October 18, 2018 Celeste Monforton, DrPH, MPH 0Comment

There’s plenty of evidence of the positive impact on families and on public health when workers have paid sick leave.

For me, the first thing that usually comes to mind are employees who have influenza. Without paid leave, they are put in the situation of having to choose between losing a couple days’ wages or staying home to recover. They belong at home and resting up—not spreading the virus at work.

But the benefits of paid leave go well beyond the influenza season. We also have data on the positive relationship between paid leave and receiving cancer screenings (e.g., mammograms, Pap tests, and fecal occult blood test) as well as the benefits for maternal health, breastfeeding, and children receiving routine preventive health care services (e.g., see herehere, here.)

A new paper appears to be the first to examine preventive care use among manual laborers in the U.S. depending on their paid leave status.

Bart Hammig and Brooke Bouza with the University of Arkansas used data from the National Health Interview Survey ((NHIS) 2013-2016) to evaluate the relationship between use of health care services and access to paid sick leave. They focused their research question on a subset of the data, specifically, 8,550 adult males who were employed in manual labor jobs, such as in construction, mining, utilities, and agriculture. The relevant question in the NHIS “Do you have paid sick leave on this main job or business?”

Hammig and Bouza report several interesting findings about this population of blue collar workers:

  • Only 35 percent reported having paid sick leave.
  • The odds of having visited a health care provider and/or receiving screenings for cholesterol or blood pressure in the past 12 months was at least two times higher for the laborers who had paid leave.
  • The odds of having seen a dentist in the past 12 months was more than two times higher for the laborers who had paid leave. The authors note that their’s may be the first study to specifically examine the relationship between paid leave and oral health services.

I happened unexpectedly upon Hammig and Bouza’s paper. I’m glad I did. First off, I appreciate the research question they set out to answer. More important to me is the thoughtful way they present the conditions of employment (i.e., wages and benefits) as a potential contributor to health disparities. They write:

“a majority of lower income workers and blue collar workers, such as those represented in our sample, do not have access to paid sick leave benefits. This is noteworthy as persons in lower socioeconomic income brackets often have a disproportionately higher prevalence of chronic health conditions, such as higher rates of obesity, diabetes, smoking, and associated cardiovascular risk factors. As such, the low prevalence of sick leave benefit among labor workers likely furthers the disparity in health conditions. Therefore, this group of workers may stand to gain the most from paid sick leave, specifically in terms of preventive medical visits and control of chronic illnesses, such as diabetes.”

I often find myself making the public health pitch for paid leave. My first go-to reason is influenza, but now I’ll have another example that most people can relate.

I’ll tell a reader or listener to imagine the worst tooth pain—pain so severe you’d beg a dentist to pull out your tooth. The torment and expensive treatment could have been prevented by regular dental check-ups. But without paid leave (or flexibility in a work schedule to get to the dentist) you had to forego those routine visits.

This paper was a good reminder that our lists of preventive care activities should have dental visits near the top. And that “paid leave” is not just when your sick, but to keep yourself well.








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