Is paid sick leave bad for business? A systematic review.

Vigorous legislative activity both for and against paid sick leave has occurred over the last decade. Although a compelling body of evidence suggests that paid sick leave supports personal and public health goals, a notable barrier in opposition to paid sick leave is apprehension about the potential short-term and long-term harms to business. This review critically assesses the relationship between paid sick leave and favorable or unfavorable business conditions. Utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically review six research databases between 2000 and November 2022. Of 2664 studies identified, 123 were considered potentially relevant and 43 were included in the review. In addition to absence from work, paid sick leave was associated with favorable business conditions such as increased job satisfaction; improved retention; and reductions in occupational injury, contagion, presenteeism, and death; as well as some measures of firm performance and labor market conditions. Overall, our review discovered more evidence supporting the relationship between paid sick leave and favorable business conditions as compared with evidence that supported unfavorable business conditions. Although more research is needed, these findings can be used to inform firm-level and public policy decisions about paid sick leave.

Differences Between U.S. Workers With Asthma by Paid Sick Leave Status: An Analysis of the 2018 National Health Interview Survey.

Having asthma is a chronic condition that requires both acute and preventive care as a vital component of asthma action plans. This study looks at how having access to paid sick leave days may be important to adherence to asthma action plans. Does having paid sick days facilitate preventive care, help people avoid acute asthma incidents, reduce the number of lost work days, reduce the cost of care, and lessen financial worry among asthma sufferers? This research builds on a growing body of literature that has established a relationship between paid sick leave days and preventive and acute health care use and outcomes and yet is the first of its kind to examine the relationship specifically between asthma and paid sick leave. This study used secondary data analysis to examine the relationship between six outcome variables categories and having paid sick leave in a nationally representative sample of N = 1,676 working U.S. adults in the National Health Interview Survey. Workers without paid sick leave benefits were significantly more likely to report they were worried about finances and struggle to afford their prescription medication compared to their counterparts who have paid sick leave benefits. Examined in light of past findings, workers with asthma who lack paid sick leave are in a precarious situation where they have increased worry likely due in part to reduced take-home pay due to unpaid sick days and increased medical expenses. There was no relationship between having paid sick leave and the receipt of preventive asthma care, measures of asthma control, receipt of patient education, and asthma medication use. Implications for policy and practice are put forth.

How does paid sick leave relate to health care affordability and poverty among US workers?

Secondary data analysis on the 2015 National Health Interview Survey was conducted to determine if having paid sick leave increases the odds of being able to afford specific health care goods and services, and not having access to paid sick leave increases the odds of being in poverty, being food insecure and having elevated medical costs among a representative sample of US workers age 18-64. We found a statistically significant association between paid sick leave and ability to afford dental care, eyeglasses and prescription medication. Workers who lack paid sick leave are more likely than those with paid sick leave to be in poverty and have high medical costs. In conclusion, we found a relationship between paid sick leave benefits and being able to afford needed healthcare services and goods and being more vulnerable to economic hardship.

Paid sick leave and preventive health care service use among U.S. working adults.

Managing work and health care can be a struggle for many American workers. This paper explored the relationship between having paid sick leave and receiving preventive health care services, and hypothesized that those without paid sick leave would be less likely to obtain a range of preventive care services. In 2016, cross-sectional data from a sample of 13,545 adults aged 18-64 with current paid employment from the 2015 National Health Interview Survey (NHIS) were examined to determine the relationship between having paid sick leave and obtaining eight preventive care services including: (1) blood pressure check; (2) cholesterol check; (3) fasting blood sugar check; (4) having a flu shot; (5) having seen a doctor for a medical visit; (6) getting a Pap test; (7) getting a mammogram; (8) getting tested for colon cancer. Findings from multivariable logistic regressions, holding 10 demographic, work, income, and medical related variables stable, found respondents without paid sick leave were significantly less likely to report having used six of eight preventive health services in the last 12months. The significant findings remained robust even for workers who had reported having been previously told they had risk factors related to the preventive services. These findings support the idea that without access to paid sick leave, American workers risk foregoing preventive health care which could lead to the need for medical care at later stages of disease progression and at a higher cost for workers and the American health care system as a whole.

Prevalence of Cognitive Impairment Without Dementia and Dementia in Tremembé, Brazil.

