The rise of immigrant labor has been so incremental that it's hard to pinpoint when the workers' compensation community should have collectively realized that immigrant workers often pose a heightened work injury risk. But it's clear that we are past that date.
Foreign-born workers (including legal and undocumented) comprised about one-tenth of the country's workforce in 1990. Today, they amount to about 17 percent, and are more widely distributed geographically.
Since 2000, foreign-born workers have added more bodies to the workforce than have native-born Americans. Demographers expect this trend to continue through 2020.
Many immigrants are highly skilled. But a large share of those that are less well educated provide manual labor that is relatively injury-prone.
Our manual workforce is thus segregated by injury risk. Pair an immigrant and a native-born worker, both doing jobs that require limited education, and statistics reveal that the foreign-born worker encounters twice the risk of work injury as the native.
I estimate from federal data that in the top 30 jobs that don't require a high school education, immigrants sustain at least one of every four injuries.
That's based on an assumption that they report injuries at the same rate as native-born workers.
The immigrant worker is also less inclined to have health insurance. Having health insurance is widely thought to lower work-injury claims and to fund the treatment of co-morbidities which, left untreated, can complicate injury recovery.
You would think health care reform would address this, but it doesn't. In fact, the Affordable Care Act and the current version of the Senate's immigration reform bill prohibit access to health insurance for large numbers of non-naturalized immigrants.
A lack of English literacy further precludes immigrant workers from access to adequate health care and exposes them to a lack of understanding of safety procedures, making them even more vulnerable.
Further isolating immigrant workers is fear on the part of employers of legal prosecution should they be found harboring an illegal immigrant. Employers fear if they are too proactive, they will stumble over an undocumented worker and incur legal liability. Millions of supervisors, therefore, lack the education to effectively manage immigrant workers.
One positive step for employers would be to adhere to a timidly publicized OSHA requirement that "instruction must be provided in a language the employee can understand."
Another step is for medical provider networks to expect that their providers adhere to a requirement arising out of the 1964 Civil Rights Act that health professionals conduct patient encounters in the preferred language of the patient.
We have a yet more difficult step ahead. Some say we are a multi-ethnic society. But, as with much of the world, we are moving towards a transnational society. Millions of American residents, including even naturalized citizens, see themselves as members of two societies. Many of our workers are transnationals rather than permanent immigrants, per the iconic Ellis Island narrative.
To ensure work safety and injury recovery, we may need to devote a lot more attention to buying into the culture of the foreign-born workers, rather than waiting for the worker to learn how to speak and act like a native.
PETER ROUSMANIERE is an expert on the workers' compensation industry.
September 1, 2013
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