StatCan COVID-19: Data to Insights for a Better CanadaThe contribution of immigrants and population groups designated as visible minorities to nurse aide, orderly and patient service associate occupations

In the current context of the COVID-19 pandemic, there is a growing need for additional information on the population groups that are more likely to be negatively affected by the pandemic in Canada, such as immigrants and population groups designated as visible minorities. One of the issues immigrants and visible minority groups have been facing since the start of the pandemic is that many of them are essential workers, which puts them at higher risk of contracting COVID-19.

In particular, nurse aides, orderlies and patient service associates were at higher risk of contracting COVID-19, especially those working in long-term care facilities in Quebec and Ontario. A number of workers in these occupations contracted the virus, which was an additional risk factor for their families and communities.

To better understand how different sub-groups of workers were exposed to the risks associated with COVID-19, this article provides a profile of nurse aides, orderlies and patient service associates. In particular, using data from the Census of Population, we look at the importance of immigrants and population groups designated as visible minorities in these essential occupations. The Employment Equity Act defines visible minorities as “persons, other than Aboriginal peoples, who are non-Caucasian in race or non-white in colour.” They include the following groups: South Asian, Chinese, Black, Filipino, Latin American, Arab, Southeast Asian, West Asian, Korean and Japanese.  

Immigrants account for a growing proportion of nurse aides, orderlies and patient service associates

In 2016, 245,500 people were employed as nurse aides, orderlies and patient service associates in Canada. Of these workers, more than a third (87,925) were immigrants. By comparison, immigrants represented less than 1 in 4 people in all other occupations (Chart 1).

Women accounted for the majority of nurse aides, orderlies and client service associates, among both immigrants (86%) and non-immigrants (87%).

Over the past 20 years, the share of immigrants in these occupations has grown more quickly than their share in all other occupations. Between 1996 and 2016, the proportion of immigrants in the occupations of nurse aide, orderly and patient service associate rose from 22% to 36%,^Note  an increase of 14 percentage points. By comparison, the corresponding proportion for all other occupations increased from 19% in 1996 to 24% in 2016.

The ratio between immigrant women and men remained relatively stable during the same period. In 2016, of all Canadian workers in a nurse aide, orderly and patient service associate position, 31% were immigrant women.

Furthermore, the share of immigrants among nurse aides, orderlies and patient service associates varied significantly from one province to another. In 2016, 52% of workers in these occupations in Alberta were immigrants, compared with less than 8% in each of the Atlantic provinces (Table 1).

The proportion of immigrants in these occupations was even higher in the country’s largest census metropolitan areas (CMAs). In the Toronto, Vancouver and Calgary CMAs, over 70% of nurse aides, orderlies and patient service associates were immigrants.

Moreover, in each of these provinces and CMAs, the majority of immigrants in these occupations—nearly always over 80%—were immigrant women.

Black and Filipino women are highly overrepresented among nurse aides, orderlies and patient service associates

There are significant differences between the ethnocultural characteristics of nurse aides, orderlies and patient service associates and those of workers in other occupations. Specifically, nurse aides, orderlies and patient service associates were more likely to belong to a population group designated as a visible minority (34%) than workers in all other occupations (21%).

However, some groups were more likely to be represented among nurse aides, orderlies and patient service associates than others. For example, 12% of all workers in these occupations were Black, 11% were Filipino, and 4% were South Asian. By comparison, Black and Filipino workers each accounted for 3% of workers in all other occupations, and South Asian workers, 5%.

Immigrants working as nurse aides, orderlies and patient service associates were especially likely to belong to certain population groups. In 2016, 30% of immigrants working in these occupations were Black, and 30% were Filipino. In contrast, these proportions were 8% and 9%, respectively, among immigrants in all other occupations (Table 2). Moreover, Black women accounted for 26% of all immigrant nurse aides, orderlies and patient service associates, while they accounted for less than 4% of all immigrant workers in all other occupations.

In 2016, the three main place of birth regions of immigrant workers in these occupations were Southeast Asia (32%, almost all of whom were born in the Philippines), the Caribbean and Bermuda (18%, nearly half of whom were born in Haiti, and a third from Jamaica) and sub-Saharan Africa (13%).

Many immigrants who work as nurse aides, orderlies and patient service associates have a university degree

Since the occupations of nurse aide, orderly and patient service associate are in high demand and offer good employment opportunities, they can be attractive to newcomers seeking to settle in Canada. In 2016, the proportion of recent immigrants was higher for nurse aides, orderlies and patient service associates than it was in all other occupations. Specifically, among immigrants working in one of these occupations, 39% had settled in Canada between 2006 and 2016. This compares with 29% for all other occupations.

Immigrants in general—and recent immigrants to Canada in particular—are known to have higher levels of education than non-immigrants.^Note  This is also true among nurse aides, orderlies and patient service associates, who require post-secondary training. In 2016, 25% of immigrants working as nurse aides, orderlies and patient service associates had at least a bachelor’s degree, versus 5% of non-immigrants. Furthermore, 45% of the most recent immigrants in these occupations (those who had settled in Canada between 2011 and 2016) had at least a bachelor’s degree.

Among overqualified immigrant workers in these occupations, many had a university education in a field related to health care. Specifically, among nurse aides, orderlies or patient service associates with at least a bachelor’s degree, immigrants were twice as likely (44%) as non-immigrants (22%) to have earned their degree in a health-related field. The majority of these immigrants with a bachelor’s degree or higher in a health-related field had, in fact, a nursing degree (69%). There was little difference between men and women.

It should be noted that the proportion of immigrants and groups designated as visible minorities was lower in other health care sector occupations. For example, among registered nurses, the proportion of immigrants was 23%, almost identical to that for all other occupations (24%). The proportion of individuals designated as visible minorities among registered nurses was also similar to the national average of 21%.

Data sources and definitions

The data used in this study are limited to the employed labour force, aged 15 years and older. The 2016 National Occupational Classification is used to identify nurse aides, orderlies and patient service associates.

Nurse aides, orderlies and patient service associates assist nurses, hospital staff and physicians in providing basic care to patients. Although the majority of nurse aides, orderlies and patient service associates work in nursing and residential care facilities (53%), many also work in hospitals (23%), facilities providing individual and family services (6%) and other health care establishments.

Nurse aides, orderlies and patient service associates perform some or all of the following duties: bathe, dress and groom patients; take their blood pressure, temperature and pulse; administer first aid. For more information, please see the National Occupational Classification.

The term “immigrant” refers to a person who is or has ever been a landed immigrant or permanent resident. These persons have been granted the right to live in Canada permanently by immigration authorities. Immigrants who have obtained Canadian citizenship by naturalization are included in this group.

The term “visible minority” refers to whether a person is designated as belonging to a visible minority population group as defined by the Employment Equity Act. The Employment Equity Act defines visible minorities as “persons, other than Aboriginal peoples, who are non-Caucasian in race or non-white in colour.” They include the following groups: South Asian, Chinese, Black, Filipino, Latin American, Arab, Southeast Asian, West Asian, Korean and Japanese. Inasmuch as possible, these groups are disaggregated in the presentation of the results so as to account for the specific experiences and heterogeneity of the population groups designated as “visible minorities.”