La infracción administrativa de otorgar licencias con evidente ausencia de fundamento médico y el proyecto de ley que facilita su sanción / The administrative violation of granting sick leave with an evident absence of medical grounds and the bill that facilitates its sanction

This article deals with the regulatory violation of issuing sick leave with an evident absence of medical grounds. Two problematic aspects present in the sanctioning practice of the Social Security Regulatory Agency are analyzed: the discrepancy between the wording of the regulation and its application, and the multiplicity of duties that can configure the behavior defined by the law, although they do not constitute fraud against the sick leave system. The context of this study is the bill that seeks to lower the standard for the regulator to impose administrative penalties on offenders who issue unjustified sick leave and aggravate those penalties.

Cancer Screening after the Adoption of Paid-Sick-Leave Mandates.

BACKGROUND: By the end of 2022, nearly 20 million workers in the United States have gained paid-sick-leave coverage from mandates that require employers to provide benefits to qualified workers, including paid time off for the use of preventive services. Although the lack of paid-sick-leave coverage may hinder access to preventive care, current evidence is insufficient to draw meaningful conclusions about its relationship to cancer screening. METHODS: We examined the association between paid-sick-leave mandates and screening for breast and colorectal cancers by comparing changes in 12- and 24-month rates of colorectal-cancer screening and mammography between workers residing in metropolitan statistical areas (MSAs) that have been affected by paid-sick-leave mandates (exposed MSAs) and workers residing in unexposed MSAs. The comparisons were conducted with the use of administrative medical-claims data for approximately 2 million private-sector employees from 2012 through 2019. RESULTS: Paid-sick-leave mandates were present in 61 MSAs in our sample. Screening rates were similar in the exposed and unexposed MSAs before mandate adoption. In the adjusted analysis, cancer-screening rates were higher among workers residing in exposed MSAs than among those in unexposed MSAs by 1.31 percentage points (95% confidence interval [CI], 0.28 to 2.34) for 12-month colorectal cancer screening, 1.56 percentage points (95% CI, 0.33 to 2.79) for 24-month colorectal cancer screening, 1.22 percentage points (95% CI, -0.20 to 2.64) for 12-month mammography, and 2.07 percentage points (95% CI, 0.15 to 3.99) for 24-month mammography. CONCLUSIONS: In a sample of private-sector workers in the United States, cancer-screening rates were higher among those residing in MSAs exposed to paid-sick-leave mandates than among those residing in unexposed MSAs. Our results suggest that a lack of paid-sick-leave coverage presents a barrier to cancer screening. (Funded by the National Cancer Institute.).

[The administrative violation of granting sick leave with an evident absence of medical grounds and the bill that facilitates its sanction]. / La infracción administrativa de otorgar licencias con evidente ausencia de fundamento médico y el proyecto de ley que facilita su sanción.

This article deals with the regulatory violation of issuing sick leave with an evident absence of medical grounds. Two problematic aspects present in the sanctioning practice of the Social Security Regulatory Agency are analyzed: the discrepancy between the wording of the regulation and its application, and the multiplicity of duties that can configure the behavior defined by the law, although they do not constitute fraud against the sick leave system. The context of this study is the bill that seeks to lower the standard for the regulator to impose administrative penalties on offenders who issue unjustified sick leave and aggravate those penalties.

Union Efforts to Reduce COVID-19 Infections Among Grocery Store Workers.

Grocery store workers are essential workers, but often have not been provided with appropriate protection during the current pandemic. This report describes efforts made by one union local to protect workers, including negotiated paid sick leave and specific safety practices. Union representatives from 319 stores completed 1612 in-store surveys to assess compliance between 23 April 2020 and 31 August 2020. Employers provided the union with lists of workers confirmed to have COVID-19 infection through 31 December 2020. Worker infection rates were calculated using store employees represented by the union as the denominator and compared to cumulative county infection rates; outcome was dichotomized as rates higher or lower than background rates. Restrictions on reusable bags and management enforcement of customer mask usage were most strongly associated with COVID-19 rates lower than rates in the surrounding county. Stores that responded positively to worker complaints also had better outcomes. The union is currently engaging to promote improved ventilation and vaccination uptake.

