This paper presents the challenges and opportunities of the senior care economy. The last two decades have seen the United States grow continuously older, resulting in a growing elderly care economy which translates into the creation of a significant number of jobs, now and in the future, for senior housing and care options. The demographic trends in the United States show an aging nation, where home healthcare workers are estimated to be the third fastest-growing occupation. At the same time, a shortage of paid caregivers has led immigrants to play an essential role in filling the gap in nursing homes and in-home care. This paper focuses on three states where one-fourth of these older Americans live: California, Florida, and Texas, analyzing the trends in senior care, the options available, the costs, and the contribution of the immigrants to the labor force.

Background of Study

Over the years, there has been a significant increase in the number of the aged population leading to an expansion of the senior care economy. Contextually, since 2019 the aged population has grown by 36% compared to the young population (65 years and below), which has only grown by 3%. As ACL (2020) puts it, the increased life expectancy has been as a result to the improved living conditions. A person born in 2019 has a higher life expectancy than one born in 1990. This shows that with time, life expectancy is increasing, and more people will reach the age of 65 years and above (Kilduff, 2021). As it were, there was a low life expectancy in the 1990s due to the lower number of children born during the Great Depression, which was characterized by tough economic conditions. However, after the Great Depression, the quality of life increased, increasing life expectancy and leading to a more aged population. The baby boomers were the first generation to have an increased life expectancy, and soon, all boomers will be over 65 years hence contributing to an increase in US aged population. As ACL(2020) posit, “In the US, the number of people aged 85 and up will more than double to 14.4 million by the year 2040”. This means that out of every 5 Americans, one will be of retirement age. The increased access to healthcare advantages like the Medicare and Medicaid programs have contributed to increased life expectancy for baby boomers and to the trend of aging in the country (Costs. Medicare, n.d;Robin Rudowitz et al., 2021,). The racial and ethnic groups in the US also contribute to the rise of older populations in the US. The predicted rise in the aged population means that there will be more demand for senior care in the upcoming years, and it is essential to navigate the economic options available for them while at the same time analyzing the impact of these options on the economy.

The increased demand for senior care has made facility-care workers a fast-growing occupation in the US. Immigrant workers are increasingly filling the positions of facility-care health workers in the US to help care for the increasing aged population. Since the 1990s, the number of immigrants in the United States has grown dramatically. Immigrants make up a significant share of the US workforce, and their impact is especially evident in the senior care economy. Immigrants work in healthcare occupations, including health assistants, registered nurses, and primary care providers, primarily needed in rural areas. According to research by Butcher et al. 2021, immigrant workers are more likely than native-Americans to work in the senior care economy. The educational backgrounds of immigrants are essential as most are highly skilled healthcare workers aged 25 and above. 35% of registered nurses and 36% of state physicians were born in foreign countries (Butcher et. al., 2021). However, most foreign healthcare professionals receive training abroad, and those not trained enroll in programs that guide them through the steps required to join the state’s healthcare workforce. The programs support the roles in health that take four years to attain a college degree. Hence, these programs encourage low-skilled workers to join the health workforce as they can enroll in health programs and get the skills required to start working. Also, most immigrants work in the senior care economy because they help provide effective care to immigrant patients in the US. California, Texas, and Florida are the biggest states in the US, with a high population of immigrants. Immigrants in the US fall under the low-income earning group, and thus using immigrants to provide senior care helps make them a resource for the low-income earning group. Immigrant care workers are bilinguals and thus can help address the language barrier when caring for aged immigrant patients. In California, 77.5% of immigrant healthcare workers are bilingual (Zallman et al., 2019). This can help break the communication barrier and make the patient feel more comfortable with their caregiver, as they can communicate easily regarding their wants and needs. For example, in California, a community of immigrants based in Oakland provides personal support to the aging population.

Succinctly, there is an increase in the immigrant workforce in the senior care economy New American Economy Research Fund, 2020). However, there needs to be more on the impacts of the immigrant workforce on the US economy. Thus, it is essential to understand the impact that the immigrant workforce in the senior care economy will have on the US economy regarding GDP. Also, it is crucial to determine whether the supply of jobs and demand for senior care has increased or decreased with the aging population. According to many researchers, the patterns suggest that there will be an increase in demand for senior housing and care choices for seniors who require some degree of care. The future, however, is somewhat rocky. The business, which depends on employees to deliver services and care at the bedside, is concerned about growing labor shortages and the resultant rising cost of labor. One of the main challenges in this business sector is the labor shortage. The study will help come up with a concise conclusion regarding the impact of the immigrant workforce in the senior economy to the US economy regarding California, Texas, and Florida states. The research will help individuals understand what the senior care economy is doing to the US economy.

Problem Statement

In the recent past, there has been a significant rise in the aged population, and it is estimated to rise gradually with time. The number of people aged 65 years and above is becoming more in the US, and by 2030, all the baby boomer’s generation will be 65 years and above, resulting in more population increase. As the aged population in the US continues to grow, the demand for facility senior caregivers is also growing (Hoyt, 2022). Immigrants supply a great share of senior care labor in California, Texas, and Florida (New American Economy Research Fund, 2020). However, little work concerns the impact of the senior care economy comprising the immigrant workforce in the US economy. Thus, the specific problem in this study is to investigate the impact of the immigrant workforce in the senior care economy on the US GDP and the supply of jobs and demand for senior care.

Statement of Purpose

This quantitative research study aims at investigating the impact of the immigrant workforce in the senior care economy on the US economy. The study will determine if there has been an increase or decrease in GDP over the recent years based on legal immigrant work in the senior care economy. It will also establish the impacts by determining whether the supply of jobs and demand for senior care has increased or decreased with the increase in the senior care economy. The study will be conducted using a case study approach with the US economy as the dependent variable and the legal immigrants in the aging care workforce as the independent variable. The case study will involve collecting various pieces of evidence about the US senior care economy and the immigrant workforce in the senior care sector. The case study will also involve a comprehensive analysis of research works from different researchers on the US senior care economy and senior care immigrant workforce.

Research Question(s)

This research study focuses on creating an understanding of the impact of legal immigrants in the senior care sector on the US economy in terms of GDP and labor demand and supply from the states of California, Texas, and Florida. The study will focus on answering two research questions to help determine the impacts. The first one is, “has GDP increased or decreased over the recent years based on the legal immigrant workforce in the senior care economy?” and the second question is, “has the amount of jobs supply and senior care demand increased or decreased over the recent years?” With these two research questions, it will be possible to come up with a concise conclusion about the impact of the senior care immigrant workforce on the US economy. The paper seeks to tell whether US GDP has declined or increased with the rise in the immigrant workforce in the senior care economy. There are two possible outcomes from this research study. One is that the senior care economy’s immigrant workforce has no impact on the US economy. The other alternative is a decline or rises in GDP due to legal immigrant work in senior care. Undeniably, the growing senior economy has several impacts on the overall US economy. It must be assumed that the rise of the immigrant workforce will not impact the senior care economy and the overall US economy. There will be either a decline or rise in GDP and jobs supply and demand for senior care will either decrease or increase. To come up with concise answers to the research questions, the study focuses on California, Florida, and Texas since they have the highest contribution to the US economy and have the highest populations with both immigrants and old aged population.

As seen beforehand, the aging population in America is increasing at a high-rate necessitating facility-based senior care. This has translated into an increased demand for senior care workers. And as Zhang and others (2020) explains, the demand for senior care is high than the supply of workers. As a result, immigrant workers are increasingly being hired as senior caregivers in various US states. According to research by Zhang et al. (2020), the immigrant population accounts for about 18.2 percent of senior caregivers in the US. In a state like California, the highest percentage of the aged population relies on immigrant labor for facility-based care services. Also, immigrants who are primarily women, represent 70% of paid caregivers in California (60%), 60% in Texas, and 50% in Florida (Eckstein & Peri, 2018). Yet, even with the increased immigrant workers in senior care, there is still a shortage of healthcare workers. Numerous pieces of research in the issue of immigrant workers and the US aging population prompts the need to develop an evidence-based answer on the impact of the legal immigrant workforce in the senior care sector on the US economy. Has the GDP increased or decreased due to an increase in the legal immigrant workforce providing senior care? Has the demand for senior care and job supply increased or decreased? This research study will help establish clear answers to these questions and eliminate future incorrect predictions concerning the research questions. It will help the general population understand the relationship between the legal immigrant workforce in the senior care sector and the US economy. The research questions will be a guiding tool to facilitate a smooth pathway to the result.

Significance

The wider significance of this research study lies in its ability to serve as a potential creative bridge in quantitative research. The research study will help come up with a concise conclusion regarding the impact of the legal immigrant workforce in the senior care economy on the US economy. The findings will help create advancing knowledge in economics and healthcare. One of the ways through which the research findings will benefit the healthcare sector is that it will help understand the trends in the senior care economy. Senior care falls under the healthcare sector. Thus, when relevant authorities are updated with the existing trends in the senior care economy, they can make informed decisions that are in accordance with the existing trends.

The study is conducted using a case study approach which means that different data sources will be analyzed to deduce the current and future trends in the senior care economy. The aging population in California, Texas, and America is increasing at an alarming rate, which raises the need for senior care. The increased rate of the aged population in America has increased the demand for senior care. Increased demand for senior care impacted the healthcare sector and necessitated employing more healthcare providers to provide senior care to the aging population. The healthcare sector must employ more healthcare givers to cope with the increasing demand for senior caregivers. Thus, with this study, relevant stakeholders in the healthcare sector, including policymakers, will thus have a clear picture of how the decrease or increase affects the overall healthcare sector.

Understandably, the study findings will play a significant role in economics. The economic field is concerned with human beings and helps explain a country’s economic status. The research findings in this paper will equip people with vast knowledge of the economic status of the US. The study seeks to determine whether the legal immigrant workforce will increase or decrease GDP. The GDP Of a country is a key economic indicator since the size of a country’s economy is determined by GDP. The gross domestic product of a country is affected by many factors including what is happening in the healthcare sector. Almost all economic sectors help determine a country’s economic status. Thus, with the finding of this research, economic experts will have relevant knowledge on how the legal immigrant workforce in the senior economy is affecting US GDP. The study will investigate how the legal immigrant workforce in the senior care economy is affecting the US economy. From this research question, it will be possible for economic experts to get clear pictures of the economic status from the healthcare sector’s viewpoint.

