Immigration enforcement and the institutionalization of elderly Americans

Area of Science:

• Sociology
• Public Policy
• Gerontology

Background:

• Immigration enforcement policies can have unintended consequences on social services.
• The availability of home care services is crucial for enabling elderly individuals to age in the community.

Purpose of the Study:

• To investigate the impact of the Secure Communities (SC) immigration enforcement program on the institutionalization rates of the elderly.
• To explore the role of household service supply shocks in this relationship.

Main Methods:

• Utilizing a quasi-experimental design, this study exploits the staggered rollout of the SC program across U.S. counties between 2008 and 2014.
• Econometric analysis was employed to assess the causal effect of SC implementation on elderly institutionalization.

Main Results:

• The Secure Communities program led to a 0.26 percentage point (6.8%) increase in the likelihood of institutionalization for Americans aged 65 and above.
• Elderly individuals most likely to use domestic services showed a higher propensity to move into nursing homes post-SC implementation.
• Evidence suggests significant reductions in work hours for housekeepers, personal care aides, and home health workers.

Conclusions:

• Immigration enforcement, through programs like SC, can indirectly affect elderly care by disrupting the labor supply for essential home and community-based services.
• Negative supply shocks in domestic and personal care occupations appear to be a key mechanism driving increased nursing home admissions among the elderly.
• The findings highlight the complex interplay between immigration policy, labor markets, and elder care, underscoring challenges for community-based aging.