At the American Public Health Association's annual meeting in Boston this week, the organization officially approved 17 policy statements, including one calling for the US to improve access to paid sick and family leave and one urging the Occupational Safety and Health Administration (OSHA) to require workplace injury and illness prevention programs. Having APHA on the record supporting these improvements will bolster ongoing campaigns for paid leave and OSHA's efforts to advance an injury and illness prevention standard. (Check out more news from Boston at the APHA Annual Meeting blog.)
Celeste Monforton and I are co-authors of the policy on paid sick and family leave policies. In our statement, we note that the US is the only industrialized nation that doesn't give workers access to paid sick time to recover from illness, or to paid maternity leave following the birth of a new baby. Except in Connecticut and the cities with laws requiring employers to let workers earn paid sick days,* employers can decide whether or not to allow their workers time off when they're dealing with a health issue or caring for a sick family member. Low-wage workers are least likely to have paid-leave benefits, and they're also the ones who can least afford to miss a day's pay when they're sick or caring for a sick loved one. The impact of inadequate paid-leave policies falls hardest on the poorest families, and it also harms public health when workers with the flu and other transmissible diseases come to work sick.
In addition to the cities and states addressing earned sick days, some states have created systems to provide partial payments to workers who need longer-term leave to address a serious health condition or bond with a new child. California and New Jersey both have successful family-leave insurance systems, which are funded by small contributions from workers' paychecks and replace a portion of workers' wages while they're on leave. Rhode Island recently passed a law establishing such a "social insurance" system.
At the federal level, the Family and Medical Leave Act (FMLA) provides job security for workers who take unpaid time off to deal with a serious health condition (their own or a family member's) or care for a new baby. Around 40% of workers are ineligible for FMLA leave, however, including those working fewer than 25 hours per week with an employer (even if they have multiple part-time jobs), workers at businesses with fewer than 50 employees, and those who want to care for a family member who doesn’t meet the official “family” designation, like a domestic partner or grandparent. And because the leave is unpaid, many of those who are eligible can't afford to take it.
The new APHA policy statement calls for laws that expand access to paid sick days and paid family and medical leave. The Healthy Families Act, which has been introduced in Congress by Congresswoman Rosa DeLauro and Senator Tom Harkin, would allow workers across the US to earn paid sick time. Meanwhile, local and state campaigns for paid sick days continue.
The other APHA policy from the organization's Occupational Health and Safety section concerns injury and illness prevention programs (also known as I2P2). It's not feasible for the Occupational Safety and Health Administration (OSHA) to issue a separate standard on every occupational hazard that US workers face; instead, it could require employers to identify the hazards in their workplaces and create and implement plans to protect workers from them. OSHA is working on a proposed rule that would require employers to have these programs.
Improving workplace injury and illness prevention and expanding access to paid sick, family, and medical leave will be good for public health. It's wonderful to have APHA's official support for these policies, and I hope this support will help win stronger US laws and standards in the near future.
* San Francisco, DC, and Seattle currently have paid-sick-days laws in effect; New York City, Portland (Oregon), and Jersey City have passed laws that will be implemented next year. The National Partnership for Women and Families has a handy chart breaking down the provisions of the various laws (except Jersey City's, which was signed just last month).