Additionally, the research findings focus on addressing the existing gaps in the literature concerning the US economy and the legal immigrant workforce in the senior care economy. Several researchers have explained the stipulated rise in the aging population in the US and the rise of the immigrant workforce in the senior care economy. However, they have failed to address the impacts of these factors on the US economy. They have not touched on whether GDP will increase or decrease due to legal immigrant senior caregivers. Also, there have been controversies concerning the supply of jobs and demand for senior care. Some argue that the demand for senior care will rise while the supply of jobs will decrease. In contrast, others argue that the increased use of immigrant labor in senior care will create a balance between the demand for senior care and the supply of jobs. The findings of this study will thus help address this dilemma which acts as a gap in the literature concerning the senior legal immigrant workforce and the US economy.

Assumptions

A key assumption in this case study is that time will be enough to review different data sources to help establish the impact of the legal immigrant senior care workforce on the US economy. The research study assumes that the research study will take place within the allocated time and thus help come up with more accurate findings to the research questions. This assumption is necessary because time is important when conducting research using a case study approach. Another assumption in this study is that the Texas, Florida, and California states have the greatest contribution to the US economy, and this trend will remain the same during the period of this study. Usually, the economy is very volatile, and different factors in the economy keep changing depending on what is happening in the country. The three states that act as this study’s background may not be among the highest contributors to the US economy. However, the study assumes they will remain the greatest contributors to help us develop contributors. The economic growth, inflation, unemployment percentage, and other factors that affect a country’s economy will remain constant in all US states, making California, Texas, and Florida the biggest contributors to the US economy.

Additionally, the study assumes that the projected increase in the immigrant population in the US will remain the same. The trends that indicate a future rise in the aged population in the US will remain constant, and no factors will affect this trend. This assumption is necessary for this context since the study is concerned with the rising aged population and increased demand for legal immigrant senior care.

Limitations

Every research has its limitations depending on the research approach used. Thus, this research study has potential limitations. The research study will be conducted using a case study approach, which will analyze quantitative data to come up with conclusions concerning the investigated issue which exposes the research to potential bias. The researcher may establish biased conclusions influenced by their previous experiences or what they think instead of what the research says. For instance, when seeking to determine whether GDP has increased or decreased because of the legal immigrant workforce in the senior care economy of California, Texas, and Florida, one may be tempted to assume that GDP will increase due to their reasons rather than what the available research says.

Another potential limitation is time constraints. Generally, case studies are time-consuming since they involve vigorous analysis of several data sources to help establish concise conclusions about the research topic. Thus, there is a possibility that more time will be needed to conduct intensive research on the issue being studied. Thus, time constraints will force the research to be conducted straightforwardly to avoid extra expenses that come along with an extended time in research. Another possibility resulting from time constraints is that the study may take longer than expected, failing to meet the deadline for each part of the study and the overall completion date.

Also, the complexity of the research topic may pose an eminent limitation to the study. The research topic is wide since it touches on different things, including the legal immigrant workforce, the senior care economy, the aged population in the US, and the US economy in terms of GDP. The complexity of this topic might make it difficult for a researcher to understand what they are expected to do and thus result in incorrect inferences and findings. The complexity may make a researcher fail to understand what is required of them, resulting o substandard research that does not substantially respond to the research questions.

Definition of Terms

Gross Domestic Product (GDP)

GDP refers to the monetary value of services and goods produced in a country within a specific period, usually one year. GDP provides an overview of a country’s economy, helping determine its economic health. In most cases, GDP is calculated annually, though, at times, it is calculated quarterly.

Immigrants

Immigrants refer to individuals who move from their countries and go to another country to live there. In other words, immigrants live in a country where they were not born. Most of the immigrants in the US are from India, Mexico, Vietnam, and China. Immigrants always provide cheap labor since they need money to help them survive. People may move from their countries to a new country either legally or illegally.

Legal Immigrants

Legal immigrants are documented foreign-born individuals in the US. S A legal immigrant possess the necessary documents that allow them to stay in a country that is not theirs by birth. For instance, for one to be a legal immigrant in the US, they need to have a valid visa which shows that they are acceptable in the country. Also, one must pass through an inspection before being allowed to live in the US as a legal immigrant.

Senior care

Senior care refers to services provided to the aging population to enable them to live a normal life that is less challenging. It can also be defined as healthcare assistance provided to aged individuals to help them with daily activities such as cleaning themselves, medication management, going to the toilet, bathing, and other self-care activities (Hoyt, 2022). Senior care primarily focuses on enabling the aged to live a comfortable lifestyle as they approach the end of life.

Chapter 2 Literature Review

Introduction

The number of immigrants working in the US senior care sector has risen. This is attributed to the increased number of the aged population in the country, which has significantly increased the demand for senior facility caregivers. California, Texas, and Florida have the highest number of the older generation and immigrant workforce. Specifically, for a long time, Florida has served as a home for many immigrants. One of every five Florida residents is an immigrant (American Immigration Council, 2020). This explains why the immigrant workforce is high in Florida’s senior care sector. Facility-based Senior care services are essential since they enable older people to age appropriately and with high-quality facility care. Some facility care services provided to the aged population include helping them with self-care services such as feeding, medication, and visiting the toilet. Foreign-born healthcare workers constitute a disproportionate number of senior care providers in California, Texas, and Florida.

As much as the immigrant workforce is growing in the US senior economy, more information needs to be revealed concerning their economic impacts. The research thus focuses on exploring this issue by examining whether US GDP has declined or increased due to the legal immigrant workforce. It also seeks to establish whether the demand for labor and supply for senior care has declined or increased. This chapter presents an empirical literature review that forms the basis of this study. The chapter comprises several sections, including the literature search strategy, conceptual framework, literature review, and literature synthesis. The chapter also ends with a summary section which summarizes everything that has been covered throughout the chapter. The overall aim of all the sections included here is to help establish a reasonable basis for the study.

Literature Search Strategy

For this paper to come to fruition, several resources and databases were used. All through, current literature and sources (those within the last five years) were used. The main search engine is Google. Using google and key terms, it was possible to arrive at current websites which were quite useful. All the websites used were within this range of five years. The use of key search terms such as “older population and care and senior care”, “immigrants and senior care”, “workforce and senior care or elderly citizens”, “immigrant labor and American elderly or disabled people”, and “immigrants and US economy” was key. These were just some of the key search phrases used on the project.

Apart from the use of websites, google scholars also proved rich in current, authoritative, and reliable resources. Besides, most of the materials from Google scholar were quite credible and peer reviewed. With peer-reviewed articles, the research becomes more reliable and credible. It means that the papers have been well-critiqued and have passed the test of credibility. This database was thus quite useful. The key search terms were quite like those used on the websites.

Apart from the websites and google scholar, using the range of online libraries came in handy to enrich the research. Using library catalogs, it was possible to arrive at periodicals and collections of eBooks that could inform the research. Again, the use of key terms was very essential to arrive at relevant information.

Google as the search engine, google scholar, and online libraries were essentially the sources of materials used in this work. However, some of the concepts had little information to back them up. In such cases, deductions from the available resources or publications from recognized institutions were important.

Conceptual Framework

The Human capital theory and Economic growth Theory guided the study. The two theories serve as robust theoretical frameworks for this study as they help develop definitive conclusions regarding the research questions. The Human Capital theory is an economic concept emphasizing the importance of a knowledgeable, educated, and skilled workforce. The theory states that a well-educated workforce contributes positively to a company’s economic condition and the country. The theory originated in the 1960s when economists Theodore Schultz and Gary Becker realized the importance of training, knowledge, and education to increase productivity. The two economists argued that training and education are essential in a workforce as they contribute to productivity. In the context of this study, the theory explains that the level of education and training among immigrants impacts the productivity of the US economy.

The legal immigrant workforce’s knowledge, education, and training level impact the senior care economy. They can either increase or decrease productivity, resulting in a decline or increase in US GDP. The economic growth theory is also a theoretical concept in economics, explaining that labor productivity has a significant role in economic growth. According to the theory, the real GDP is determined by the level of labor productivity. The origin of economic growth theory dates to around 1776, when Adam smith first published it in his book “The Wealth of Nations.” The theory emphasizes the causes of the increase in labor productivity and how this affects economic growth. In the context of this study, this helps explain the impact of labor productivity among the immigrant workforce on the US economy. Using the theory, it is easy to tell how the immigrant workforce in the senior care economy impacts the supply of jobs and demand for senior care. The theory helps tell whether US GDP increases or decreases due to the increased legal immigrant workforce in the senior care economy.

Economic growth and human capital theories have been extensively used in research. Ehrlich, I., & Pei, Y. (2021) have integrated the two theories to examine the economic impacts of immigration to a country whereby physical and human capital are productive assets. Their research findings indicate that an increase in immigrants increases the job supply. Job supply by immigrants has long-term and short-term impacts on the economic growth of a country. The research study argues that immigrants can contribute to an increased labor force and bring valuable expertise and skills to increase productivity, boosting a country’s economy. The study draws inferences from economic growth and human capital theories to come up with this conclusion.

Also, Tibajev’s (2022) research utilizes human capital theory to explain the productive skills and knowledge that immigrants bring to a country and the benefits that their skills and expertise bring. The study indicated that human capital is essential for productivity and helps determine the economic growth of a country. An increase in the number of skilled and qualified immigrants in a country result in increased productivity, positively contributing to economic growth. Vidyattama et al. (2022) have also used the human capital theory to examine the impact of immigrant workers on the Australian economy. The study uses the theory to explain the usefulness of migrant workers to the economic growth of a country. From these, it is evident that the two theories have been used severally to explain different aspects affecting a country’s or organization’s economic status. They are essential in explaining economic growth dependent on human capital, job demand, and labor supply.

