 5,000 fewer deaths nationwide.

In each Metropolitan Statistical Area in the United States, 1,000 additional immigrants would result in 9.8 fewer deaths among the elderly.

More immigrant workers also would lead to reduced use of nursing homes.

Older Americans would receive more medical care and other assistance and be able to avoid or delay admission to nursing homes. More older Americans would be able to stay longer in their preferred residences instead of residing in nursing homes.

The results of the study are consistent with previous studies that found increased immigration of health care workers reduces the number of institutionalized adults and results in more staff and better quality of care at nursing homes.

Those studies focused on Americans in nursing homes and similar institutions. This study took a broader view by examining the impact of increased immigration on the mortality of all elderly Americans.

An interesting finding is that increased immigration would not lead to increases in overall Medicare spending.

The overall conclusions were that immigration extends the lives of the elderly and improves their overall health. The elderly also are able to avoid or delay admission to nursing homes, and those in nursing homes receive better treatment than they otherwise would.