BACKGROUND: The prevalence of cognitive impairment is insufficiently determined in developing countries. The aim of this study was to ascertain the prevalence of cognitive impairment without dementia and dementia in community-dwelling elderly in Brazil. METHODS: This was a single-phase cross-sectional survey of the elderly (aged 60 years and above) living in the municipality of Tremembé, Brazil. Twenty percent of the households with elderly persons were randomly selected from urban and rural areas, to obtain a homogenous representation of all socioeconomic and cultural levels. RESULTS: We assessed 630 individuals [mean age, 71.3 y (±7.99); mean years of education, 4.9 (±4.54)] and found prevalence rates of 17.5% (95% confidence interval, 14.6-20.6) for dementia and 19.5% (95% confidence interval, 16.6-22.8) for cognitive impairment without dementia. These prevalence rates were influenced by age (P<0.001) and by educational level (P<0.001). There was no significant sex difference among diagnostic groups (P=0.166). The prevalence of dementia was higher in relatively younger individuals (below 70 y) when compared with other studies. Besides, dementia was associated with low socioeconomic status, stroke, previous psychiatric disorder, alcoholism, and epilepsy. CONCLUSIONS: The prevalence of dementia in this study was higher than in other studies, particularly among younger elderly.

Unintentional prescription drug non-compliance for financial reasons in families with a child with a limiting health condition.

Area probability sampling via U.S. postal addresses was used to select households from seven high poverty U.S. metropolitan areas. In person and telephone interviews with one adult household member were used to determine the odds of delaying or failing to fill a needed prescription for families with a child member with a limiting health condition. Logistic models indicate families with a child with a limiting health condition are 1.57 times more likely to delay or fail to fill a needed prescription, and families with more than one child with a limiting condition are 1.85 times more likely. Implications are set forth.

Association between mental health disorders and juveniles' detention for a personal crime.

BACKGROUND: Youth involved with juvenile courts often suffer from mental health difficulties and disorders, and these mental health disorders have often been a factor leading to the youth's delinquent behaviours and activities. METHOD: The present study of a sample population (N = 341), randomly drawn from one urban US county's juvenile court delinquent population, investigated which specific mental health disorders predicted detention for committing a personal crime. RESULTS: Youth with attention-deficit hyperactivity disorder and conduct disorder diagnoses were significantly less likely to commit personal crimes and experience subsequent detention, while youth with bipolar diagnoses were significantly more likely. CONCLUSION: Co-ordinated youth policy efforts leading to early identification and treatment of bipolar disorder symptoms may be necessary.

Paid Sick Leave and Sleep: An Analysis of US Adult Workers.

OBJECTIVE: This study examines links between paid sick leave benefits and sleep as an indicator of well-being. METHODS: Using data from 12,780 employed adult US workers in the 2018 National Health Interview Survey, the relationship between paid sick leave and sleep was explored while controlling for demographic and health status variables. RESULTS: Logistic multiple regression analyses revealed that compared with workers without paid sick leave, workers with paid sick leave had significantly higher odds of staying asleep, lower odds of feeling rested, and marginally significantly higher odds of having little trouble falling asleep. The groups did not differ regarding the odds of taking sleep medication or getting the ideal amount of sleep. CONCLUSION: The findings suggest a link between sleep quality and access to paid sick leave, adding to a growing list of health and well-being variables associated with paid sick leave benefits.

Predicting juvenile delinquency: the nexus of childhood maltreatment, depression and bipolar disorder.

BACKGROUND: It is important to identify and provide preventative interventions for youth who are most at risk for offending behaviour, but the connection between early childhood or adolescent experiences and later delinquency adjudication is complicated. AIM: To test for associations between specified mental disorders or maltreatment and later delinquency adjudication. METHOD: Participants were a random sample of youth before the juvenile courts in two Northeast Ohio counties in the USA (n = 555) over a 4-year time frame (2003 to 2006). RESULTS: Logistic regression analysis identified a lifetime diagnosis of depression and/or bipolar disorder to be predictive of later youth delinquency adjudication, but found that childhood maltreatment (or involvement with the child welfare system) made delinquency outcomes less likely. IMPLICATIONS: Study implications are discussed as they relate to professionals working in the fields of child welfare, social work, mental health and juvenile justice. Awareness of risks associated with maltreatment may have led to effective interventions, while there may be less awareness of risks from depression in young people; however, studies tend not to take account of intervention variables.