Having the two theories utilized in similar research studies as the one here, it is evident that they help enhance the design of this study. The two economic theories are concerned with economic growth, and thus they make sense to this study since the study is all about the US economy. This study deals with how the immigrant workforce in Texas, California, and Florida affects the US senior economy regarding the country’s GDP and demand for senior care and supply of jobs. The theories will help make theoretical-based conclusions regarding the research findings, which makes the study more appropriate. The theories will help eliminate possible bias in the research findings. It is possible to tell the relationship between human capital, productivity, and economic growth, helping answer the research questions appropriately. For instance, if there is an increase in job supply and senior care demand, the two theories can be used to tell what this means to the US economy. Also, the relationship between the legal immigrant workforce and GDP is well explained using the human capital theory. The theory explains that an increased skilled and educated workforce produces productivity, boosting the economy. Thus, the legal immigrant workforce in California, Texas, and Florida may raise or lower GDP depending on their training, knowledge, and skills. The immigrant workforce in California is highly skilled. Thus, using the human capital theory, it is possible to conclude that having such a workforce in California’s senior care sector contributes to significant production, raising the country’s economic situation. Undeniably, the two theories play a significant role in enhancing the design of this study.

Review of the Literature

The aging population in the US is growing at an alarming rate, which has contributed to increased demand for senior care from immigrant workers. Texas, California, and Florida are the leading states with the highest aged population. Kilduff (2021) explains that about one-fourth of individuals aged 65 are distributed in California, Texas, and Florida. The three states are among the most populous states in the US, so they record many aging populations. Among the three, Texas has the most populous population and older people. As of 2020, Texas had a population of 29 361 and 3, 874 aged individuals. Figure 1 compares the total population and aged population in Texas, Florida, and California. Comparing the three states, California has the highest aged population as compared to all other states. The increasing aged population in the three states has significantly contributed to the overall rise of the aged population in the US. Since 2019, the aging population in the US has grown by 36%, linked to increased life expectancy. The baby boomer’s generation, those born in 2019 population of onwards, contribute the highest percentage to the aged population in America. Baby boomers have a higher life expectancy due to improved living standards, such as the availability of improved healthcare services. Medicaid and Medicare programs are critical contributors to increased life expectancy among the baby boomer generation and to the trend in the aging population. Soon, all baby boomers will be 65 years and above due to an increased life expectancy. People born in the 1990s had lower life expectancy due to the lower quality of life that resulted from the Great Depression. The quality of life improved after the Great Depression, explaining why baby boomers have a high life expectancy. Soon, the aging population in California, Texas, and Florida will double since all baby boomers will be 65 years, doubling the overall US aging population.

Fig 1: Total Resident and Aged Population in Texas, Florida, and California

The increased rate of the aging population in the US has significantly contributed to an increased demand for facility-based senior care services. Caring for the aging population has become a fundamental challenge to the US healthcare workforce since the demand for senior care has become higher than the supply of jobs available. Immigrant workers are increasingly filling the positions of facility care health workers in California, Texas, and Florida to help attend to older people. By vision 2030, the number of healthcare workers needed to provide senior care will be 305 million. Currently, legal immigrants in the US are increasingly filling the positions of senior caregivers. They are greatly helping address the critical shortage of senior care providers, such as rural physicians. From a general perspective, foreign-born workers are more skilled and educated than US-born healthcare workers, so they are increasingly filling the positions of senior caregivers. Another reason immigrant workers have become common in the US senior care economy is because they are willing to work at lower remuneration rates than US-born healthcare workers. The increased rate of the legal immigrant workforce significantly impacts the US labor market. A study by Eckstein and Peri (2018) indicates that the increased number of highly skilled immigrant workforce in the US labor market contributes to the economy’s growth. Foreign-born individuals in the US are always determined to learn different skills that will enable them to get good-paying jobs, and by doing so, they contribute to the economic growth of the US. Senior care services are essential to the elderly as they help them live more fulfilling and peaceful life. The number of foreign-born healthcare workers in the US has grown significantly, though the numbers vary geographically. California, Texas, and Florida have the highest immigrant healthcare workforce. This explains why the number of legal immigrants providing senior care services is high in the three states.

The increasing rate of the legal immigrant workforce and the aging population in Texas, Californian, and Florida play a significant role in establishing the impact of the immigrant workforce in the US economy. Eckstein and Peri (2018) have deeply explored the immigrant workforce in the US labor market and their impacts on the US economy. Foreign-born workers in the US offer skills and abilities that are differentiated from those offered by native-born Americans. Other than craftsmanship and competencies, foreign-born workers have added advantages that make them be considered in the US labor market, including work ethics, ability to ensure extreme outdoor conditions, willingness to work, and high stamina. Immigrant workers have played a significant role in the US economy since they enabled it to transform from a manufacturing-based economy to a service-based economy. A service-based economy has dramatically contributed to the country’s economic success since the various numbers of individuals in different labor niches contribute to an increase in GDP, which indicates economic progress. From this study, it is evident that the increased number of senior care legal immigrant workforce is more likely to contribute to an increase in the country’s GDP and result in economic progress.

As explained earlier, the increasing elderly population in California, Texas, and Florida has raised the demand for senior care jobs. The increased demand for senior care jobs has led to increased recruitment of immigrant workers in healthcare to meet the increasing demand for senior care. Increased accessibility to Medicare and Medicaid programs has also increased the demand for facility-based care among elderly individuals, raising the demand for senior caregivers. Both Medicaid and Medicare are available to seniors in different states but with varying regulations and conditions from one state to another. Medicaid is financed by the federal government and is run by the state government. It offers health insurance to low-income individuals aged 65 years and above. According to Rudowitz, Williams, Hinton, and Garfield in the article “Medicaid Financing: The Basics Medicaid is a countercyclical program, meaning that during economic downturns, more people become eligible and join, but at the same time, governments may incur income drops making it challenging to sustain the state component (Rudowitz, 2021). For example, to obtain Medicaid in California, seniors 65 and older must have a maximum annual income of $18,075 before taxes if the old lives by himself or herself. This is similar to Florida. However, in Texas, for a senior 65 and older living by him or herself to be eligible, his or/her maximum annual income before taxes should be $26,909.

On the other hand, the federal government manages the Medicare program and offers health insurance services to older adults. Medicare has part A (Hospital Insurance). This is constant nationwide, and coverage will be the same no matter what state the senior resides in. For part A: If the old o his or her spouse paid Medicare taxes for approximately ten years while working, the cost would be $0. They pay $278 or $506 a month if they are not eligible, depending on how many years they or their partner worked and contributed to Medicare taxes. The average price for staying in a skilled nursing facility is $0 co-payment for the first 20 days. After that, from days 21- 100, the senior pays $200 daily; if the time exceeds 100 days, the senior must pay all costs. For home health care, the cost is $0; however, for medical equipment such as hospital beds, walkers, and wheelchairs, the senior must pay 20%. Over 13 million Californians, one out of three, rely on Medicaid for health coverage. Contrarily, California’s number of Medicare beneficiaries increased by 11.3% from 5.8 million in 2016 to 6.5 million in 2021. In addition, starting in May 2022, California will be the first state in the union to grant low-income persons 50 years of age and older, regardless of immigration status, full-scope Medicare coverage. Suppose a veteran in California can demonstrate that they cannot afford the cost of a nursing home. Medicare may occasionally cover their long-term home and home care expenses in that case. The increased access to Medicare and Medicaid among elderly individuals in California, Texas, and Florida has significantly increased the demand for senior care jobs.

A study by Sherman et al. (2019) indicates that immigrants have a significant role in the US economy. Foreign-born individuals contribute to about a third of the working population in the US. They help respond to labor shortages for senior caregivers in different states. Their willingness to work and stamina helps them get hired hence helping respond to labor shortages, which in turn helps smoothen the gaps that could otherwise weaken the country’s economy. Sherman et al. (2019) explain that the immigrant workforce helps provide facility-based care to elderly individuals. The increased number of legal immigrant workforce in the senior care sector helps increase the number of workers in the country, which in turn helps boost the economy. The increased number of immigrant workforce in the senior care sector benefits the individual workers and their families and the overall US economy. Immigrants are vital in helping baby boomers with facility-based care services in their retirement years. Sherman et al. (2019) explains that the increased number of immigrants in the senior care economy dramatically helps improve the ratio of the working group versus the retirees. Were it not for the immigrant workforce in the senior care economy, there would be a lower number of working-age adults, which would affect the labor market, resulting in a decline in the country’s GDP. The New American Economy also points out that the immigrant workforce greatly benefits the senior care economy in Texas state (Lampert, 2019). Despite foreign-born individuals being about 18.7% of Texas’s population, they contribute to a quarter of the state’s working group. The contribution of the legal immigrant workforce is intensely felt by facilities that provide elderly care services. The increased labor supply from immigrants is helping meet the elderly care services for baby boomers. Immigrants are helping fill out lower-skilled senior care positions, increasing positions for highly skilled positions that native-born Americans mostly fill. Essentially, foreign-born workers in Texas fuel its economic growth and help create more opportunities for fellow immigrant workers and native-born US workers. In 2017, immigrant households in Texas had total earnings of $43.8 billion and contributed about $7.3 billion to federal taxes and $3.2 billion to the state (Lampert, 2019). The immigrant workforce in the senior care economy is increasingly contributing to the success of the Texas healthcare sector, which results in economic growth.

Moreover, the Pew Research Center has also examined the relationship between the immigrant workforce and the US economy. The research center indicates that since 2007, immigrants in different states have significantly contributed to the country’s labor force. Fig 2displays the estimates of the US labor force in 2007 and 2017. Thechart helps identify the percentage of change the immigrant workforce brought to the US labor force between 2007 and 2017. In 2017, 17% of the US labor force comprised immigrant workers. The fact that the immigrant workforce contributed to the rise of the US labor force indicates that immigrant workers have the potential to boost the country’s economy. The immigrant workforce is likely to continue increasing in the senior care sector due to the increasing rate of the elderly population in the country. By 2030, all baby boomers will be 65 years and above, meaning they will demand more elderly care services. Hiring more immigrants to provide senior care services means that the US labor force is expanding, resulting in a rise in the country’s GDP.

