It seems obvious that workers with paid sick leave are more likely to stay home and seek out medical care when they or a family member is ill. But it’s always good to confirm a hunch with some solid data.
In this month’s issue of Health Affairs, researchers used data from the National Health Interview Survey to provide some clarity on the relationship between paid sick leave and health-related behaviors. They found that workers without paid sick leave were three times more likely to forgo medical care than workers who do get paid sick leave. Also, during 2013, both full- and part-time workers without paid sick leave were more likely to show up to work while sick. Not surprisingly, workers earning the lowest incomes and who did not have paid sick leave also faced the highest risk of putting off or forgoing medical care for themselves and their families.
Study authors LeaAnne DeRigne, Patricia Stoddard-Dare and Linda Quinn write:
(Paid sick leave) is particularly important to the nearly 50 percent of U.S. adults who have one or more chronic health conditions and the more than half of working Americans who provide care to a child or family member. Paid sick leave allows workers (and presumably their dependent family members) to receive prompt preventive or acute medical care, recuperate from illness faster, and avert more serious illness.
In fact, paid sick leave is increasingly being framed as sound public health policy — for example, the American Public Health Association adopted official policy on paid sick leave in 2013. In addition to giving workers a chance to care for themselves without having to choose between their jobs and their health, paid sick leave also helps curb the spread of disease. In other words, paid sick leave isn’t only fair, it’s common-sense prevention. The Health Affairs study noted that the U.S. is the only highly developed nation that doesn’t guarantee paid sick leave, with nearly 49 million workers having no access to paid sick days. Paid sick leave is less common among young and low-income workers who are uninsured and report fair to poor health. Just three in 10 low-income workers with a child in fair or poor health has access to paid sick leave.
To conduct the study, researchers identified more than 10,000 working adults with paid sick leave and nearly 8,000 workers without such a benefit. They found that workers without paid sick leave had a greater risk of delaying medical care for themselves and family members. In the absence of paid sick leave, family members were two times more likely to delay needed care and 1.6 times more likely to forgo needed care altogether. Workers attributed such delays to cost, which researchers said may reflect the cost of medical care as well as the cost of lost wages. Workers with paid sick leave were also more likely to miss work due to an illness or injury than workers without such a benefit. The study noted that the ability to stay home when sick not only prevents the spread of contagious disease, but is associated with shorter recovery times and reduced health complications.
About 65 percent of families with incomes below $35,000 a year had no paid sick leave, compared to a quarter of families with incomes of more than $100,000. That disparity, the researchers write, “left the most economically vulnerable without the protective benefit of paid sick leave.”
“Understanding the public health impact of employment policy is an important step toward implementing sound workplace regulations that may lessen the longstanding health care disparities between higher- and lower-wage workers,” the study stated.
Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for nearly 15 years.