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Why 3 million Americans go to work ill each week

Of the 3 million U.S. employees who to go to work sick each week, about half do so because they would not get paid — and they may even risk getting fired — if they don’t report to work.

Minnesota’s flu season, which peaked late this year, is now in full swing.  And although this flu season has been much milder than in recent years, state health officials are still asking people to take steps to protect themselves — and others — from getting the virus.

It’s particularly important, they stress, to “stay home if you are sick.”

Yet, for many employees, here in Minnesota and across the United States, staying home is not a viable option. The reason: They lack paid sick leave.

In fact, according to a recent study published in the journal Health Services Research, of the 3 million U.S. employees who to go to work sick each week, about half do so because they would not get paid — and they may even risk getting fired — if they don’t report to work, no matter what infectious disease they may be carrying.

“Particularly employees in the low-wage sector lack access to paid sick leave, and many of those employees work sick and spread diseases,” said study co-author Nicolas Ziebarth, a health and labor economist at Cornell University in Ithaca, N.Y., in a released statement. “Mandating access to paid sick leave and changing the sick leave culture would help to reduce the number of employees working sick.”

A common dilemma

The study, which is based on survey data collected by the Department of Labor in 2011, found that 65 percent of full-time employees have sick leave coverage in the United States. The proportion drops to 20 percent, however, for full-time workers whose hourly wage is under $10, as well as for part-time employees and people in the hospitality and leisure industries.

The survey data also revealed that in a given week, almost 10 percent of U.S. employees report having to deal with an illness. On average, 4.8 percent of employees take sick leave because of their own illness each week, and 1.6 percent take it because of the illness of a relative (usually a child). Another 1.3 percent will rearrange either their work hours or their work location, such as by working from home, when they or a relative is ill.

That leaves 2 percent — or about 3 million working Americans — who need sick leave during a given week, but do not take it, according to the study. Forty percent of these employees cite not having paid sick leave as their reason for not staying home.

More than a quarter (27 percent) of employees who go to work ill say they do so because they can’t afford the loss of income if they stay home. Other key reasons for not taking sick leave when needed are a high workload (20 percent) and a fear of negative job consequences (11 percent).

Key factors: gender and age

Ziebarth’s analysis of the survey data also revealed that certain groups of people are more likely to go to work when ill than others. 

Women, for example, are more than twice as likely as men to go to work sick (2.9 vs. 1.3 percent), even when controlling for type of job, age and number of children at home. Parents with more than three children and young adults between the ages of 25 and 34 are also significantly more likely to work through any illness.

Those findings suggest, writes Ziebarth and his co-author, “that children both directly and indirectly increase the need for sick leave through (1) own sickness, and (2) transmission of infectious diseases to parents.” 

But hourly wage is also a major factor in who stays home or goes to work when ill. Employees who earn under $20 an hour are more than three times as likely as those who earn more than $30 an hour to report having gone to work ill during the previous week, the study found.

Those low-hourly-wage earners are also the people most likely to not have sick leave coverage.

‘A strong rationale’

As Ziebarth points out in his paper, the U.S. is the only industrial country without universal access to paid sick leave. 

“A strong rationale for sick pay coverage is public health promotion,” writes Ziebarth. “Without sick pay, contagious employees come to work sick, which … spreads diseases.”

The lack of such coverage may also be adding to the economic burden of our health-care system. According to another study published Monday in the journal Health Affairs, people without paid sick leave are three times more likely to delay seeking medical care for themselves and twice as likely to delay seeking care for a family member.

They are also more likely to have received medical care recently in a hospital emergency room.

The study was not designed to determine if the lack of sick leave worsens the workers’ health, but as its lead author, LeaAnne DeRigne, an associate professor of sociology at Florida Atlantic University, noted in a released statement, “delaying or forgoing needed medical care can lead to more complicated, disabling and expensive health conditions.”

“Paid sick leave is an important employer-provided benefit that helps workers and their dependents receive prompt preventive or acute medical care, recuperate from illness faster, and avert more serious illness,” she added. “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.”

FMI: You can download and read Ziebarth’s study at the website for Health Services Research. DeRigne’s study is, unfortunately, behind a paywall, but you’ll find an abstract at the Health Affairs website.

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Comments (2)

  1. Submitted by Nathaniel Finch on 03/08/2016 - 10:15 am.

    What this article does not mention…

    What this article does not mention is that these days most companies that do provide “sick leave” combine sick leave and vacation into paid time off. If you take off a day because you’re sick, you get one less day of paid time off – which you otherwise would use for vacation. If an employee is planning a vacation, he or she is often loathe to take a sick day and lose a day of paid vacation.

    Another factor is that companies are hiring fewer employees and using more workers who work on contract or as temporaries. These people are paid only for the hours they show up and work. If they don’t work they aren’t paid. This includes many workers who earn higher hourly wages as contract workers.

    In general, workplaces have gotten less humane on many levels in the last 30 years.

  2. Submitted by dan buechler on 03/08/2016 - 03:47 pm.

    I almost died.

    Caught pneumonia from a student. Worked for 5 days then saw my doctor. Have high deductible insurance and no sick days as reason for delay. Almost needed an IV but Zithromax worked. Could have gotten endocarditis.

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