The increasing rate of immigrant workforce in California, Texas, and Florida also best explains why so many immigrants work in the senior care economy. As stated earlier, California, Texas, and Florida are the most populous states in the US. The three states have continuously contributed to a higher percentage of the US population. In 2015, about 27% of the US population was distributed in any of the three states. This percentage has increased over the years, whereby the three states continue to become more populous. Fig 3 indicates the share of the US population in the three states from the 1910s to 2015. As indicated, the population in the three states has been increasing rapidly throughout the years, which indicates that future three will be more repaid population growth. In the 1990s, the three states accounted for only 34% of the US population, which later increased to 38% in the 2000s.

Fig 3: Share of US population in California, Texas, and Florida.

A key reason that has contributed to the rapid population growth rate in California, Texas, and Florida is economic prowess which has attracted immigrants. The high concentration of documented and illegal immigrants in these states contributes to the high population growth rate.56% of legal immigrants live in California, Texas, and Florida. Comparing the three states, California has the highest percentage of legal immigrants, followed by Florida and Texas. The Pew Research Center analyzed the US population in 2018 to determine the number of immigrants eligible for voting in different US states. Their research shows that California leads with the most eligible voters, followed by New York, Florida, and Texas. Their research shows that Texas, California, and Florida have the highest percentage of immigrants in the US Fig 4 indicates the legal immigrant population in millions. As indicated, California leads with a population of 5-5 million legal immigrants, followed by Florida with 205 million and Texas with 108 million immigrants. From the chart, it is thus evident that among all states in the US, Texas, California, and Florida have the highest number of foreign-born individuals. These immigrants have different origins, including Mexico, the Philippines, Vietnam, China, Jamaica, and India.

Fig 4: Legal Immigrant Population in US

The increasing number of immigrants in Texas, California, and Florida has greatly helped address the increased demand for senior care due to the increasingly aging population. As earlier mentioned, immigrant workers are increasingly providing elderly care to old [people. The three states have the highest number of older adults, just as their population is high. The high number of immigrants has helped meet the increasing demand for senior care. The supply of jobs has increased with the increasing number of immigrants in the U.S. Orrenius et al. (2020) conducted a study to determine how immigration affects the US labor force. The study anticipates that the US GDP rate will likely remain lower over the coming years due to various reasons, including low productivity, the mismatch between native-born workers’ skills and those needed by employers, and an imbalance between retirees and the working-age group. The study indicates that documenting more immigrants will help address this economic menace and help boost the US labor force and economy. The study admits that documentation of immigrants comes with additional costs that make people view it as unnecessary and a threat to the country’s economy. However, the costs of documenting immigrants are worth the benefits they bring to the US economy. Legal immigrants can enter the US labor force, providing both skilled and nonskilled labor, which significantly contributes to the growth of the country’s GDP.

The study places much concern on the increasingly aging population resulting from the declining US labor force. The increased number the elderly in California, Texas, and Florida is making the US move towards a future for old workers. Most baby boomers have reached retirement age, and all will be retirees in the next few years. The working-age population is declining and is more likely to decline in the near future. Orrenius et al. (2020) express their concern about the danger that awaits the US if nothing is done to counter the declining labor force in the US. They emphasize that employing immigrant workers to replace the aging workers in different sectors, including healthcare, will help address the menace that awaits the US Immigrant workforce in healthcare. Other sectors will raise the US labor force, contributing to DGP growth.

Bruce-Tagoe (2022) also conducted a study to determine the impact of the immigrant workforce on the US labor force. The study uses a dataset from seven states: Texas, California, Massachusetts, New Jersey, Florida, New York, and Illinois. The dataset reveals that the seven states have the highest rate of immigrant workers. These workers help increase labor supply in different sectors of the US, including the healthcare sector, whereby more facility-based senior caregivers are needed. The study has acknowledged how some people view immigrant workers as threatening American jobs. However, it emphasizes the positive side of it, whereby immigrant workers help raise the country’s GDP. Immigrants positively influence the country’s labor market by reducing unemployment. As they take up lower-skilled jobs, they help create more opportunities whereby native-born Americans fill the highly skilled positions.

Synthesis of Literature Findings

Several studies have been conducted on the growing rate of the aging population and immigrant workers in the US. The aging population is growing alarmingly and is expected to grow more as all baby boomers will be 65 years and above. The growing rate of the elderly has led to increased hiring of the immigrant workforce to help provide senior care services to this population. The existing literature has explained the relationship between the increased immigrant workforce in the US labor market and the US economy. Immigrant workers are expanding the US labor market, helping raise the country’s GDP. Immigrant workers are helping address labor shortages in different sectors, including the increased demand for senior care. Existing literature has failed to focus on the legal immigrant workforce in the senior economy. Little study has been conducted to ascertain how the legal immigrant workforce providing senior care services in California, Texas, and Florida will affect the economic progress of the United States. Also, the existing literature creates a dilemma regarding legal immigrants’ impacts on the US economy, with some arguing that the demand for senior care will rise.

In contrast, the supply of jobs will decrease, and others state that the increased use of immigrant labor in senior care will create a balance between the demand for senior care and the supply of jobs. This study helps address this dilemma, which is a gap in the literature concerning the senior legal immigrant workforce and the US economy. It complements the existing literature to help determine whether GDP has increased or decreased over the years based on the legal immigrant workforce in the senior care economy. The study focuses on California, Texas, and Florida because they are the most populous states and are key determiners of the US economy. They also have the highest population of legal immigrants and a high number of the aged population. The study integrates economic growth and human capital theories to derive conclusions from the existing literature and help address the gap.

Summary

The issue of the rate of immigrants in the US, the elderly population, and the US economy compared to the immigrant workforce are key themes addressed in this literature review section. The immigrant population is increasing alarmingly in California, Texas, and Florida. Documentation of immigrants has become easy hence the increased number of foreign-born individuals in the United States. This has contributed to the already high population in California, Texas, and Florida. Also, the elderly population is increasing ad is projected to grow higher in the coming years. Most of the baby boomers’ generation is 65 years and above. In the coming years, they will all have attained retirement age, contributing to an increased rate of the elderly population. An increasing number of individuals with 65 years and above has raised the demand for senior care jobs. The elderly deserves facility-based care from healthcare providers to age gracefully. Different US states highly rely on the immigrant workforce to provide senior care services to their age population. Immigrants are always willing to work under extreme conditions and accept lower wages than native-born workers. Also, the senior care sector’s immigrant workforce helps address the cultural divert issue by eliminating language and communication barriers. The US labor market has experienced enormous over the recent years due to the increased number of immigrant workers in the US. Although some researchers expressed concerns about the dangers hiring immigrants would bring to the US economy, most have explained that it will boost the country’s economy. In some sense, hiring immigrant workers means taking away American jobs. However, doing so helps increase the number of employed individuals in the US, contributing to the country’s GDP. With this available literature, the study will make concise conclusions regarding the impact of the immigrant workforce in the senior care economy.

Chapter 3: Research Method

Impacts of legal immigrants in the senior care sector on the US economy in terms of GDP and labor demand and supply from the states of California, Texas, and Florida. The two research questions are.

Over the recent year, has the GDP increased or decreased based on the legal immigrant workforce in the senior care economy?

Has the amount of jobs supply and senior care demand increased or decreased over the recent years?

Introduction

In this section of the paper, the focus will be to portray some statistics of immigrants in the States of California, Florida, and Texas. The main issue addressed will be the impact of immigrants on the senior care sector. This section will discuss quantitative information on how the GDP of each state has either decreased or increased based on immigrant work in the senior care economy. It will also discuss the amount of supply and demand, has it decreased or increased over the years?

The section outlines the rationale that has been used for this research approach. It also outlines how the methodology part will be addressed to arrive at the answers of the two questions. In addition, this section outlines the measures and parameters that will be used to come into useful conclusion in regard to the hypothesis and the research questions. Further, the validity of the research and the methods used herein will be evaluated to ensure credible research. moreover, the section will list the number of ethical considerations that has been undertaken in this project.

The rationale for the Research Approach

A research design is the specific methods a researcher uses to collect, analyze, and interpret data. It is usually utilized in any research, and it serves as a master plan that comprises different methods and procedures for collecting and analyzing data needed to establish clear answers to the research questions. Thus, a research design used in specific research determines the procedures and methods used to collect the required data and analyze it. This research case study utilizes a quantitative research design. Quantitative research design entails the collection of numerical data and analyzing it to test a hypothesis or come up with a relationship between the data. It aims at establishing answers to who, what, where, how, and when questions throughout the course of research. The results obtained through quantitative research are presented in the form of charts, graphs, and statistics hence making it easy for people to understand the results through observation, without having to read through so many materials as it is with qualitative research design. The use of quantitative research in this study will make it possible to establish the impact of legal immigrants in the senior care economy.

The study employs various quantitative research methodologies including descriptive research, correlational research, and survey research. Descriptive research entails the investigation of one or more variables to describe a situation, population, or phenomenon. It seeks to determine or describe the status of the identified variables. In this research, descriptive research was used to describe the US economy and legal immigrants in the senior care economy. Describing the existing status and changes that have occurred over the recent years were crucial in coming up with conclusions on changes that have taken place over the years and thus help establish the impact legal immigrant workforce in the US economy. The study design also utilized correlational research which entails determining the relationship between different variables using statistical data. The use of statistical data to determine the relationship between variables helps identify patterns and trends in the data obtained. Correlational research was used to establish the relationship between the legal immigrants in the senior care economy and the overall US economy. It was used to collect relevant data on the number of immigrants in Texas, California, and Florida and establish how this affects the US economy. Through correlational research, it was possible to determine the relationship between the GDP of the three states and the legal immigrants in those states. The data obtained here helped identify the patterns in the GDP of the three states over the recent years based on the legal immigrant workforce in the senior care economy.

The study also utilized survey research to help come up with concise answers to the research questions. Survey research entails the collection of data from a sample population through questionnaires or interviews. The study utilized online surveys whereby different questionnaires were sent to the sample population. The data obtained from the online surveys helped come up with information regarding the trends in the US economy over the recent years, the number of legal immigrant workers in Texas, California, and Florida, and the level of senior care demand in the US. The responses from the online surveys provided insightful information that made it possible to come up with conclusions on the GDP of the three states regarding the legal immigrant workforce.