COVID-19 Emergency Sick Leave Has Helped Flatten The Curve In The United States.

This analysis examines whether the coronavirus disease 2019 (COVID-19) emergency sick leave provision of the bipartisan Families First Coronavirus Response Act (FFCRA) reduced the spread of the virus. Using a difference-in-differences strategy, we compared changes in newly reported COVID-19 cases in states where workers gained the right to take paid sick leave (treatment group) versus in states where workers already had access to paid sick leave (control group) before the FFCRA. We adjusted for differences in testing, day-of-the-week reporting, structural state differences, general virus dynamics, and policies such as stay-at-home orders. Compared with the control group and relative to the pre-FFCRA period, states that gained access to paid sick leave through the FFCRA saw around 400 fewer confirmed cases per state per day. This estimate translates into roughly one prevented case per day per 1,300 workers who had newly gained the option to take up to two weeks of paid sick leave.

Valoración medicolegal de la infección por COVID-19 en el ámbito laboral / Medico-legal assessment of the COVID-19 infection in workplace

España ha sido uno de los países con mayor afectación por la pandemia COVID-19. Hasta la fecha, un 22% de los casos notificados son personal sanitario, siendo significativamente mayor este porcentaje entre las mujeres (76% del personal sanitario contagiado). Ante la evidencia de que muchos profesionales sanitarios pueden haberse contagiado en su puesto de trabajo, hemos revisado la problemática en el ámbito de la salud laboral que produce la COVID-19. Se describen los decretos publicados por el Gobierno de España y las recomendaciones de la Organización Internacional del Trabajo. Concretamente se analiza la clasificación del SARS-CoV-2 como agente biológico del grupo 3, su calificación como accidente de trabajo o enfermedad profesional y sus repercusiones en las situaciones de incapacidades (temporales y permanentes), secuelas y muerte, así como el estudio de las posibles demandas de aquellos que lo han sufrido como consecuencia de falta de medidas preventivas

Spain is one of the countries most affected by the COVID-19 pandemic. To date, 22% of reported cases are healthcare professionals, and 76% of them are women. Given that many healthcare professionals may have been infected in their workplace, we have reviewed the occupational health challenges posed by COVID-19. The Spanish laws and the recommendations of the International Labor Organization are described. The review covers the classification of SARS-CoV-2 as a biological agent in group 3 and of COVID-19 as an occupational accident or disease, its repercussions in temporary and permanent disabilities, sequelae and death, and the possible claims of those who may have developed the disease due to the lack of preventive measures

Protecting health during COVID-19 and beyond: A global examination of paid sick leave design in 193 countries.

Well-designed paid sick leave is critical to ensure workers stay home when sick to prevent the spread of SARS-CoV-2 and other infectious pathogens, both when the economy is open and during an economic shutdown. To assess whether paid sick leave is available in countries around the world, we created and analysed a database of legislative guarantees of paid leave for personal illness in 193 UN member states. Original labour and social security legislation and global information on social security systems for each country were obtained and analysed by a multilingual research team using a common coding framework. While strong models exist across low- middle- and high-income countries, critical gaps that jeopardise health and economic security remain. 27% of countries do not guarantee paid sick leave from the first day of illness, essential to encouraging workers to stay home when they are sick and prevent spread. 58% of countries do not have explicit provisions to ensure self-employed and gig economy workers have access to paid sick leave benefits. Comprehensive paid sick leave policies that cover all workers are urgently needed if we are to reduce the spread of COVID-19, and be ready to respond to threats from new pathogens.

Paid Sick Leave in Washington State: Evidence on Employee Outcomes, 2016-2018.

