Paid Sick Leave Laws

Paid sick leave laws require employers in the affected jurisdiction to provide paid time off to employees for use when ill or injured. Sick employees may use the time to see a health care provider or stay home until they are healthy enough to work again, without concern for lost wages. As of 2017, the US Bureau of Labor Statistics estimates that 38% of employed adults in the US do not have paid sick leave (US DOL-PSL). Women, Hispanics, low-wage workers, and employees with low levels of education are less likely to have paid sick leave than their counterparts (Chen 2016); individuals with paid sick leave also tend to have higher incomes (Cook 2011,Clemans-Cope 2008,CWF-Collins 2004). Some local governments cannot enact such measures due to state preemption legislation (Grassroots Change).

Expected Beneficial Outcomes: Increased access to paid leave; Increased access to health care. Other Potential Beneficial Outcomes: Improved health outcomes; Increased use of parental leave.

Evidence of Effectiveness: There is some evidence that paid sick leave laws increase access to paid sick leave (PSL), especially among women without a college education and workers in industries which have historically lacked access. Access to paid sick leave can increase use of preventive health care services. However, additional evidence is needed to confirm effects. Access to paid sick leave can increase use of outpatient preventive care services including cancer and other health care screenings, flu vaccinations, and dental care, as well as decrease emergency room use for children and adults. Workers who receive six days or more of PSL may be more likely to use preventive care services than those with two days or less, and those with ten or more days may be even more likely to. Parental access to paid sick leave improves children’s access to health care. Lack of access to paid sick leave appears to lead to lower levels of preventive health care use, including screenings, and delayed or forgone medical care, particularly among those with very low incomes. Workers without access to PSL are more likely to report being in fair or poor health, may be less able to afford needed health care services and goods (such as dental care and eyeglasses), and are more likely to incur elevated medical expenses. Lack of PSL is also associated with increased psychological distress and financial worry, while access to paid sick leave is associated with reduced financial hardship and improved quality of life. Access to paid sick leave is associated with an increased likelihood that employees stay home when they are ill or injured, and to care for children who are ill or injured, particularly among low income parents. When workers gain access to paid sick leave, flu rates decrease approximately 10%, likely due to fewer employees coming to work while contagious; PSL mandates in Connecticut and Washington, DC appeared to decrease illness-related leave taking by all workers, not just those directly affected by the change. Lack of access to paid sick leave may increase the risk of illness for individuals and the spread of contagious illness among the wider population. Paid sick leave is associated with a decreased risk of mortality from all causes, particularly from heart disease and unintentional injuries. Access to PSL is also associated with a decrease in nonfatal occupational injuries among private sector workers, particularly in high risk sectors and occupations. For example, three years after implementation of Connecticut’s PSL law, occupational injuries and illnesses declined in the industries targeted by the law.
Impact on Disparities: Likely to decrease disparities.