Quantitative research design is relevant for this study since it involves the presentation of data obtained in statistical form, charts, data, and numbers. The study entails determining the impact of the senior care immigrant workforce on the US economy and to establish this, the study is guided by two research questions. The research questions entail determining whether GDP has declined or increased over the recent years and establishing whether the amount of job supply and senior care demand has declined or increased. Quantitative research design plays a significant role in this study as it helps obtain statistical data needed to come up with concise answers to the study questions. The use of quantitative research methodologies including descriptive research, correlational research and survey research in this study helped come up with the charts and graphs included here. The research methodologies employed helped come up with statistical data which is relevant to the research questions since they also require statistical data.

Methodology

Population or Data

The study focused on three US states as the study population. It focused on Texas, California, and Florida, to obtain data on the impact of the senior care immigrant workforce on the US economy. Since the study did not involve real experiments, online surveys were used to obtain information whereby questionnaires were sent to people from these states for them to fill out information regarding the number of immigrants in their states and their income levels. Thus, the study did not involve dealing with the whole population. Texas, California, and Florida acted as the study population for this study since the three states greatly contribute to the US economy. They are more highly populated than other states and have the highest number of legal immigrants and an aging population, hence making the states an appropriate study population for this study. California, Texas, and Florida contribute the highest percentage to the US GDP. Thus, the study uses the three states as the study population since it helps come up with concise answers to the research questions and establishes the impact of the senior care immigrant workforce on the US economy.

Sampling and Sampling Procedures

The sample population used for online surveys in the study was selected through simple random sampling whereby all individuals in Texas, California, and Florida had equal chances of responding to the questionnaires. The questionnaires were structured such that individuals could answer questions on their income, the possibility of having a senior who uses care, the supply of jobs and demand for senior care, and the overall view of senior care in the three states. Thus, the online surveys did not target a specific population in the three states. Instead, all individuals in the three states had equal chances of responding to the survey questions. The only inclusion criteria that were used in the study is that the sample population had to come from Texas, California, or Florida and is focused on states that contribute the highest to the US economy and states with the highest number of aging population and legal immigrants. Additionally, the various data sources that were reviewed in this study to help describe the impact of the senior care immigrant workforce on the US economy were selected based on the criteria that they all address the issue of the US economy and legal immigrants. Given that the study focused on Texas, California, and Florida, the study materials were also anchored on the three states for them to be included in this study.

Data Analysis Plan

The two research questions are:

Over the years, has GDP increased or decreased based on the legal immigrant work in the senior care economy.
Has the amount of supply(jobs) and demand (senior care) increased or decreased?

In this research work, several software will be useful. One of them is Excel which will be widely used to derive graphs, pie charts, and other graphics necessary in coming up with definitive conclusions on which to base the hypothesis. In addition to Excel, the SPSS package will be critical in the analysis of data. it will also be useful in compiling descriptive data as well as graphical depictions of the results through its interface.

Data cleaning and screening procedure is the other face that requires special attention. Carrying out statistical analysis is one thing while using the right data to do the analysis is the other. Using the excel sheet, it will be possible to critically look at the data and see those that require fixing or removal. The incorrect, duplicate, or incomplete data from the various sets will also be cleaned. For instance, in the case of California, it’s clear to see some data is duplicated or incomplete it will require sorting. Besides, using a comparative procedure, it will be possible to determine which source had more accurate data and those that required to be discarded.

With the two research questions, there will need to use appropriate tests to determine whether our hypotheses are plausible or otherwise. If the statistical tests showed enough evidence on a given issue, we shall use that to accept the null hypothesis. If the statistical tests say otherwise, the verdict would be to reject the null hypothesis.

Being a one-sided test of hypothesis, our first null hypothesis will be over the years, the GDP has increased due to legal immigrant work in the senior care economy. A positive statement insinuating that the GDP has had a positive impact on the economy. On the other hand, the alternative hypothesis is over the years, the GDP has decreased due to legal immigrant work in the senior care economy. This is a negative statement indicating that the GDP has not had an upward trajectory even with respect to legal immigration.

Equally, the other hypothesis that needed to be determined is the supply of jobs and demand for senior care has increased over the years. The alternate hypothesis will negate this by indicating that there has been a decline instead. Again, this will be a one-sided hypothesis testing that needs to be evaluated and will be central attention to this research.

To facilitate this, a number of tools will assist in coming to conclusions. Mainly, simple regression analysis will be used to compare legal immigration input versus the GDP over the years. The explanatory variable, in this case, will be the legal immigration in the three states while the GDP will be the dependent variable. This regression analysis will indicate whether there is a change in the dependent variable as a consequence of the change in the explanatory one.

If a direct relationship is established between the independent and dependent variable, we shall determine that the increase in legal migration leads to an increase in the GDP of the given state. Say for instance, if in California the GDP is rising over the years in correspondence to the increasing legal immigration then this is a direct relationship. This is the same with other states of Texas and Florida. If the relevant GDP is declining over the years as legal immigration is increasing, then there shall be an inverse relationship between the two variables. Using either the case, it will be possible to reject or fail to reject the null hypothesis.

Using the same simple regression, it will be possible to determine whether there has been an increase or a decrease in the number of job supply and demand for healthcare workers. Just as is the case with GDP, a direct relationship between jobs and demand for senior care with the increase in legal immigration will serve to support the second question at hand.

Another statistical test that will be used in this research is correlation analysis. In correlation analysis, the degree of association between two variables is evaluated. A correlation coefficient, which ranges from -1 to 1 indicates the direction and strength of the association. For a positive correlation coefficient, the association is shown by a positive number while a negative number indicates a reverse relationship/ association. In a positive correlation, the coefficient is positive, and it indicates that as the number of legal immigrants entering the job market is increasing the GDP increases too. If the relationship is negative, then the coefficient will be negative which suggests that as the number of legal immigrants in the senior care labor force increases, the GDP will tend to move in the opposite direction.

In addition to the correlation analysis and the regression analysis, the research may also employ multiple regression analysis where the level of GDP will be determined not only using one variable but a number of items. The variables included will range from the education level, skill level, and wage level of the immigrant. Some other factors such as government policies and the rate of unemployment may not be used in the regression analysis and will be treated as compounding factors.

As suggested above, to test the hypothesis, different parameters will be used. For the correlation analysis, a Pearson correlation coefficient will be calculated to indicate the direction and strength of the relationship between the GDP and the legal immigration in the three states. the same will be done for the supply and demand hypothesis. For the regression analysis, a fitness fit line is drawn to show whether the data has a positive relationship or otherwise. For the multiple regression analysis, a correlation matrix that can help identify whether there is a correlation between more variables will be utilized. Using these parameters, it will then be possible to identify the relationship that exists between legal immigration in senior health care and the GDP of the country.

Some of the assumptions while doing the statistical tests are as follows for the first hypothesis.

That the wages of the legal immigrants have either increased or decreased over the given period of time.
Other factors such as the changes in economic conditions or government policies have not significantly affected the GDP over time.
The senior care industry has correspondingly changed as it affects the GDP.

On the second hypothesis, the following assumptions are handy;

The senior population has indeed increased or decreased over the years which has led to the demand for senior care services.
Again, the number of legal immigrants has increased or decreased which affects the supply of jobs.
Also, the policies and the economic conditions have not really been significant in affecting the supply and demand in the senior care industry.
Moreover, as the supply and demand in senior care shifted, the quality of the care services has remained constant.

Trustworthiness

External Validity

External validity is a critical issue of concern in research since it determines the degree to which results obtained from a study can be generalized to other situations, events, or groups. It tells how accurate the data obtained from a study is and conclusions made from the data can be applied to the larger population or situation. The external validity of this study determines whether the conclusion made concerning the impact of the senior care immigrant workforce on the US economy can be precisely applied to other countries. The external validity of this study also determines whether the data patterns concerning the GDP of Texas, California, and Florida in relation to the legal immigrant workforce can be applied to all states in the US.

There exist various threats to external validity including effects of testing reactivity, specificity of variables, reactive effects of experimental arrangements, and multiple-treatment interference. A key threat to the external validity of this study is the interaction of time and treatment effects, whereby the results from a study may not be appropriate for application to the general population for a longer period of time. This is a key threat because the study deals with demographic data including the number of the aging population in Texas, California, and Florida. Also, the study deals with data concerning GDP changes, and the legal immigrant workforce in the senior care sector. Such data changes over time and the changes can at times turn out to be the opposite of what the study has approximated. Therefore, the interaction of time and treatment effects serves as a key threat to external validity in this study. Sampling bias and researcher bias are also possible threats to external validity in this study. The sample population in this study, which includes Texas, California, and Florida, may not be representative of the entire population, hence interfering with the external validity of data and conclusions obtained from this study. Researcher bias is another possible threat to external validity whereby the researcher ‘s characteristics and behaviors interfere with the analysis of secondary data sources. It is likely that the study conclusions may be made based on the researcher’s knowledge and characteristics hence influencing the external validity of the results obtained.

The study has focused on eliminating threats to external validity in all ways possible. For the interaction of time and treatment effects threat, the study intends to conduct the research for a specified period of time to ensure that the results obtained do not change over time. Concerning the secondary sources of data, the article reviews and books with varied time intervals to ensure that the conclusions made are accurate and free from the interaction of time and treatment effects threat. To avoid researcher bias, the study has integrated different research methods. Utilizing different research methods helps ensure that the results obtained are accurate and free from researcher bias. Also, the study utilized peer review to help reduce researcher bias. The findings of the study were open to peer review and are still open to peer review. Asking other people to review the study findings will greatly contribute to the clarity of the data obtained. It will help identify any gaps in the study that needs to be addressed before making a final conclusion hence eliminating researcher bias, which is a possible external validity threat in this study. The study seeks to eliminate all possible threats to external validity to ensure that its findings can be applied to other states.

