Exploring the association of paid sick leave with healthcare utilization and health outcomes in the United States: a rapid evidence review

Abstract

Objective

Paid sick leave (PSL) laws mandate employers give workers paid time off when they are sick or injured. This current study aims to examine whether access to PSL is associated with healthcare utilization and health outcomes and to summarize the types of utilization and outcomes which have been reported to be associated with PSL.

Methods

We conducted a rapid evidence review. Our search of seven databases, including Medline, Embase, PsycINFO, Cochrane Library, CINAHL, Scopus, and JSTOR, on September 21, 2020, identified 757 studies, 30 of which were retained.

Results

Previous evidence is mostly provided by cross-sectional studies with survey data. In this study, evidence suggests that PSL is significantly associated with some types of healthcare utilization and health outcomes. In terms of healthcare utilization, findings indicate PSL is associated with an increase in the use of some preventive services and a decrease in the use of emergency care; while findings are mixed regarding associations of PSL with health provider visits and the use of mammograms and pap smears. As for health outcomes, findings suggest PSL is associated with improved mental and self-rated health, decreased incidence of influenza-like illness, and lower occupational injuries and mortality rates.

Conclusion

PSL may be an effective tool in improving some healthcare utilization and health outcomes. Future research could help identify mechanisms through which PSL access works and identify what policy components lead to better outcomes.