Paid sick leave policy was brought to the forefront of U.S. public discourse this past week after President Biden and congressional leaders moved to block a nationwide rail strike over union workers’ objections to the lack of sick leave policies in their contract. Under the imposed deal, workers receive no paid sick days. Four unions had already voted against the contract.
Congress’s move to block the strike comes after massive layoffs undertaken by railroad companies in recent years. Railroad bosses, who have taken in over $200 million in compensation in just three years, have laid off nearly one-third of the workforce of the seven Class I railroads and by implementing “precision scheduled railroading,” an operating strategy that critics say cuts costs to increase profits for shareholders. In essence, rail bosses have created the crisis by putting workers under increasing strain while refusing to offer benefits in return — including paid sick days.
Although Senate Democrats failed to push through a last-minute measure to add seven days of paid sick leave to the agreement, the measure passed in the House. Just after the Senate blocked the strike, Sen. Bernie Sanders (I-Vermont) released a statement saying he was proud of the House-passed legislation. But the “struggle is not over,” he wrote. “At a time of record-breaking profits for the rail industry, it is disgraceful that railroad workers do not have a single day of paid sick leave.” Sanders vowed to do “everything [he] can to make sure that rail workers in America are treated with dignity and respect.”
On December 1, a railway union source told The Intercept that the “next phase of the fight would be a demand that Biden include rail workers in a coming executive order that would mandate 56 hours of paid sick leave for federal contractors.” Advocates added that “all organizing should go toward” that executive order.
That labor disputes over paid sick days have come to this point is no surprise. Rail unions have been agitating for sick pay over a years-long bargaining process. Throughout the pandemic, too, progressive public health experts and advocates have sounded the alarm for increased access to paid sick leave for all workers.
Pandemic paid sick leave expired in December 2020, leaving the country without a federal paid sick leave program. The U.S. is one of the only high-income countries in the world without federal paid sick leave. Now, advocates say, in light of renewed public attention on the issue due to the rail unions’ statements, is the time to make strides toward federal legislation — for rail workers and for the millions of other U.S. workers who currently have no access to full or partial paid sick leave. These policies, they say, are absolutely necessary for workers’ economic and health well-being.
Julia Raifman, an assistant professor of health law, policy and management at Boston University’s School of Public Health who has tracked states’ policies to mitigate COVID since the start of the pandemic, told Truthout that the people who most need paid sick leave “are the least likely to have it.” Indeed, work absences due to COVID and other illnesses tend to disproportionately affect Black, Latinx and low-income workers and women. In Raifman’s prior work with the Urban Institute, she found that “when people reported missing work [due to COVID-related illness or caregiving], they also reported food insufficiency.” People with low wealth “have little flexibility to meet their immediate needs when they miss work due to illness.” Paid sick leave, she argued, is thus a policy “that helps people avoid a health and an economic hit. It’s really important that paid sick leave policies cover low income, self-employed and part-time workers.”
Late last month, Raifman asserted that instead of blocking the rail strike, Congress should focus on “expanding paid sick leave — by passing the Healthy Families Act,” H.R. 2465.
H.R. 2465 is a piece of proposed sick day legislation which would require employers with 15 or more employees to provide up to 56 hours of paid sick leave in a year. It has been introduced in every Congress since 2004. But the bill is currently stalled in the House.
Discussion of paid sick days has mainly focused on the benefits to workers once they get sick. But sick leave policy is also strongly correlated with preventive health benefits that can keep them from getting sick in the first place. Paid sick leave policies, Raifman argued, thereby benefit “all of society.” Sick workers get to stay home and recover, and they also don’t risk infecting coworkers. Studies have shown that requiring employers to provide paid sick days reduces the spread of flu and other airborne illnesses, and reduces emergency room visits by 1.3 million annually. And emergency pandemic paid leave helped slow the spread of COVID by roughly 15,000 cases per day.
Raifman, alongside colleagues from Boston University and Drexel University, recently found that paid sick leave policies are also strongly associated with increased vaccination rates, because they may make it easier for workers to get vaccinated. Since vaccination decreases morbidity, mortality and rates of long COVID, strengthening paid sick leave policy can lead to a positive domino effect for workers and lessen the associated economic impacts of illness-related work absences.
Raifman and her colleagues found that vaccination coverage may be 17 percent higher in cities with paid sick leave policies compared to cities without such policies. The study came out of the Big Cities Health Coalition, a group that connected some of the largest health departments in the country to combat COVID inequities. The researchers examined national and city-level data on vaccination coverage, paid sick leave policies and social vulnerability across 37 cities — representing 20 percent of the U.S. population.
Alina Schnake-Mahl — Raifman’s coauthor and an assistant professor in the Urban Health Collaborative and the Department of Health Policy and Management at Drexel University’s Dornsife School of Public Health — said that the coalition investigated “why COVID health disparities differ across cities.” This question compelled the group to look at the policies that affect vaccination rates, including paid sick leave.
Regardless of whether a city has paid sick leave or not, socially vulnerable neighborhoods have lower vaccination rates. But Schnake-Mahl emphasizes that in cities with a comprehensive paid sick leave policy, her group saw a “smaller gap in vaccination between the least and most socially vulnerable neighborhoods” — meaning that the policy also works to lessen the disparities within cities. (The group defined vulnerability based on the Centers for Disease Control and Prevention’s Social Vulnerability Index, a summary measure.) The authors conclude that paid sick leave may indirectly reduce disparities not only in COVID-19 exposure, but also the burden of illness and death, by “increasing vaccination among cities’ most vulnerable residents.”
The authors also find that in the 22 cities with paid sick leave that were analyzed in the study, the median percentage of vaccinated residents aged 18-64 was 73.2 percent, compared to only 66.5 percent in cities without paid sick leave policies. This discrepancy held up even after controlling for a host of other factors that might contribute to higher vaccination rates, such as county- and state-level election result data and the political party of the state’s governor. “It’s not just [about] how progressive a city is,” Schnake-Mahl said. All the models “show that paid sick leave correlates with higher vaccination.”
Schnake-Mahl added that in the absence of federal policy, a number of cities and states have enacted their own paid sick leave policies. “But there are also states that haven’t passed them, and have actually prohibited cities from passing new expanded policies.” These statewide preemptions, which are often tied to minimum wage laws, “inhibit the benefits for low-income and communities of color,” Schnake-Mahl said. “Absent federal policy, we also have the option for states to rescind these preemptions and allow cities to pass policies that would benefit public health and decrease disparities.”
Raifman emphasized broader federal action. “We need to aspire to do better across the whole country,” Raifman said. While the federal government has failed to move paid sick leave policy forward, leaving states and cities to pick up the slack, it is imperative that “the federal government does it.” That is the only way to “reach everybody.”
President Biden campaigned on Build Back Better, Raifman reminded us — a bill whose original proposal set aside $200 billion toward paid sick leave. “The American public voted for him based on that platform.” And as much as the August 2021 passage of the Inflation Reduction Act was a victory, the law left out policies that are key to a robust social safety net, like paid sick leave. Raifman says, “We still have a lot to do on that front.”
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