The Impact of Employment Status, Income, and Occupation on the Association Between Workplace Benefits and Health-Related Work Absences.

Background: Workplace benefits such as paid sick leave and employer-sponsored health insurance influence workers' ability to take time off when ill or injured. We examined whether and to what extent these workplace benefits complement each other in affecting health-related work absences, and whether associations varied by employment status, income, and occupation.

Methods: This cross-sectional study analyzed pooled data from the 2021 and 2023 National Health Interview Survey (NHIS), a nationally representative survey of US adults. The sample included 31,280 employed adults. Workers were classified into four workplace benefits groups: paid sick leave only, employer-sponsored health insurance only, both benefits, and neither benefit. The primary outcome was health-related work absence in the past 12 months. Interaction terms assessed differences in probability of absence by employment status (full-time vs. part-time), income (< 400% vs. ≥ 400% of the federal poverty level), and occupation type (Management, Professional, Service, Sales, and Production).

Results: Compared to those with neither benefit, the probability of work absence was 7.3 points higher with employer-sponsored health insurance only (p < 0.001), 4.6 points higher with paid sick leave only (p = 0.002), and 12.0 points higher with both benefits (p < 0.001). The association between workplace benefits and health-related work absence varied by employment status, income level, and occupation type (p < 0.001 for all interactions).

Conclusions: Access to paid sick leave and health insurance increased the likelihood of taking time off due to illness or injury, with differences by employment status, income, and occupation.