Internal Validity

Internal validity is also an issue of concern in any given research. It determines the extent to which the study approach and analysis respond to the research questions. Internal validity tells extent to which the research study results represent the truth in population under study. There exist various threats to internal validity including history, maturation, statistical regression, experimental mortality, and selection-maturation interaction. History is a possible threat to internal validity in this threat since it entails influence of research by unrelated events. For instance, if the study materials stored in different software get lost before making conclusions on impact of senior care legal immigrant workforce to the United States, it means the results obtained will be inaccurate. Also, unrelated events such as failure of study population to respond to online surveys due to sickness or any other reason, then the internal validity of the study results will be at risk. Another threat to internal validity of this research is maturation. Research conducted for a lengthy period of time is prone to maturation whereby the study outcomes may be affected by time changes. It is challenging to tell how time factor affects study results and this interferes with internal validity. The study has established some measures to eliminate possible threats to internal validity. The study intends to take place within the shortest time possible to eliminate the likelihood of history threat. Having the research happen within a short period of time means that no significant history changes will have happened within that time hence helping improve the internal validity for the results obtained. Also, conducting the research within a short period helps ensure that maturation is not a threat.

Construct Validity

In research, researchers can use measures such as construct validity to validate their experiments and tests. Construct validity entails the extent to which inferences can correctly be made from a research study. It tells whether a study is conducted in a manner that it successfully responds to the study question and whether a test is constructed in a manner that it accurately tests what it is supposed to. The study involves conducting online surveys to help collect relevant data to determine the impact of senior care immigrant workforce to the US economy. The study is concerned more about statistical data to help respond to the research questions and achieve the study objectives and goals. Making statistical conclusion is prone to different construct validity threats including unreliability of measures, violated assumptions of the test statistics, and hypothesis guessing. Hypothesis guessing happens because researchers make inferences about the data obtained based on what they guess is correct. To eliminate this threat, the study focuses on making inferences based on the research findings rather than on the researcher’s views. The study intends to integrate different research methods to ensure that the statistical data obtained is accurate and so the conclusions made from the data.

Ethical Considerations

Undoubtedly, research that involves contact with human subjects requires a given level of ethical consideration. In most cases, the Institutional review board plays an important role in reviewing and even approving any research that involves humans as subjects. In this study, an application to the committee will be written. in it, we shall address the study protocols and the written consents that we shall use with the participants. All this is aimed at ensuring that the necessary approvals are met and the study adheres to ethical and regulatory standards.

Further, the issue of recruitment materials and processes needs to be keenly looked at. One of them is the discrimination aspect. The recruitment materials and process ought not to discriminate against anyone especially based on race, gender, and other characteristics as proposed by law. Besides, the materials should adhere to justifiable information and should not contain false information that has the possibility of deceiving the applicants. Also, these materials should not contain any language or imagery that is inappropriate, offensive, or discriminatory. They should also not purport to invade the privacy of the applicants.

To ensure that these concerns are looked at, it is important to create a clear and comprehensive policy that guides recruitment materials and processes. These commitments should be adhered to and complied with. Also, it would be important to train the recruiters on using the appropriate language and facilitate a respectful process. monitoring and regular evaluation would form the hallmark of ensuring that the recruitment materials and processes are doing well as expected.

As is the case with interactions with participants, ethical concerns will be a key issue. In this research, informed consent will form a pivotal role in ensuring that the participants understand the role they will play in the research in addition, privacy and confidentiality will be important while respect for the autonomy of the participants will be held with the utmost regard. In case of any adverse event such that the participant wants to withdraw from the project, their will shall be held as a priority.

For data treatment, it will be important to ensure that all the data that has been collected is kept in confidence and shall be treated with autonomy. In addition, the data collected from the participants will not contain their names which protects their privacy. Any sensitive information will also be discarded and destroyed after the research. If a participant so wishes to have their information not kept, the researchers will equally do the same.

In case of any stored data, the necessity to ensure that it is stored in the right procedures and in the right places overrules the plan. Data shall only be stored in secure disks and shall only be disseminated to appropriate persons. The IRB might want to review the data, and they shall have access to it. Not many other people might have access to this data.

Other ethical concerns include the possibility of conflict of interests or power differentials. This study will adhere to its objectives, have the right procedures followed and no conflict of interests shall be tolerated while at it. The study may also consider the use of incentives that will help in attracting participants and meeting the required target over the given time. A 20-dollar incentive for everyone who completes the interview will be considered to ensure we complete the survey.

Summary

Summarily, the design and methodology part are an integral part of any research. It informs the procedures, the plan, and the overall path that will be used to carry out the research. If this section is not well orchestrated, the research will not come to fruition whatsoever.

For the research, we shall use quantitative methodologies to come to our conclusions. using the available secondary and government resources, we shall be able to obtain the data. further, a survey containing a questionnaire will be administered to the citizens of Texas, California, and Florida to help determine the extent to which legal immigrants affect the GDP of the economy. With all the information, this research will then utilize simple regression, correlation analysis, and multiple regression to come up with the relationship between the independent and dependent variables. On this, the main concern is to establish whether there is an association between GDP and the legal immigrant’s labor force. While a number of factors may confound the experiment, this research will assume that such factors do not have a profound effect on the results. Such factors include government policies, economic conditions, etc.

Assuredly, the research will pay attention to the external and internal validity of the whole process to underscore its applicability to the larger region. In addition, ethical considerations such as informed consent, privacy, confidentiality, and respect to autonomy will be assured. All this will ensure that the project is meaningful and has been done in the right manner.

Chapter 4: Results

Introduction

The analysis, presentation, and interpretation of the data will be covered in this chapter. The influence that immigrants have had on the field of senior care will be the primary topic of discussion. In this section, we will provide quantitative information on how each state’s gross domestic product (GDP) has either declined or increased as a direct result of the participation of immigrants in the senior care market. It will provide responses to the following research questions:

a) “Has the GDP risen or declined over the recent years due to the legal immigrant workforce in the senior care economy?”
B) “Over the recent year, has the supply for jobs and demand for senior care risen or declined?”

In addition, this section will test the hypotheses of the research. The research hypotheses include the following:

First Hypotheses:

Null hypothesis: “Gross Domestic Product has risen over the years due to legal immigrant work in the economy of senior care.”

Alternative hypothesis: “Gross Domestic Product has declined over the years due to legal immigrant work in the economy of senior care.”

Second hypotheses:

Null hypothesis: “Over the years, job supply and demand for senior care has risen.”

Alternate hypothesis: “Job supply and demand for senior care has declined over the years.”

Correlation analysis is another statistical test which will be utilized in the analysis process. The purpose of this test is to establish whether the link between GDP and number of lawful immigrants in the three states is positive or negative. A Pearson’s correlation coefficient will be computed to establish the nature and extent of the connection that exists between the GDP and the number of people who entered the country legally in each of the states of California, Florida, and Texas. Similarly, we will test hypothesis of demand and supply. In addition, multiple regression analysis will be used, in which the level of GDP will be determined not just by one variable but by some different factors. The degree of education of the immigrant will be included as a factor in this analysis.

Data Results

We surveyed several literatures for one month on immigration in the US, focusing on three states: California, Florida, and Texas. We obtained data on the USA’s legal immigrants for senior workers in 2018 and their GDP from American Immigration Council (2020), California, AIC (2020), Florida, and AIC (2020) Texas. We encountered challenges in obtaining immigration information on the supply and demand of senior health care. We, therefore, consulted other websites for data, such as Google, to obtain demands and supply per individual state. The general demographic results included the following:

Demographic information

Immigrants in California

In 2018, immigrants made up 27 percent of the total population, totaling 10.6 million people. There were 5.3 million foreign-born females, 4.9 million males, and 421 thousand and twenty-five minors living in California. “Mexico was the most common country of origin for immigrants (38%), followed by the Philippines (8%), China (7%), India (5%), and Vietnam (5%).” At least 9.6 million Californians were born in the United States to immigrant parents in 2018. This represented 24 percent of the state’s total population. In California, legalization rates are significantly higher than the national average. As of 2018, 5.6 million immigrants had naturalized, while 2.2 million were in the process of becoming naturalized US citizens in 2017. Sixty-nine percent of immigrants rated their command of the language as “well” or “very well.”

The educational backgrounds of California’s immigrant population tend to fall on two extremes. In 2018, nearly a third (32%) of adult immigrants did not have any formal education beyond high school, while nearly a quarter (29%) had some college (AIC 2020).

There are more than 2 million US citizens in California who have an undocumented family member. In 2016, 2.2 million people in the United States were living in the country illegally, making up 20% of the immigrants and 6% of the entire state population. Between 2010 and 2014, at least one illegal family member was present in the homes of 4.7 million Californians, including 2.4 million US citizens. Nearly 1.7 million children in the state at the time were US citizens living with at least one non legal family member, making up nearly 20% of the state’s youth population. “More than 183,000 people who qualified for Deferred Action for Childhood Arrivals live in the Golden State.” As of March 2020, over 183,460 DACA holders were residing in California, with a total of approximately 238,432 having received DACA since 2012.

One in three Californians in the workforce were immigrants, and they were an integral element of the state’s economy across many sectors. In 2018, 33 percent of the workforce was made up of immigrants, who numbered 6.6 million. The healthcare field had an increase of 882041 workers in California (Zhang et al., 2020).

In 2018, $80.8 billion was paid to the federal government by immigrant-led households and $38.9 billion was paid to the state and local governments. “In 2018, undocumented immigrants in California contributed an estimated $2.5 billion in state and local taxes on top of the $4.5 billion they paid in federal taxes, while DACA enrollees and DACA-eligible persons in California contributed $497.6 million to the local and state governments.”

Immigrants in Florida

More than 20% of Floridians were born outside the United States, and 1 in 8 Floridians are US citizens of immigrant parentage. In 2018, immigrants made up 21 percent of the total population or 4.5 million people. There were 2,250,000 foreign-born women, 2,000,000 foreign-born males, and 247,316 foreign-born children in Florida.

The countries where most immigrants came from were; “Cuba, Haiti, Colombia, Mexico, and Jamaica.” More than half of all immigrants in Florida are legal US citizens (AIC, 2020). In 2017, roughly 759,614 foreign nationals met the requirements to apply for US citizenship; of those, 2.5 million had already naturalized as of 2018. Immigrants in Florida represent a wide range of backgrounds and educational attainment. Roughly a fifth of adult immigrants in the United States in 2018 did not finish high school, while roughly a third of them earned a bachelor’s degree or above. About a quarter of Florida’s workforce is foreign-born, and they’re vital to the state’s success in many fields. Florida reported growth in the health care sector as 417607.

