A study published in the March 2016 issue of Health Affairs reports that workers without paid sick leave are less likely to take time off for illness and more likely to delay or put off healthcare visits entirely compared to those with paid sick leave.

EBN spoke with lead author LeaAnne DeRigne an associate professor at the Florida Atlantic School of Social Work to find out why the study was conducted, and what the implications of her findings are for both employers and public health policy.

EBN: It seems intuitive that people who do not have paid sick leave will take fewer sick days off. Why did you feel it was necessary to test this hypothesis?

DeRigne: Our research was meant to start filling in the gap in scholarly evidence around the benefits or the outcomes of having paid sick leave. For example, the public health implications of employees being at work when they are sick are huge.

EBN: Employer-paid sick leave or sick leave paid through national social insurance plans is not mandated in most of the U.S. How does this compare with other countries?

DeRigne: We are at the bottom of the pack, as usual. Workers in as many as 145 countries have some paid sick days mandated through work or paid for by government programs.

EBN: What percentage of full and part-time US workers actually have paid sick leave benefits?

DeRigne: Seventy percent of the full time employed U.S. civilian population has paid sick leave benefits, while only 19% of part-time workers have the same coverage. That leaves nearly 49 million workers without access to paid sick leave.

EBN: What does your survey data reveal about how much less sick leave full and part-time workers actually take when they don't have paid sick leave benefits?

DeRigne: People with paid sick leave miss one and a half days more of work a year. We are assuming that probably people without paid sick leave are at work when they are sick.

EBN: What does the typical profile of a worker without sick leave look like?

DeRigne: Access to paid sick leave varies by race, so Hispanic workers have the lowest rates of coverage. It is also not as common among those who are younger, less educated, low income, who report only fair or poor health and who are uninsured. That’s a pretty vulnerable population. Only three out of 10 low-income workers with a child in fair or poor health have paid sick leave benefits.

EBN: What are some of the workplace health and productivity advantages when employees have paid sick leave?

DeRigne: Research we reviewed on this subject suggests that paid sick days help improve job stability and employee retention. This benefit translates into fewer employee errors in production jobs and a decrease in workplace accidents and injuries. It also means that caregivers who have family responsibilities for children and aging parents are able to better achieve a better work and family balance.

EBN: In workplaces like restaurants, daycare centers and healthcare institutions what happens if employees don't have paid sick leave?

DeRigne: We're really concerned about the public health implications. So if you have the flu, but you can't stay home from work and you are making people burritos, what kind of contagious conditions are you spreading? We're also worried about sick employees who are working with vulnerable populations who may be already ill and more susceptible to secondary infections.

EBN: Based on the survey findings, how would you advise employers that currently do not offer paid sick leave, but are considering the pros and cons of adding several days per year of paid sick to their benefit plans?

DeRigne: I think that in the long run, it doesn't save money to keep people working when they are sick. They should be able to recuperate at home and treat their illness. If the have paid sick leave benefits, employers are going to reduce workplace turnover because people feel supported when they have access to paid time off so they are able to take care of themselves and their family.

EBN: Vermont will be the fifth state after Connecticut, California, Massachusetts and Oregon to mandate a specified number of paid sick leave days annually. By 2018 in Vermont, the minimum required leave will be a minimum of 40 hours or five days of earned sick leave over the course of a year. Is that enough?

DeRigne: We really don't know, and we've said this is a place where additional research is needed in the future. I think that most commonly municipalities and states offer five or seven days. Nine days I think is the highest number of paid sick days we’ve seen. So about a week seems to be enough to allow people recuperate and take care of necessary doctor’s appointments that have to be made during normal business hours.

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