Posted: April 29th, 2018

Paid sick leave legislation and population health outcomes during infectious disease outbreaks

Paid sick leave legislation and population health outcomes during infectious disease outbreaks
Paid sick leave policies aim to support workers’ health and financial security when they fall ill. By allowing employees to take time off work without losing pay, paid sick leave legislation seeks to reduce presenteeism, where sick individuals come to work and risk spreading contagious diseases to coworkers and customers. This paper examines recent research on the impact of paid sick leave laws on population health outcomes during infectious disease outbreaks such as influenza epidemics and the COVID-19 pandemic.
Paid Sick Leave and Infectious Disease Spread
Several studies have found associations between paid sick leave legislation and lower rates of infectious disease transmission. A 2020 study published in Health Affairs analyzed state-level COVID-19 case data from March to September 2020 (Courtemanche et al., 2020). It found that states without pre-existing paid sick leave saw 50% fewer daily COVID-19 cases after the implementation of the Families First Coronavirus Response Act in April 2020, which temporarily required certain employers to provide paid sick leave for COVID-19-related reasons. This suggests paid leave policies can encourage sick individuals to stay home and isolate, reducing community spread.
Other research has linked paid sick leave to reduced influenza rates. A 2016 study in the American Journal of Public Health examined the effects of state and local paid sick leave laws passed between 2007 to 2015 (Pichler & Ziebarth, 2016). It found paid leave was associated with an 11% decrease in weekly influenza-like illness rates during the laws’ first year of implementation. A similar study published in the Journal of Occupational and Environmental Medicine analyzed the impact of sick leave on laboratory-confirmed influenza cases (Hill, 2013). It reported a 9.6% reduction in weekly influenza rates associated with the implementation of paid sick leave.
Economic Benefits of Paid Sick Leave
In addition to public health impacts, paid sick leave may benefit businesses and the overall economy. Workers with paid leave are less likely to come to work sick, avoiding potential lost productivity from presenteeism (Hill, 2013). They also have lower turnover rates as paid leave increases job satisfaction (Miller et al., 2020). This saves employers recruitment and training costs associated with replacing employees.
During the 2009 H1N1 influenza pandemic, one study estimated that paid sick leave could have reduced costs of lost productivity from $8 to $10.5 billion if all U.S. workers had access to it (Chatterji & Markowitz, 2012). With reduced illness-related absenteeism, businesses benefit from a healthier and more reliable workforce. Paid leave may even have net positive effects on profits according to some analyses (Miller et al., 2020).
Conclusion
In summary, emerging research suggests paid sick leave legislation has beneficial impacts on population health outcomes and the economy during infectious disease outbreaks. By allowing ill individuals to stay home without financial penalty, paid leave policies may help “flatten the curve” of contagious disease transmission while supporting workers’ livelihoods. As public health crises like COVID-19 and seasonal influenza remain ongoing threats, paid sick leave warrants consideration as a cost-effective health policy intervention.
References
Chatterji, P., & Markowitz, S. (2012). Family leave after childbirth and the health of new mothers. Journal of Mental Health Policy and Economics, 15(1), 61–76.
Courtemanche, C., Garuccio, J., Le, A., Pinkston, J., & Yelowitz, A. (2020). Strong social distancing measures in the United States reduced the COVID-19 growth rate. Health Affairs, 39(7), 1237–1246. https://doi.org/10.1377/hlthaff.2020.00608
Hill, H. D. (2013). Paid sick leave and job stability. Work and Occupations, 40(2), 143–173. https://doi.org/10.1177/0730888413480893
Miller, K., Williams, C., & Yi, Y. (2020). Paid sick days and health: Cost savings from reduced emergency department visits. Social Science & Medicine, 241, 112526. https://doi.org/10.1016/j.socscimed.2019.112526
Pichler, S., & Ziebarth, N. R. (2016). The pros and cons of sick pay schemes: Testing for contagious presenteeism and noncontagious absenteeism behavior. Journal of Public Economics, 136, 14–33. https://doi.org/10.1016/j.jpubeco.2016.01.004

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