In 2018, immigrant households paid 23.2 and 8.5 billion to the federal government and to the state and local governments respectively. About $77.6 million was contributed to Florida’s state and municipal governments by DACA holders and DACA-eligible persons in 2018. Immigrants spend almost $100 billion annually in the state of Florida. In 2018, households headed by immigrants in Florida had $98.5 billion in discretionary income.

Immigrants in Texas

The bulk of Texans’ immigrant ancestors came from Mexico, and that trend has continued for quite some time. A sixth of the state’s total number of people is foreign-born, and they contribute to the economy in a wide range of sectors. One in six Texans is foreign-born, while another is a US citizen whose parents came from other countries.

In 2018, foreigners accounted for 4.9% of the total population. There were 2.33 million immigrant adults and 319,331 immigrant children living in Texas. 51% of immigrants came from “Mexico, India, El Salvador, Vietnam, and Honduras.” Over one in six Texans or 4.5 million people, were born in the United States to immigrant parents. In Texas, naturalization rates are significantly higher than the national average.

As of 2018, 1.9 million immigrants had been legalized, while 957,647 were eligible to naturalize in 2017. Texas has high- and low-educated immigrants. In 2018, twenty six percent of older immigrants owned college degrees or higher, while thirty seven percent had less than a high school diploma.

Families headed by immigrants contributed 26.3 billion to the federal government and 12.3 billion to state and local governments in 2018 (AIC, 2020). Taxes paid in 2018 by unauthorized immigrants in Texas were 2.6 billion dollars at the federal level and 1.6 billion dollars to the state and local governments. In 2018, those who received DACA and those who were eligible to apply for DACA in Texas paid the state and local governments 244.7 million dollars. Over $100 billion is spent annually in Texas because of immigrants. In 2018, immigrant-headed households in Texas had a purchasing power of $112.8 billion.

Data representation in tables and pie charts for easier data analysis

US COUNTIES	Legal immigration for senior care workers increases from 2017	GDP (billion)
California	882041	16
Florida	417067	4.5
TEXAS	353951	4.1

Table 1: A table showing each state’s legal immigration in senior health care and GDP.

Figure 1: A pie chart showing GDP growth.

Us counties	College degree or more	Some college	High school diploma	Less than a school diploma	GDP (billions)
California	255,792	167,588	176,408	282,253	16
Florida	120,949	95,925	116,779	83,413	4.5
Texas	92,027	56,632	70790	130962	4.1

Table 2: “A Table showing each state’s legal immigration in senior health care based on their college degree, some college, high school diploma, and less than a school diploma and GDP.”

Us counties	Legal immigrants in senior care Increase from 2017	Supply of jobs and Demand for senior care
California	882041	1142041
Florida	417067	517067
Texas	353951	499200

Table 3: A table showing the legal immigrants in senior care increase and their effect on supply and demand for senior care.

Figure 2: A pie chart showing supply and demand for jobs in senior care in California, Florida, and Texas

Data Analysis

First Hypothesis testing

Null hypothesis (H0): “The GDP has increased due to legal immigration workers in the senior care sector.”

Alternate (H1): “The GDP has decreased due to legal immigration workers in the senior care economy.”

Graph 1: Scatter plot showing GDP against legal immigrants in senior care.

Multiple Linear Regression

We inputted the data results from Table 2 in Excel and used ANOVA to analyze the data results using multiple linear regression. We obtained the following statistics.

Correlation matrix

	college degree or more	some college	high school diploma	less than a school diploma	GDP
College degree or more	1
Some college	0.981906	1
High school diploma	0.960232	0.99573	1
Less than a school diploma	0.922136	0.832191	0.777451	1
GDP	0.990683	0.946968	0.913262	0.966230902	1

Figure 4: “A correlation matrix of (GDP) and the independent variables college degree or more, Some college, high school diploma, and less than a high school diploma.”

Second Hypothesis Testing

Null Hypothesis (H0): “The number of immigrants in USUS senior care has increased demand and supply for senior care.”

The alternate hypothesis (H1): “The number of immigrants in USUS senior care has decreased the demand and supply of senior care.”

Graph 2: Linear Scatter plot of legal immigrants’ growth in US states to Supply of jobs and demand for senior care.

Correlation analysis

From our regression Figure 5, the correlation coefficient (multiple R) is 0.996369, which is positive.

Interpretation

The graph 2 above showed a positive relationship between legal immigrants’ growth in senior care and the supply of jobs and demand for senior care.

From the linear regression figure 5, Y represented our dependent variable supply and demand for senior care workforce in US states, while X₁ represented our independent variable, legal immigrants in the aged care sector. Comparing our p-value (0.05426) to the significance p-value of .05, our p-value was above 0.05. A p-value above .05 necessitates acceptance of the null hypothesis (Alkarkhi et al., 2020). We, therefore, accepted the null hypothesis that “the supply for jobs and demand for senior care workforce has increased due to the immigrants increase in the senior care sector.” R-square was .9928 meaning we could explain 99% of the results.

From the correlation analysis, 0.996369 was positive and strong since it was near+1, which is strong (Zhuo et al., 2022). This suggested a strong positive correlation between our dependent variable, supply and demand for senior care workforce in US states and our independent variable, legal immigrants in the senior care sector.

Summary

The data analysis provided answers to the research questions by testing the hypotheses. We accepted both null hypotheses that“the GDP has increased due to legal immigrant work in the senior care economy” over the years and that “the supply of jobs and demand for senior care has increased over the years due to legal immigrant work in the senior care economy.” Orrenius et al. found similar results that an increase in immigration leads to an increase in the supply and demand of workers; thus, our results support the evidence from the literature review.

Chapter 5:Summary and Conclusion

Introduction

The problem getting addressed is to investigate the impact of the immigrant workforce in the senior care economy in the United States (U.S.) GDP and the supply of jobs and demand for senior care. A growing population of baby boomers aged 65 years and above need healthcare provisions at different times to support their wellbeing. Thus, the mandatory need for senior caregivers increases. The U.S. is gradually getting presented with a need for senior caregivers. Yet, the immigrant workforce is the one that provides the most population of such workers in California, Texas, and Florida (New American Economy Research Fund, 2020). The results of this study can be underestimated because there needs to be a proper review of all illegal immigrants who work in the senior care sector. Shortages of paid caregivers increase, influencing immigrants to play a critical role in assisting the ageing population while serving them in nursing homes and using in-home care settings.

SummaryoftheResults

Analysis of the influence of immigrants in the field of senior care is imperative since it supports an advanced method of supporting the workforce. The study got performed using two main research questions whereby the first one sought to find out if the country’s GDP rose or declined due to the existence of a legal immigrant workforce in the senior care economy. In contrast, the second research question sought to find out the measure of supply and demand for jobs in the senior care industry. Regulation of the research questions was performed using null and alternative hypotheses, which created a proper statistical review of how the research questions adhered to the main study topic of immigrants working in the senior care industry. Immigrants in different states had varying education levels, including having a college degree or more, being graduates of some college, having a high school diploma, and having less than a high school diploma.

The study’s research questions were answered using a testing hypothesis which illustrates how advanced reviews of the study topic got performed. The research design involved a survey of other literature that integrated data from California, Florida, and Texas and statistical data from websites on Google to determine demographic details about the state. According to 2018 research data in California, it was discovered that immigrants constituted a total of 27% of the state’s population which means 10.6 million people, including 4.9 million females and 5.3 million males. Most of them came from Mexico, the Philippines, India, Vietnam, and China. In Florida, data from 2018 illustrated that 21% of the population, which was 4.5 million, accounted for immigrants, most of which came from Cuba, Haiti, Colombia, Mexico, and Jamaica. In Texas, data from 2018 indicated that immigrants accounted for 4.9% of the population, which was 2.33 million people, mainly from Mexico. The legality of the immigrants could not be guaranteed since many were undocumented and lived with fellow immigrants who did not report them.

Using multiple linear regression working on the research questions, it was possible to discover that most immigrants had a high school diploma. A positive correlation was found between the dependent variable, supply and demand for the senior care workforce, and the independent variable, which is legal immigrants working in the senior care sector. Statistical review using a linear scatter plot illustrated how the immigrant population increased concurrently with an increase in the senior citizens’ population.

Interpretation of Findings

Legal immigrants are essential because they help grow the economy by paying taxes. The contention that immigrants do not pay taxes and are a net drain on services is a myth. The immigrants are very committed to paying their taxes, which helps in growing the economy of the host countries and states. The immigrants are very committed to paying their taxes, which helps boost the host countries’ economies. An increase in the host countries’ productivity has been noted due to the immigrants getting in, and when senior citizens’ health is the focus of many legal immigrants’ work, the resultant outcome is a reliable work environment. This is because they bring new skills and new energy and strike a balance in the workforce. Immigration helps facilitate cross-border social and economic ties between countries, increasing the mobility of ideas and technologies.

Immigrants in Texas, Florida, and California promote advanced citizen management procedures that allow productive methods of promoting each state’s GDP. There are many concerns revolving around immigration regarding the potential adverse effects of immigration if the immigrants are not legal. The immigrant workforce affects employment and wages for low-skilled workers since there is an advanced contribution of immigration to the economy and the labor market. Local residents promote collaboration with legal immigrants by allowing job security to be performed appropriately. Senior healthcare organizations can seek to gain more profit while maximizing available resources for advancing health statuses. Caregivers with advanced expertise are reliable in validating appropriate economic advancements needed to generate proper healthcare implementation.

Data from the study illustrated that in 2018, immigrants in Florida paid 23.2 to the federal government and 8.5 billion to the state and local governments. In this regard, the positive contribution of immigrants in the senior healthcare industry can receive the proper support. In 2018, immigrants in California paid $80.8 million to the federal government and $38.9 billion to state and local governments. Thus, immigrants who work in different sectors provide a reliable economic development process. In the same year, immigrants in Texas contributed $26.3 billion to the federal government and 12.3 billion to state and local governments accounting for significant growth in the country’s profitability. Availability of labor is a reliable method of supporting proper health outcomes since it is possible to help senior citizens’ health status.