Paid sick leave status in relation to government sponsored welfare utilization.

Nearly a third of all U.S. workers, primarily lower-paid employees, do not have paid sick leave benefits, prompting some lawmakers to consider mandating paid sick leave for all U.S. employees so workers can access timely health care without lost wages. A representative sample of 19,537 workers in current paid employment was examined, searching for the association between access to paid sick leave benefits and receipt of six different welfare and welfare-related services. After controlling for relevant demographic, work, income, and medical/health care variables, results of the logistic models indicate that, among working adults age 18-64, those without paid sick leave are 1.41 times more likely to receive income from a state or county welfare program, 1.36 times more likely to receive other welfare assistance (transportation and child care supports), 1.33 times more likely to received sponsored rental assistance, and 1.34 times more likely to receive Supplemental Nutrition Assistance Program benefits (referred to as food stamps commonly and in this article). Mandating paid sick leave benefits may impact usage of social welfare assistance since families with paid sick leave do not have to lose wages when work is missed because of health and caregiver responsibilities. (PsycINFO Database Record

Paid sick leave and psychological distress: An analysis of U.S. workers.

Paid sick leave is increasingly identified as a social justice issue having important implications for health and wellness; however, little is known about its relationship to mental health. Data from the 2015 cross section of the National Health Interview Survey (NHIS; 2015) were used to examine the relationship between paid sick leave and psychological distress during the last 30 days among N = 17,897 working United States adults. The 6-item Kessler Psychological Distress Scale (K6), a valid and reliable instrument for assessing psychological distress in population based samples, was used to measure the outcome variable of interest. The K6 score was computed from 6 questions and was regressed on paid sick leave status, after controlling for variables known to be related to psychological distress. Results indicated that workers who lack paid sick leave benefits report a statistically significant higher level of psychological distress, and are 1.45 times more likely to report their distress symptoms interfere a lot with their life or activities compared with workers with paid sick leave. This research adds to a body of work analyzing institutional structures and social determinants of health. Findings support the potential value of paid sick leave as an intervention to promote behavioral health. (PsycINFO Database Record

How Many Paid Sick Days Are Enough?

OBJECTIVE: This study analyzes the relationship between number of paid sick days and reported preventive health care service usage among older US workers. METHODS: Using a 2014 cross-section of 3235 US workers age 49 to 57 from the National Longitudinal Survey of Youth, this study is the first to measure paid sick leave as an ordinal variable in an effort to refine our understanding of sick leave, and identify the ideal range of sick days necessary for people to access preventive health care services. RESULTS: We find workers with 10 or more paid sick days have increased odds of reporting five different preventive health care services. CONCLUSION: To support worker and public health, policy planners may want to consider the number of paid sick days that are needed before changes in preventive service use are observed.

Workers Without Paid Sick Leave Less Likely To Take Time Off For Illness Or Injury Compared To Those With Paid Sick Leave.

Paid sick leave is an important employer-provided benefit that helps people obtain health care for themselves and their dependents. But paid sick leave is not universally available to US workers. Little is known about paid sick leave and its relationship to health behaviors. Contrary to public health goals to reduce the spread of illness, our findings indicate that in 2013 both full- and part-time working adults without paid sick leave were more likely than workers with that benefit to attend work when ill. Those without paid sick leave were 3.0 times more likely to forgo medical care for themselves and 1.6 times more likely to forgo medical care for their family compared to working adults with paid sick leave benefits. Moreover, the lowest-income group of workers without paid sick leave were at the highest risk of delaying and forgoing medical care for themselves and their family members. Policy makers should consider the potential public health implications of their decisions when contemplating guaranteed sick leave benefits.

Prevalence of depressive symptoms among elderly in the city of Tremembé, Brazil: preliminary findings of an epidemiological study.

