Paid Leave as Health Policy: Program Design, Uptake, and Health Impacts

Session Submission Type: Panel

Abstract

Paid leave policies – paid family and medical leave (PFML), paid sick leave (PSL), and paid paternity leave – are increasingly central to health policy because they shape when workers can access preventive and diagnostic care, recover from illness, and provide caregiving without risking income or job loss. Yet, major policy questions remain unresolved: How do program rules and administration translate into real-world utilization? How do employers respond when public programs expand? And do paid leave mandates measurably change health-related behaviors and care use? This panel brings together four papers that connect policy design to take-up, employer behavior, and downstream health outcomes, leveraging quasi-experimental designs and rich administrative, survey, and employer data across the United States as well as a cross-national policy case.

The first paper uses New Jersey administrative data (2020-2025) to document how Temporary Disability Insurance and Family Leave Insurance utilization varies across demographic, employer, and regional groups, and whether uptake shifted following COVID-era policy changes. It highlights how outreach, application procedures, and local labor market conditions can determine whether legal eligibility translates into real access, especially for underserved groups.

The second paper examines how firms respond when states implement Paid Family and Medical Leave (PFML). Using nationally representative employer benefit data (2009-2023), the authors estimate the extent to which public PFML crowds out employer-provided leave and reshapes the overall bundle of fringe benefits, with heterogeneity by firm size. This evidence is critical for anticipating unintended consequences, understanding the true net increase in leave access, and designing PFML policy that complements (rather than displaces) employer benefits.

The third paper tests whether paid sick leave (PSL) mandates affect memory-related care seeking and management of dementia risk factors, using survey data and commercial claims with difference-in-differences and event-study designs. It tests a concrete health mechanism: whether paid time off enables earlier clinical engagement and chronic-condition management during midlife, when modifiable risks emerge.

Finally, the fourth paper complements the U.S. evidence by testing whether adopting national paid paternity leave policies shifts public gender equity beliefs across 12 African countries. While cross-national, it complements the U.S. evidence by testing whether leave policies can alter social norms that influence caregiving roles and, ultimately, family health investments and care-seeking behavior.

Together, these papers offer a cohesive, policy-relevant framework for evaluating paid leave as health policy: how implementation and administration shape equitable uptake, how public programs interact with private benefits, when paid leave translates into measurable changes in health-related behaviors, and the social context of caregiving. The panel will also include two discussants with expertise in paid family and sick leave: Jiwan Lee (Brown University) and Meredith Slopen (Stony Brook University).

Policy Area

• Health Policy

Chair

• Emily A Parker, University of North Carolina, Chapel Hill

Discussants

• Jiwan Lee, Brown University

• Meredith Slopen, Stony Brook University

Organizer

• Katherine J Wen, Vanderbilt University

Individual Presentations

• Utilization of Temporary Disability and Family Leave Insurance in New Jersey: Evidence from Administrative Data, 2020-2025 - Presenting Author: Rebecca Logue-Conroy, Rutgers University; Non-Presenting Co-Author: Andrea Hetling, Rutgers University - New Brunswick; Non-Presenting Co-Author: Emily A Parker, University of North Carolina, Chapel Hill; Non-Presenting Co-Author: Stephanie Walsh, Rutgers University - New Brunswick; Non-Presenting Co-Author: Kirsten Meidlinger, Rutgers University - New Brunswick

• Public Paid Leave and Private Benefits: Evidence on Crowd-Out and Welfare - Presenting Author: Nicolas Robert Ziebarth, Center for European Economic Research

• Paid Sick Leave and Cognitive Health: Effects of Mandates on Memory-Related Visits and Dementia Risk-Factor Management - Presenting Author: Katherine J Wen, Vanderbilt University

• National Paternity Leave Policy Adoption and Public Gender Equity Beliefs: A Quasi-Experimental Study of African Countries - Presenting Author: Marie Salem, University of California - Los Angeles