Education of the legal immigrant workforce is imperative in supporting the wellbeing of persons in senior healthcare facilities since their needs will be met with professional care. There is a critical requirement for training, education, and knowledge for caregivers since it improves productivity. In the senior care economy, an advanced care improvement process is attained when labor productivity increases at all times using significant benefits of economic growth. Improvement of GDP can then be possible when legal immigrants acquire advanced knowledge to support the senior healthcare industry. When educational interests increase, the result shall be more sourcing of skilled labor, an action that has a productive outcome on the local workforce. Permitting legal immigrants who are highly qualified to move freely among states effectively promotes equalization of wages.

Labor mobility can get used in the senior care economy to facilitate the moderation of regulations. Economic growth can get reliably performed when legal immigration processes increase labor endowment whereby a country possesses vast resources for the mass production of products. This creates a new internal balance that helps lower national wages and higher employment rates, leading to higher national returns. There have been concerns about whether reducing the number of immigrants would meet the demand for senior caregivers. Providing reliable healthcare expertise is highly imperative in different ways to ensure there will be no issues in relation to analyzing healthcare needs in equal measures. The positive contribution of immigrants can gradually have a dramatic positive impact on the economy as they will become more educated and more productive professionals.

Integration of the human capital theory is imperative in supporting legal immigrants’ contribution to the economy since it is possible to determine how their training, knowledge, and skills can significantly improve an economy. It is essential to streamline the process of immigration. Immigrants go through many struggles to maintain comfortable lives and provide for their families. However, as the immigrants try to cross the border, they face many tribulations and struggles. For instance, the root causes of trafficking are many and often very complex and correlated. This includes illegal crossing, which increases the individuals’ vulnerability, increasing demand for the trafficked person, their labor, and services. That erodes the capacity of different states to prevent and combat trafficking.

Emphasizing the dangers of illegal crossing is an excellent intervention in solving the issue of illegal immigrants since as long as immigrants experience legal processes, they can get registered by the government. The ageing population is constantly increasing. Thus, a ready workforce is needed to support a reliable health management process. The significance of healthcare organizations is imperative in allowing the detection of economic vulnerabilities that can reduce accuracy when trying to manage healthcare expertise. The provision of a ready workforce for the ageing population is imperative since it can serve the ageing population’s needs for therapy, physical assistance, and medication adherence. States, where legal immigrants reside can solve their problems internally rather than run away from their issues whenever they arise. It is imperative to collaborate among different members of a workforce since providing education to other healthcare providers will eliminate the lack of healthcare access.

An increase in life expectancy is the most contributing factor to the rise in the baby boomer population. The increase in life expectancy is productive due to the availability of insurance programs like Medicare and Medicaid that support healthcare provisions which different baby boomers integrate into their health needs. Demand for caregivers can increase at all times due to positive quality of life, and thus when they reach stages in which they cannot support themselves, caregivers find a ready market for their expertise. The development of a positive relationship between immigrants and their host countries’ educational institutions is imperative to promote the gradual development of an economy. With practical experience, there will be an equitable distribution of resources, reducing the negative impact of no good expertise for healthcare providers.

Positive qualities of immigrant workers include competencies, craftsmanship, and new work ethics that allow persons receiving their services to attain reliable healthcare experience. An increase in the elderly population results in an increase in senior care jobs, and immigrants are the target workforce for the industry. The provision of facility-based care can occur at organizational sites where the baby boomers must commit to healthcare guidelines. Caregivers can receive training which allows them to provide an appropriate diagnosis to persons they care for since it is difficult to manage their conditions with their full participation.

Immigration is significant in the labor force due to its excellent economic and social benefits to the host countries. Legal immigration is the best technique for acquiring a skilled and educated workforce that benefits any host country. Immigrants are a significant part of the labor force. There is a considerable demand for immigrant workers in the senior care industry due to their interest in the industry and capability to promote advanced care. Therefore, immigration helps provide constant growth in the labor force, improving the host’s labor market. This is evident whereby immigrants have been proven to boost foreign relations between host countries and their home countries. There are immigrants who are highly skilled to take on employment opportunities through lawful employment channels. This proves the fact that immigrants are a reliable workforce that should not be marginalized as health labor providers.

As the older population continues increasing, the consequent increase in legal immigrants serving as caregivers is a reliable solution in promoting advanced care. It is essential to give people some hope for regular migration. The migrants should be given an opportunity of migrating according to the law through regular legal pathways. This will make people seek jobs in areas where labor is needed to come to these countries lawfully. Healthcare provision can then get performed in the proper methods supporting safe healthcare outcomes. Regular migration shuns the problem of lack of workforce since greater transparency is created. Through such ways, illegal immigration will reduce, and people may be able to move freely to areas where they can be able to provide for themselves and their families.

The data also indicated that undocumented immigrants contributed significantly to the U.S. population. There are millions of migrants in different states in the U.S. who positively contribute to a state’s GDP. In California, illegal immigrants make up 20% of the total immigrant population. Adherence to proposed senior care management processes is critical for the project’s effectiveness as it is possible to assess the baby boomers and their healthcare needs. It can be possible to assure all persons in senior care centers of their wellbeing by increasing their capability of public engagement. Well-informed interactions can promote medical adherence as the caregivers assess medical conditions and then determine the expected contingency measures for supporting people’s health in the facilities.

Limitationsof the Study

The study involved various limitations, including biased results from the literature chosen from the study since it can be appropriate to determine the positive impact of immigrants in different areas. A limitation exists while trying to determine the main contributing factors to GDP growth in California, Texas, and Florida since the states can be provided with other robust businesses. Another limitation is the issue presented by the literature and Google sources to determine whether the immigrants involved were truly legal or illegal. There can be an issue of finding conclusive information since the online resources would not be skimmed through to determine who the participants were and if they were legally living in the U.S.

Issues can exist when determining senior citizens’ care needs and their health-related factors connected to advanced management since the condition affects the physical status and environmental factors surrounding them. Another area for improvement is the issue of finding the impact of supply and demand jobs on the U.S. population, as it would be regulated depending on whether immigrants were working in the senior care industry and receiving appropriate payments. Another limitation is the process of finding out the accurate connection between time and treatment of variables involved in the research for the measure of external validity. It would be an issue when attempting to find out how the study results would be connected to a general population since diverse views can be discovered from different studies.

Another limitation is connected to finding out how the data collected from California, Texas, and Florida would be suitable for inferring details about immigrants working in senior care facilities. Another area for improvement of the study is the synthesis of literature findings which got constructed with limited content that affected a suitable method of cohesively analyzing different information. Another limitation is that the research methods developed for the study need to address assumptions presented in another chapter properly. The effect of job supply and demand has yet to be discussed appropriately to determine the impact on the economy, as shown in an assumption in the second hypothesis.

Recommendations

Many citizens emigrate from their own countries and seek citizenship in another country through legal processes such as naturalization. Since the U.S. legally offers naturalization to immigrants provided they meet various conditions, contribution to host countries’ GDP can be reliable at all times. A suitable recommendation is to ensure all immigrants working in the senior healthcare industry are legally present in a country so that they can file all taxes that promote better economic management in the states where they work. This whole process is very fundamental since it has a significant impact on the U.S. labor force and, thus, its economy. Documentation is usually comprehensive and influences a productive method of a smooth immigration process that would provide a constitutional process.

People living in senior healthcare centers encounter issues whereby it is imperative to manage their personal conditions and ensure they adhere to medication to limit critical situations. Due to such a process, it is essential to allow legal immigrants to promote socio-economic factors that are involved in advanced healthcare management. Senior healthcare centers’ information can get used in improving better access to care by ensuring related factors in healthcare effects do not affect their capability of attaining advanced conditions. Legal immigrants can improve their experience concerning senior citizens by enhancing their knowledge concerning the procedures involved in managing senior healthcare facilities by focusing on medical adherence.

Another recommendation is for legal immigrants to get appropriately trained as caregivers using new technologies that can advance their capability to improve patients’ health and mental statuses. Management of healthcare conditions can get adequately handled as patients’ response to medication depends on their ability to take medicines on time and in the proper method. Caregivers are required to serve patients with such needs, thus creating a reliable process for validating suitable learning outcomes. Assessing the contribution of caregivers to safe healthcare delivery is highly imperative since it promotes proper methods of generating reliable care. Health system factors that caregivers work on can affect the reliability of care since it is evident that adherence to medical information requires proper medication and the involvement of physicians in the management of patients.

There is another need presented whereby caregivers are required to take care of themselves so that they would not get stressed about their profession. Assessment of caregivers’ wellbeing is highly imperative since it can provide better health outcomes by allowing all encounters with senior citizens to produce reliable health outcomes. Caregivers need to get supplied with therapy since it ensures they cannot get by any issues required to manage their conditions as patients get monitored by physicians or nurses. Condition-related factors need to be assessed so that caregivers would not get burned out during their daily interactions with senior citizens. It is the duty of caregivers to identify the needs of various citizens to ensure they can adequately adhere to medical procedures.

The interpersonal relationship between medical providers and caregivers requires improvement since it affects their `medical adherence. Senior citizens’ education can be conducted to ensure they understand the proposed metrics of healthcare management.All healthcare managers can engage with senior citizens to assess their cognitive function, adherence to medication, and physical health status to ensure proper response to treatment. Assessment of senior citizens’ needs can get conducted and reveal how legal immigrants who work effectively can promote reliable healthcare management operations. A crucial requirement is to ensure caregivers’ conduct can produce advanced healthcare operations. Future management of senior citizens’ needs can get reviewed at all times using caregivers’ expertise to provide a reliable technique for managing all types of conditions.

Conclusion

The study of the impact of legal immigrants on the U.S. population has promoted a proper review of their positive contribution to the economies and GDP of California, Texas, and Florida. A linear correlation got detected between the dependent variable, supply and demand for senior care workforce in U.S. states, and the independent variable, which is legal immigrants’ growth in the senior care sector. Legal immigrants thus provide an advanced method of supporting senior citizens, which is imperative in generating a productive healthcare environment. As legal immigrants work in various states, there is an advanced method to ensure they get provided with reliable job opportunities since their demand is high.

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