Paid leave broadly defined is time off from work in which employees are still paid a certain wage despite their absence. The two main types of paid leave are family/medical paid leave and paid sick leave. Family/medical paid leave is classified as time off that allows an employee to take care of an ill child (newborn or adopted), sick parent or elder in the family (like a grandparent or father in law), and maternity/paternity or parental leave. Paid sick leave, also referred to as earned sick time, is leave that employees can take if they or a relative are sick or injured.  Cities may have a paid family/medical leave policy, a paid sick leave policy, or some combination of both. Both types of paid leave are important for many reasons. It is vital that for individual well-being, families, community health, and public health that employees are provided with paid leave options so they have the ability to take time off from work to care for themselves and family members without fear of lost wages or jobs. Note that these types of leave are different from "vacation" or "annual leave" and directly relate to situations where an individual or a family member is ill, injured, or in need of care.

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In comparison to other countries with similarly advanced economies, the US lags far behind in providing paid leave – it is the only one that does not mandate paid maternity or sick leave. Other countries provide both types of leave, and some include paid paternity leave as well. The state of paid leave varies in the US, and is not equitably distributed. In 2016, about 14% of civilian workers had access to paid leave. 88% of civilian workers have access to unpaid leave, due to the Family and Medical Leave Act that guarantees eligible workers up to 12 weeks of unpaid leave during the year as long as they meet certain criteria, such as time at an employer. Employees in low wage occupations are the least likely to have access to paid sick leave. They are also the least able to forgo wages to take time off to care for themselves or sick relatives, or to visit a health care provider. More than half of Latino workers, who disproportionately work in lower paying jobs, and 38% of black workers are unable to earn a single paid sick day. Today, cities in the US are leading the charge implementing policies that mandate equitable paid leave for their employees. No employee should have to choose between their health or their families’ health and their job/wages, and cities are working to pass policies to ensure paid leave benefits for employees.


There are numerous health benefits to providing paid family leave. Mothers who take paid leave after birth experience mental and physical health improvements, as well as better prenatal and postnatal care for themselves and their child. They also may breastfeed for a longer period of time, which confers its own set of benefits for mother and child. Breastfeeding can protect infants from bacterial and viral infections, reduces the risk of children becoming overweight later in life, and women who breastfeed may have lower rates of certain types of breast and ovarian cancers. There is also increasing evidence that nurturing relationships and environments for newborns and children can improve childhood outcomes. Paid leave for new parents to spend time with their newborns or newly adopted children in early developmental life stages is important for cognitive development. Paid maternal/paternal leave allows parents to spend time with their children, strengthening family bonds and decreasing familial stress.  Elders who are cared for by family members who have paid leave through their jobs often have a higher quality of life.



According to the Bureau of Labor Statistics, one third of people who work in the private sector and a quarter of people who are earning the lowest wages in society do not have access to earned sick days.  Employees without paid sick leave are one and a half times more likely to come to work while sick and delay seeking care, which is detrimental to their health and the health of those around them. They may come into work even if they have contagious illnesses like the flu or a viral infection, infecting other employees and clients they interact with. This is especially concerning in the food preparation sector of the workforce. According to the CDC, 70% of foodborne transmission of norovirus is due to infected food workers. Beneficial sick leave policies can help to reduce the spread of contagious illness, increase employment and income stability, and save cities money in health care costs. Access to earned sick days has also been associated with more visits to health care providers, regardless of whether people have health insurance. This is especially important in the utilization of preventative care. Health issues that are caught early on may be able to prevent future hospitalizations. Paid sick leave can also help promote economic security for people who need to seek or provide care related to drug use, something that is increasingly important with the opioid epidemic.


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There are several common concerns that employers/the public may have in regards to paid leave policies. They may be concerned these policies will impose a large cost burden on employers, deter new businesses from establishing themselves, or they may be concerned that people will abuse this potential benefit. Research has shown that these concerns are largely unfounded. In a Seattle, WA study, 70% of business owners favored city’s earned sick day law after it was implemented. A report examining Washington, DC in 2013 stated that the city’s sick leave law did not discourage business owners from doing business in DC, nor did it encourage them to move away from DC. The Center for Economic and Policy Research studied paid sick leave laws in New York, and found that employers reported basically no abuse of the paid sick leave law, and that the vast majority of employers (about 85%) said that the paid sick leave law had no effect on overall business costs, and saw no reduction in hiring as a result of the new law (91%).

Paid leave policies can additionally save money in other arenas.  When employees come to work sick, their productivity is decreased. This problem is called “presenteeism” and occurs when employees come to work but their productivity is decreased for some reason, such as that they are sick, or they may be stressed or worried about a sick relative. Currently presenteeism is estimated to cost our national economy $160 billion annually. Additionally, evidence from the Department of Labor also shows that by providing paid sick leave, visits to the emergency room would also be reduced by about 1.3 million visits a year. With paid sick leave, people would be able to take time to see a health care provider before their illness or a relative’s illness progresses to a point in which they seek care from the emergency room - potentially saving approximately $1.1 billion in direct and indirect medical costs.