Paid Sick Leave and Public Health

According to new research from the Institute for Women's Policy Research, in 2010 44 million private-sector US employees, or 42% of the workforce, lacked access to paid sick time. This IWPR analysis distinguishes between employees who are eligible for paid sick time vs. those who can actually access it, because employers often don't allow for the use of paid sick time by employees in their first months on the job. IWPR reports that new employees have to wait an average of 3.5 months to access paid sick days.

The occupational categories with the lowest percentages of private-sector employees with access to paid sick days are as follows:

Food Preparation and Serving Related Occupations: 23%
Construction and Extraction Occupations: 33%
Protective Services Occupations: 34%
Personal Care and Service Occupations: 38%

This list hints at why a lack of paid sick days is a public health problem.

In low-wage service occupations, people without paid sick leave often can't afford to take unpaid days to recover from an illness - and even if they're willing to forego the income, many face threats of losing their jobs if they miss work. So, lots of workers in the occupations above drag themselves to work even if they feel miserably ill. In addition to being a rotten deal for workers, this means that the people who handle our food and care for our children are probably coming to work sick, and potentially exposing many more people to their viruses and bacteria.

Even fewer workers have access to paid time off to care for a sick family member. In a 2009 survey of employers' policies relevant to H1N1, Harvard School of Public Health researchers found that only 35% of businesses offer such paid leave. This means some parents will send sick children to school or day care, facilitating further disease transmission.

DC, Milwaukee, and San Francisco have all passed legislation requiring employers to provide employees with a minimum number of paid sick days, but there's no national-level requirement for private employers to offer such a benefit. In their book Raising the Global Floor: Dismantling the Myth that We Can't Afford Good Working Conditions for Everyone, researchers Jody Heymann and Alison Earle report that 163 other countries guarantee paid sick leave.

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I don't have enough fingers and toes to count the number of foodborne outbreaks I've investigated that centered around food handlers who couldn't take a day off.

On the bright side, the restaurants learn a valuable lesson about being proactive in keeping sick workers out of the kitchen. On the down side, it takes an outbreak to wake them up to the problem.

By Rogue Epidemiologist (not verified) on 11 Jan 2011 #permalink

When I worked for AlliedSignal, taking more than two sick days in a year resulted in disciplinary action, and could be grounds for dismissal. I was neither hourly nor salaried, but 'exempt', which meant my employer could make me do anything, including making me work 60-hour shifts. Yes, 60 hours -- two and a half days straight.

By Rose Colored Glasses (not verified) on 12 Jan 2011 #permalink

This is a huge problem even within the medical profession-in hospitals, clinics, VA's etc- caregivers, nurses, housekeepers, doctors, residents, all go to work with coughs colds and otherwise infectious diseases posing risks and, especially around the immunosuppressed, presenting life-threatening danger to their patients. The culture of "never being absent" seems to trump patient (and employee) safety every time. This has got to change. So far despite great efforts by some, it has not, and I suspect it will take regulatory clout to make appropriate changes.