Impacts of State Paid Leave Policies on Maternal, Worker, and Child Wellbeing: New Quasi-Experimental Evidence

Session Submission Type: Panel

Abstract

State paid family and medical leave (PFML) programs have expanded rapidly across the United States, positioning paid leave as a key policy lever to improve health and wellbeing across the life course. Existing research on PFML has focused heavily on parental leave-taking and short-term parent and child health outcomes, leaving important gaps in evidence on maternal safety, low-wage workers, early life environments, and longer-term outcomes. This panel presents new quasi-experimental evidence on the impacts of state paid leave policies on maternal, worker, and child well-being.   

The first paper examines whether PFML policies influence physical abuse during pregnancy, a serious maternal and infant health concern. Using national data from the Pregnancy Risk Assessment Monitoring System (PRAMS) and a staggered difference-in-differences design, the study finds suggestive evidence of reductions in abuse during pregnancy in the years following PFML adoption, particularly as programs become more established. These findings highlight the potential for economic policies to function as upstream interventions for violence prevention.   

The second paper evaluates the effects of PFML on the health and wellbeing of service sector workers, a population often excluded from employer-provided benefits. Using data from The Shift Project and a difference-in-difference design, the authors estimate impacts on self-rated health, psychological distress, sleep quality, and financial strain among more than 370,000 workers. This study provides evidence on how paid leave policies affect workers in low-wage and unstable jobs.   

The third paper examines the effects of PFML on early childhood environments by evaluating impacts on positive childhood experiences (PCEs). Using data from the National Survey of Children’s Health and a staggered difference-in-differences design, the study finds that PFML is associated with improvements in a validated measure of family resilience and connection, with larger effects observed in more recently implemented programs. This work extends prior research on adverse childhood experiences by demonstrating how paid leave policies may also promote protective factors in early life.   

The fourth paper investigates longer-term impacts of paid leave on children’s health and educational outcomes. Using linked administrative data from Rhode Island and a regression discontinuity in time design, the study evaluates the effects of Temporary Caregiver Insurance on outcomes from birth through third grade, including developmental screenings, school readiness, and academic performance. This study addresses a key gap in U.S.-based evidence on the sustained impacts of paid leave.   

Together, these papers demonstrate how state paid leave policies may shape health and wellbeing across the life course—from maternal safety and worker health to early childhood environments and longer-term development. Drawing on rigorous quasi-experimental designs and diverse data sources, this panel offers timely, policy-relevant insights for researchers, practitioners, and policymakers seeking to strengthen paid leave programs and promote health equity. The panel will be enriched by two discussants: Meredith Slopen, a leading researcher in labor policy, and Rebecca Grady, a practitioner with experience in the administration of a state paid leave program, who will provide complementary perspectives on the policy implications and real-world implementation of these findings.

Policy Area

• Family and Child Policy

Chair

• Heather D Hill, University of Washington

Discussants

• Meredith Slopen, Stony Brook University

• Rebecca K Grady, WA Employment Security Department

Organizer

• Krista Neumann, University of Washington

Individual Presentations

• Paid Family and Medical Leave and Physical Abuse During Pregnancy: A Multi-state Quasi-Experimental Study - Presenting Author: Avanti Adhia, University of Washington

• Paid Family and Medical Leave and Service Worker Health: A Quasi-Experimental Study - Presenting Author: Tom Lindman, Harvard University

• Impact of Rhode Island's Temporary Caregiver Insurance on Child Health and Educational Outcomes - Presenting Author: Jiwan Lee, Brown University; Non-Presenting Co-Author: Margot Jackson, Brown University

• Effect of Paid Family Leave on Positive Early Childhood Experiences - Presenting Author: Dina Burstein, Tufts Medical Center