We implemented the methodology for Canada in four steps:

Step 1: Estimating the foreign-born share of the health care workforce

We estimated the foreign-born share of the health/social care workforce using the 2.5 percent public use sample from the 2001 census. Our data are derived from the IPUMS International database (Minnesota Population Center, University of Minnesota). To identify this workforce, we used the intersection of workers in the health and social services industry (IPUMSI industry code 14) and three health/social care occupations: professional occupations in health, registered nurses and supervisors (occupation code 07); technical, assisting and related occupations in health (occupation code 08); and childcare and home support workers (occupation code 16). We further limited our sample to full-time workers aged 15 to 64.

The results are shown in Table II.1. For our purposes, an important finding is that the foreign-born share is remarkably similar across the three quite different occupations. We thus use the combined foreign born share of 21.9 percent for our estimates. Not surprisingly, the health/social care workforce is disproportionately female, with the female share highest for child care and home support workers (91.8%). The shares of women in the three occupations are similar for the native and foreign born, with a smaller share of women for the foreign born in professional/nursing occupations (66.6 percent versus 74.5 percent) and a slightly higher share of women for the foreign born in childcare/home support (92.5 percent versus 91.8%).

Step 2: Estimating the institutional elder care workforce in 2006

We next availed of published tabulations from the from the 20 percent sample of the 2006 census to estimate the total eldercare workforce (ages 15 to 64). (Unfortunately, public use micro data is not yet available from the most recent census.) We focused on a single three-digit industry classification in the North American Industry Classification System 2002 (NAICS 2002) to identify the institutional elder care workforce: nursing and residential care (623). Of course, workers in other industry categories could also be providing services to the elderly, including ambulatory health care services (621), hospitals (622), and social assistance (624). Our estimate should therefore be viewed as capturing only a certain portion of the elder care workforce: longer-term care provided in institutions other than hospitals. The most glaring omission is workers providing elder care in the home. Such workers are potentially captured under a subcategory of social assistance, individual and family services (6241). However, this subcategory also includes certain child and youth services as well as services for persons with disabilities, and we so decided not to use it in our estimate.

Table II.2 records our estimate of the institutional long-term elder care workforce. This estimate is 314,910 for 2006. Applying our estimate of the foreign-born share in the health/social care workforce generally, we estimate the foreign-born workforce to be 68,805. The table also records the number of such workers per person 65 and older. There is roughly one such worker for every 14 older persons. Again applying our estimate of the foreign-born share, there is roughly one foreign-born worker for every 62 older persons.

Step 3: Projecting growth in the elderly population

Figure II.1 and Table II.3 each record Statistics Canada projections of the elderly population (65 and over) out to 2056 (Statistics Canada, 2005). Statistics Canada actually report projections under six different scenarios. We use their Scenario 3, which is also used as the reference scenario by Statistics Canada in presenting their results. The elderly population rises from 4.3 million (13.2 percent of the total population) in 2006 to 11.5 million (27.2 percent of the total population) by 2056.

Step 4: Projecting required growth in the foreign- and native-born workforces

The final step was to calculate the number of additional foreign- and native-born workers required under our three scenarios assuming in all cases that the ratio of workers to elderly persons remains constant at 0.081. The evolution of the required stocks under each of the three scenarios is shown in Table II.3 above and Figure II.2 below.

Low scenario: Constant foreign-born workforce. Here we simply hold the foreign-born workforce constant at the 2006 estimate of 69,000. The full required increase in the elder-care workforce is then met by native-born workers, which must rise from 245,900 to 775,700.

Medium scenario: Constant foreign-born share. The number of foreign-born workers rises by approximately 170 percent to 185,200.

High scenario: Constant native-born workforce. Under this scenario, all of the substantial growth in the necessary workforce is met by foreign-born workers. This requires a 770 percent increase in the foreign-born stock, which rises to 598,800.

Sources: Statistics Canada (2005), Populations Projections for Canada, Provinces and Territories: 2005-2031; author calculations.

Notes:
1/ Total elder care workforce estimate based on 7.3 workers per 100 older persons (see Table 2).
2/ Initial estimate for the foreign-born share is 21.9% (see Table 1).