New Estimates of the Prevalence of Short-Term Illness and Caregiving to Inform Paid Sick Leave Enforcement

• In Event: Local Experiences with Paid Sick Leave Laws: Implementation, Enforcement, and Preemption

Abstract

While nearly universal in much of the rest of the world, American workers lack access to federally mandated paid sick leave. The ability to take paid time off from work when ill, to care for a sick family member, or to schedule needed medical care is crucial for worker wellbeing as well as for public health. In the absence of federal guarantees, dozens of cities and states across the country have enacted local labor standards that mandate employer provision of paid sick leave. Studies of the effects of these mandates have shown that such mandates increase access and reduce presenteeism (Callison & Pesko, 2022; Colla et al., 2014; Maclean et al., 2020; Romich, 2017; Schneider 2020 AJPH; Woods et al 2025 SSM-PH) but also suggest that compliance with PSL mandates is not universal.  State and local labor standards agencies are tasked with implementing and enforcing such PSL laws.  Yet, these agencies often lack crucial research to aid in that work.  Specifically, while it is often taken as given that there is widespread need for paid time off for the purposes above, the enforcement of such labor standards is complicated by the fact that the right to PSL is only triggered in the instance of such a qualifying event (as opposed to, say, the minimum wage which binds more or less universally). Specifically, when conducting investigations, labor standards agencies must have evidence on what the expected rate of PSL usage should be in order to determine if very low actual rates of usage within a workplace are indicative of a low level of need or suggest labor standards non-compliance. Yet, we know of no national surveys that directly gauge workers’ exposures to the qualifying events of own illness, caring for an ill family member, or scheduling needed medical care. At best, existing surveys measure if respondents took paid time off from work, and generally then only for their own illness.  To fill this gap and inform labor standards enforcement, we developed a novel survey module to gather systematic information on qualifying events, as well as ensuing leave-taking, and fielded it to a sample of 4,000 hourly workers employed at large firms in retail, hospitality, and logistics/delivery in the Fall 2025 wave of the Shift Project survey. In preliminary results, we find that 54% of respondents experienced mental or physical illness or injury at a time when they were scheduled to work in the past 12 months and that 75% of workers experienced that or another qualifying event for PSL. We will examine how the extent of need for PSL varies by worker demographics, geography, and sub-sector, including generating model-based estimates of workplace-level exposure to events (given workplace demographics, location, employer, etc), which will allow us to calculate the between-establishment variation in need for PSL. We will then examine patterns of taking paid and un-paid time off in response to need and the factors that shape these decisions, including the presence of Paid Sick Leave standards.

Author

• Kristen Harknett, University of California, San Francisco
  Presenting Author