Immigrants accounted for 25.7% of the workforce in the “nonformal” long-term care sector, including senior living, in 2017, according to a study published Monday by the journal Health Affairs.

The percentage includes more than 214,000 workers, said the authors, from Harvard Medical School and Hunter College of the City University of New York.

“Addressing the direct care worker shortage will require a multifaceted approach, including better wages, benefits, and education and training programs to draw people into the labor force while reducing turnover,” the authors wrote. “However, curtailing immigration will almost certainly move us in the wrong direction, worsening the shortage and the availability of high-quality care for elderly and disabled Americans.”

The investigators used data from the 2018 Current Population Survey to reach their conclusions. They said theirs is the first study to examine the role of immigrants, including unauthorized immigrants, directly hired by private households and nonmedical facilities, such senior housing and independent living sections of continuing care retirement communities, to assist older adults and disabled people.

Compared with U.S.-born healthcare workers, immigrant workers were more likely to be employed in the nonformal sector (6.8 percent versus 4.6 percent), with “particularly high” proportions of legal noncitizen immigrant healthcare workers reporting employment in the nonformal sector, the authors said.

The study also detailed the immigrant workforce in home health agencies and nursing homes.