Depression is a heterogeneous mental disease classified as a set of disorders, which manifest with a certain duration, frequency and intensity. The prevalence of depression in the elderly ranges from 0.5 to 16%. OBJECTIVE: To establish, in an epidemiological study, the prevalence of significant depressive symptoms in the population aged 60 years or older. METHODS: Results of a cross-sectional epidemiological study, involving home visits, being carried out in the city of Tremembé, Brazil, were reported. The sample was randomly selected by drawing 20% of the population over 60 years from each of the city's census sectors. In this single-phase study, the assessment included clinical history, physical and neurological examination, cognitive evaluation, the Cornell scale and the Patient Health Questionnaire for psychiatric symptoms. Scores greater than or equal to 8 on the Cornell scale were taken to indicate the presence of depressive symptoms. RESULTS: A total of 455 elders were assessed, and of these 169 (37.1%) had clinically significant depressive symptoms (CSDS). Depression prevalence was higher among women (p<0.001) and individuals with lower education (p=0.033). The Chi-square test for trends showed a significant relationship where lower socioeconomic status was associated with greater likelihood of depressive symptoms (p=0.005). CONCLUSION: The prevalence of depressive symptoms was high in this sample of the population-based study and was associated with female gender, low educational level and socioeconomic status. The assessment of the entire population sample must be completed.

Depressão é uma doença mental heterogênea classificada como um conjunto de transtornos, que se manifestam numa certa duração, frequência e intensidade. A prevalência de depressão em idosos varia de 0,5 a 16%. OBJETIVO: estabelecer a prevalência de sintomas depressivos significantes em estudo epidemiológico em população acima de 60 anos. MÉTODOS: Estudo epidemiológico do tipo transversal, no qual estão sendo realizadas visitas domiciliares na cidade de Tremembé, Brasil. A amostra foi aleatória, através do sorteio de 20% da população acima de 60 anos de cada setor censitário do município. Este estudo é de única fase, sendo realizada anamnese, exames físico e neurológico, avaliação cognitiva e aplicação de escalas de Cornell e questionário Patient Health Questionnaire para verificar sintomas psiquiátricos. Foi adotado como critério da presença de sintomas depressivos, pontuação maior ou igual a 8 na escala de Cornell. RESULTADOS: Foram avaliadas 455 pessoas e destas 169 (37,1%) apresentaram sintomas depressivos significativos clinicamente (SDSC). A maior prevalência foi entre as mulheres (p<0,001) e com escolaridade mais baixa (p=0,033). Quando realizado o teste de qui-quadrado de tendência, houve relação significativa, à medida que diminui o nível socioeconômico, aumenta a chance da presença de sintomas depressivos (p=0,005). CONCLUSÃO: A prevalência de sintomas depressivos foi elevada nesta amostra do estudo populacional e com associação com gênero feminino, baixo nível educacional e socioeconômico, mas há necessidade de finalizar toda amostragem.

Discerning reported suicide attempts within a youthful offender population.

With suicide being the third leading cause of death among young people, early identification of risk is critical, particularly for those involved with the juvenile courts. In this study of court-involved youth (N = 433) in two Midwest counties, logistic regression analysis identified some expected and unexpected findings of important demographic, educational, mental health, child welfare, and juvenile court-related variables that were linked to reported suicide attempts. Some of the expected suicide attempt risk factors for these youth included prior psychiatric hospitalization and related mental health services, residential placement, and diagnoses of depression and alcohol dependence. However, the most unexpected finding was that a court disposition to shelter care (group home) was related to a nearly tenfold increased risk in reported suicide attempt. These findings are of importance to families, mental health professionals, and juvenile court personnel to identify those youth who are most at risk and subsequently provide appropriate interventions to prevent such outcomes.

O cuidado em saúde mental no Brasil: uma leitura a partir dos dispositivos de biopoder e biopolítica / The mental health care in Brazil: a reading from the biopower and biopolitics devices

O presente artigo objetiva problematizar o cuidado em saúde mental no Brasil à luz dos conceitos de biopoder e biopolítica, enunciados por Michel Foucault. A análise das práticas de cuidado instituídas no âmbito dos serviços que compõem a rede de atenção psicossocial no Brasil, através de artigos publicados em periódicos nacionais, revelou a transversalidade do cuidado em saúde mental com relação a estratégias disciplinares e de controle das populações, limitando as possibilidades de resgate da concepção de sujeito e subjetividade no processo de produção do cuidado às pessoas em sofrimento psíquico.

This article aims to problematize the mental health care in Brazil in the light of the concepts of biopower and biopolitics, announced by Michel Foucault. The analysis of care practices imposed in the scope of the services that compose the psychosocial care network in Brazil, through articles published in national journals, revealed the mainstreaming of mental health care regarding disciplinary and control populations strategies, limiting the possibilities of rescue of the subject and subjectivity conception in the process of care production to people in psychological suffering.