More paid sick leave means less death overall, according to U.S. study

At the start of the COVID-19 pandemic, paid sick leave became a hot topic of conversation as people began to ask in earnest if it might save lives.

The answer, according to a new U.S. study, is yes — but higher paid sick leave has been associated with lower mortality rates long before the pandemic started, researchers found.

The study, published Monday in the American Journal of Preventive Medicine, analyzed two decades of data on U.S. deaths and compared it to statistics on the hours of paid sick-leave requirements across the country.

What they found was that even one extra hour of paid sick leave was associated with a measurable decrease in mortality from suicide, homicide and alcohol poisoning, according to the study’s modelling.

The study also looked at which states restricted local governments from increasing their paid sick leave, and found that these preemption laws may be having a deadly effect.

“State preemption laws that protect profits over people may be shortening the lives of working-age Americans,” Jennifer Karas Montez, a sociology professor at Syracuse University and co-investigator in the study, said in a press release.

“We were surprised by how large the ‘preemption effect’ for paid sick leave mandates turned out to be. We project that mortality could potentially decline by over five per cent in large central metro counties currently constrained by preemption laws if they were able to mandate a 40-hour annual paid sick leave requirement.”

The study calculated that there were four specific counties — Orange County in Florida, and three counties in Texas — where the mortality rates would have been 7.5 per cent lower in working-age adults in 2019 if their attempts to raise their mandated paid leave hadn’t been blocked by state laws.

Researchers obtained mortality data from the U.S. Centers for Disease Control and Prevention for 1999-2019, focusing on adults aged 25-64 and organizing them by county.

They looked at both minimum wage levels and mandated paid sick leave, but didn’t find any statistically significant connection between minimum wage levels and mortality rates.

It was a different story, however, when looking at paid sick leave.

The study’s modelling found that a one hour increase in paid sick leave was associated with a 0.2 per cent reduction in homicide levels among women and men.

It was also associated with a 0.4 per cent reduction in alcohol deaths among women and a 0.1 per cent reduction in suicide rates among men.

While the percentages are small, this would amount to 200 less homicide deaths per 100,000 people for both men and women, 400 less alcohol deaths in women and 100 less suicides among men, according to the study.

And when comparing regions with no paid sick leave baseline to those with 40 mandatory hours, the difference was even clearer.

“According to the models, moving from 0 to 40 hours of paid sick leave would decrease homicide mortality by more than 13 per cent among women and by nearly eight per cent among men,” the study stated.

During the pandemic, the question of paid sick leave became more urgent than ever, with advocates in numerous countries pushing for broad paid sick leave to be implemented to allow residents to stay home and stop the spread of COVID-19 without suffering economic consequences.

In Canada, some provinces have since implemented sick leave policies, but many are still temporary or tied to illness with COVID-19 specifically. An amendment this summer to the Canada Labour Code will provide 10 days of paid sick leave to federally regulated private sector workers, but advocates say more needs to be done to implement a truly national paid sick leave.

The results of this new study suggest that you don’t need a global pandemic for paid sick leave to have an impact on how many people live or die in a year.

“Our study adds to a growing literature pointing to the importance of states’ labor and economic policies on mortality of working-age adults,” Douglas A. Wolf, a professor with Syracuse University and lead investigator of the study, said in the release.

After looking at the connection between paid sick leave and mortality rates, researchers used modelling to see if mortality rates would change if preemption laws restricting paid sick leave were repealed.

Preemption laws affect local governments’ legislative powers. They are usually used to harmonize local, state and federal policymaking and establish a baseline, such as when federal governments set a national minimum wage.

But it can also mean setting a legislative “ceiling” that prevents local governments from setting more progressive regulations, such as preventing counties from requiring more hours of paid sick leave.

The study looked not only at the four counties whose paid sick leave laws were blocked, but also at 21 counties that currently have no paid sick leave mandates, but would fall under state preemption laws if they tried to introduce one.

If these counties were free to adopt paid sick leave mandates, their mortality rates could see reductions ranging from three per cent to more than 10 per cent, researchers predicted.

“The consequences of preemption laws stymie local government innovation, constrain opportunities to earn a living wage and take time off of work for medical care without financial repercussions, elevate the risk of death among infants and working age-adults, and contribute to geographic disparities in mortality,” Wolf said.