Why Don’t All Americans Have Paid Sick Leave?


No PSL at work
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The COVID-19 pandemic highlighted the importance of paid sick leave (PSL) policies in the workforce.

Unfortunately, 21% of America’s working population still does not have access to PSL three years after the initial COVID-19 outbreak, according to Change Lab Solutions.

Here’s why PSL continues to be so important, and how advocates can work toward achieving local, state, and national PSL policies that promote the health of Latinos and all people.

What Does Paid Sick Leave Look Like in America?

Shockingly, the US is one of only three high-income countries in the world without any form of national paid sick leave, according to Change Lab Solutions.Number of Americans without PSL

The need for PSL for all Americans is stronger than ever, especially as government leaders end various pandemic-era public benefits that have helped many families get by in tough financial times.

The end of these benefits and the current inflated economy puts many workers without PSL in a bind. Many workers simply can’t afford to stay home when sick, especially when doing so could cost them their job.

Early in the pandemic, the Families First Coronavirus Response Act provided PSL to eligible employees, but this act ended on Dec. 31, 2020, just nine months after it was enacted.

As a result, workers without PSL may feel pressured to work while sick, further contributing to the spread of COVID-19 and its even-more-contagious variants.

While there is no national policy protecting all American workers, dozens of states, cities, and counties do have PSL laws. A Better Balance provides an interactive and customizable comparison of these policies.

But in Texas, which has a 40.2% Latino population, PSL laws remain a worker’s fantasy.

In 2018, Austin enacted a PSL policy, followed by Dallas and San Antonio. However, through legal battles, these laws were struck down.

“As a result, workers in these three cities lack the legal right to paid sick time, despite the will of their communities and elected officials,” according to a Better Balance.

How Does Lack of Paid Sick Leave Affect Latinos?

Those with lower paying jobs, such as service workers, workers in production (including agricultural, construction, maintenance, and transportation workers), and part-time workers, are less likely to have paid sick leave, according to Change Lab Solutions.

Unfortunately, Latinos work many of these lower paying jobs.

In fact, studies show that Latinos are significantly less likely than non-Latino workers to have PSL, according to Change Lab Solutions.

Understandably, lack of PSL can take a toll on health.


In fact, PSL is closely associated with increased preventive cancer screenings among workers and decreased spread of infectious diseases, according to Change Lab Solutions.

Considering cancer – especially preventable cancer – is the leading cause of death among Latinos, and  this same population is disproportionately affected by COVID-19, PSL could be a game-changer in tackling health disparities in this population.

“When you are sick, you shouldn’t be forced to go to work. It’s bad for you, your co-workers, your employer, and your community,” according to a Better Balance.

“Latinos and all Americans should have access to paid sick leave, no matter their occupation, pay, or background,” added Dr. Amelie Ramirez, director of Salud America! and its home base, the Institute for Health Promotion Research at UT Health San Antonio. “Workers should have the time they need to be well and take care of family without fear of losing their job.”

How Can We Promote Paid Sick Leave?

Public health leaders can play a significant role in increasing awareness of paid sick leave and its impact on health outcomes, according to Change Lab Solutions.

Public health leaders can:

Find stakeholders to support PSL policies. These stakeholders may include state-level agencies, like departments of public health. Elected officials can also help in getting policies enacted. Private-sector and community partners like chambers of commerce, nonprofit organizations, and school districts, can also promote PSL policies.

Communicate. Public health leaders can target many types of media, including Spanish-language media. Messages should focus on the health benefits of PSL for employees, and the business benefits to employers (healthy workers are more productive).

Incentivize employers to adopt a PSL policy. Employers could be offered free publicity, special recognition, or promotion as “employee-friendly” for adopting a PSL policy.

Encourage discussion of PSL in your state’s comprehensive cancer control plan. For example, a plan could recommend educating employers about PSL and its positive impact on preventive cancer screenings.

You can help promote health equity, too.

Select your county and get a Health Equity Report Card by Salud America! at UT Health San Antonio.

In your report card, you will see maps, data, and gauges to compare health equity issues, including healthcare access, household income, and more.

Email your Health Equity Report Card to community leaders, share it on social media, and use it to make a case to address PSL where help is needed most!

Get your Health Equity Report Card!

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