These workers are three times more likely to delay medical care

The United States lags behind 22 other countries when it comes to mandating employers to provide paid sick leave. In the U.S., only four states (Connecticut, California, Massachusetts and Oregon) along with a few dozen municipalities, now mandate paid sick leave as an employee benefit. That leaves 49 million U.S. workers without paid sick leave, causing significant health care disparities as well as undesirable health care outcomes. 

A study published in the March issue of Health Affairs by researchers at Cleveland State University and Florida Atlantic University is the first to examine the relationship between paid sick leave benefits and delays in medical care for both working adults and their family members.

The findings indicate that regardless of income, age, race, occupation, full-time or part-time work status, health status or health insurance coverage, workers without paid sick leave were three times more likely to delay medical care than were workers with paid sick leave. They also were three times more likely to forgo needed medical care altogether. Furthermore, families of workers without paid sick leave were two times more likely to delay medical care and 1.6 times more likely to forgo needed medical care. The lowest-income group of workers without paid sick leave were at the highest risk of delaying and forgoing medical care for themselves and their family members — making the most financially vulnerable workers the least likely to be able to address health care concerns in a timely manner.

The researchers also found that working adults with paid sick leave benefits missed one-and-a-half days more of work because of an illness or injury compared to workers without paid sick leave, indicating that they were more likely to take time off work to care for themselves or family when needed.

 “Paid sick leave should be thought of as a public health issue,” noted Patricia Stoddard-Dare, associate professor of social work at CSU and co-author of the study.

"During the 2009 H1N1 influenza outbreak, estimates suggest that employees who did not stay home due to the lack of paid sick leave resulted in about 1,500 additional deaths,” added Linda Quinn, college associate lecturer in the department of Mathematics at CSU and study co-author.

Stoddard Dare adds, “Workers who come to work when ill are also more prone to injuries and mistakes.  There are so many positive outcomes related to providing paid sick leave that more employers should consider voluntarily offering this benefit.”

The team used data from the 2013 National Health Interview Survey (NHIS), an ongoing data collection initiative which began in 1957 and was designed to provide information on a broad range of health topics. The analytic sample included 18,655 working adults ages 18-64 – identifying 10,586 working adults with paid sick leave benefits and 7,879 without paid sick leave benefits. They used 13 control variables in the study including race, ethnicity, marital status, education, family size, occupation, full-time or part-time work status, health insurance coverage, age, presence of a limiting condition, and total annual family income.

The article also was authored by LeaAnne DeRigne, associate professor of social work at Florida Atlantic University.

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