Rural communities across the U.S. depend disproportionately on international-born physicians, according to a research letter published online Feb. 2 in JAMA Internal Medicine.
Four notes:
1. The letter, “Characterization of the International-Born Health Care Workforce in Rural US Communities,” was written by Manav Mdha, Aditi Doiphode and Erin Durry, PhD. The researchers examined how heavily rural areas rely on international-born healthcare workers relative to their overall immigrant populations, identifying regions that may be especially vulnerable to changes in immigration policy.
2. The study draws on 2023 data from the U.S. Census Bureau’s American Community Survey, analyzing nativity and occupation data aggregated to public use microdata areas, which were classified as rural or nonrural. In total, the analysis included 162,390 healthcare workers across 2,462 microdata areas. Of those workers, 12,671 were physicians and surgeons, and about 28% were international-born.
3. While rural areas had a smaller share of international-born physicians compared with nonrural regions, the authors found rural communities showed greater relative reliance on international-born physicians when that workforce was measured against the size of the local immigrant population. A similar pattern was observed among physical therapists.
4. The authors noted that this disproportionate reliance suggests rural healthcare access may be particularly sensitive to immigration restrictions. They wrote policymakers should consider expanding or strengthening pathways for international-born clinicians as a way to help address ongoing healthcare workforce shortages.
Separately, Becker’s has previously reported that one immigration pathway for international-born physicians is through H-1B visas, which have remained in limbo after a newly imposed $100,000 application fee, effective Sept. 21. Healthcare organizations have warned the change could worsen workforce shortages, and federal officials signaled they would consider exemptions for physicians and medical residents, but there have been no reports of such exceptions being granted.
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