In the U.S., only four states mandate employers to include paid sick leave as an employee benefit. That means that some 49 million Americans are vulnerable to illness and injury, causing a divide in health care outcomes. A study made by researchers at Forida Atlantic University and Cleveland State University assessed the effects of paid sick leave, or lack thereof, had on employees’ health. Those who didn’t have this benefit were at a much greater risk of forgoing medical care, either to treat or prevent an illness or injury.

Image: The Blue Diamond Gallery (free to use)

“Results from our study contradict public health goals to reduce the spread of illness, and policy makers should consider the potential public health implications of their decisions when contemplating guaranteed sick leave benefits,” said LeaAnne DeRigne, Ph.D., lead author of the study and associate professor in the School of Social Work at FAU in a statement.

DeRigne and her collaborators 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.

To assess the relationship between paid sick leave benefits and delays in medical care, researchers included 18,655 working adults ages 18-64 in their samples. A total of 10,586 adults were identified with paid sick leave benefits and 7,879 employees who were lacking the benefits.

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. At the same time, this vulnerable group were three times more likely to forgo medical care altogether, the authors report in Health Affairs.

Not having paid sick leave means that many low-income families will risk delaying maybe much needed medical care out of fear of getting fired or not being able to pay bills. This effect branched towards other family members, as the researchers found 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. As expected, the lowest-income group in the sample were the likeliest to delay or forgo medical care.

“There are so many positive outcomes related to providing paid sick leave that more employers should consider voluntarily offering this benefit,” said Patricia Stoddard-Dare, Ph.D., associate professor of social work at Cleveland State.

According to the report, an employee with paid sick leave benefits missed 1.5 days more at work than those without the benefit. This suggests that those with paid sick leave do in fact take it easy and visit the doctor. One and a half day in a whole year isn’t that much at all, addressing an unfounded fear some entrepreneurs or managers might have that employees might take advantage of paid sick benefits.

The present study seems to echo the findings of a report published in 2011 called “Failing its Families: Lack of Paid Leave and Work-Family Supports in the US.” The authors of the report interviewed 64 parents across the country. Parents said that having scarce or no paid leave contributed to delaying babies’ immunizations, postpartum depression and other health problems, and caused mothers to give up breastfeeding early. Many who took unpaid leave went into debt and some were forced to seek public assistance. Some women said employer bias against working mothers derailed their careers. Same-sex parents were often denied even unpaid leave.

The United States is one of just three countries in the world that doesn’t guarantee paid time off for new mothers. Only 13 percent of American workers have access to paid family leave through their employers.

“The personal health care consequences of delaying or forgoing needed medical care can lead to more complicated and expensive health conditions,” said DeRigne. “U.S. workers with paid sick leave are more likely to take time off work to care for themselves or for family when needed. More importantly, it enables workers to ‘self-quarantine’ when necessary, without the worries of losing their job or income while also not spreading illness to others. This is especially important for food service, health care and child care industries where the spread of illness can have large public health impacts. In recent news, corporations such as Chipotle are enacting new paid sick leave benefits to try and stop the spread of viruses such as Norovirus and E-coli.”