Objectives. To estimate if Washington State's paid sick leave law increased access to paid sick leave, reduced employees' working while sick, and relieved care burdens.Methods. I drew on new data from 12 772 service workers collected before and after the law took effect in January 2018 in Washington State and over the same time period in comparison states that did not have paid sick leave requirements. I used difference-in-difference models to estimate the effects of the law.Results. The law expanded workers' access to paid sick leave by 28 percentage points (P < .001). The law reduced the share of workers who reported working while sick by 8 percentage points (P < .05). Finally, there was little evidence that the law served to reduce work-life conflict for Washington workers.Conclusions. Mandated paid sick leave increased access to paid sick leave benefits and led to reductions in employees' working while sick. However, covered workers did not experience reductions in work-life conflict in the period immediately following passage.

Patients with rheumatoid arthritis facing sick leave or work disability meet varying regulations: a study among rheumatologists and patients from 44 European countries.

OBJECTIVES: To describe and explore differences in formal regulations around sick leave and work disability (WD) for patients with rheumatoid arthritis (RA), as well as perceptions by rheumatologists and patients on the system's performance, across European countries. METHODS: We conducted three cross-sectional surveys in 50 European countries: one on work (re-)integration and social security (SS) system arrangements in case of sick leave and long-term WD due to RA (one rheumatologist per country), and two among approximately 15 rheumatologists and 15 patients per country on perceptions regarding SS arrangements on work participation. Differences in regulations and perceptions were compared across categories defined by gross domestic product (GDP), type of social welfare regime, European Union (EU) membership and country RA WD rates. RESULTS: Forty-four (88%) countries provided data on regulations, 33 (75%) on perceptions of rheumatologists (n=539) and 34 (77%) on perceptions of patients (n=719). While large variation was observed across all regulations across countries, no relationship was found between most of regulations or income compensation and GDP, type of SS system or rates of WD. Regarding perceptions, rheumatologists in high GDP and EU-member countries felt less confident in their role in the decision process towards WD (ß=-0.5 (95% CI -0.9 to -0.2) and ß=-0.5 (95% CI -1.0 to -0.1), respectively). The Scandinavian and Bismarckian system scored best on patients' and rheumatologists' perceptions of regulations and system performance. CONCLUSIONS: There is large heterogeneity in rules and regulations of SS systems across Europe in relation to WD of patients with RA, and it cannot be explained by existing welfare regimes, EU membership or country's wealth.

Decline in the rate of occupational injuries and illnesses following the implementation of a paid sick leave law in Connecticut.

BACKGROUND: Workers with paid sick leave may have a lower rate of occupational injuries compared with other workers. This study sought to determine whether there was a decline in the rate of occupational injuries and illnesses following the implementation of a paid sick leave law in Connecticut (CT). METHODS: Data from the Bureau of Labor Statistics was used to calculate the rate of occupational injuries and illnesses in CT in the 3 years before (2009-11) and after (2012-14) the law was implemented. These numbers were compared with New York (NY) and the United States, and between the occupations specified by the CT law and other occupations. RESULTS: Among service occupations addressed by the CT paid-sick-leave law, the rate of occupational injuries declined more in CT compared to rates for those same occupations in NY and the United States. Within CT, injury and illness rates showed a greater decline in occupations specified by the law (-17.8%; 95% confidence interval [CI] = -15.6--19.9) compared with other occupations (-6.8%; 95% CI = -6.6%--7.0%) between the two periods. CONCLUSIONS: A paid sick leave law was associated with an increased decline in occupational injuries and illnesses in affected service workers in the period after implementation. Further research should examine the possible reasons for the associations seen here.

Aptitud sobrevenida tras incapacidad laboral prolongada por cáncer / Supervening Ability after Prolonged Work Incapacity due to Cancer

El número de supervivientes al cáncer con capacidad de trabajar va en aumento gracias a los avances diagnósticos y terapéuticos, pero la reincorporación al trabajo del trabajador que ha padecido cáncer se produce tras un largo periodo de incapacidad laboral y tras haber sufrido un tratamiento agresivo que hacen que el retorno se realice con una aptitud sobrevenida. Dicha aptitud es entendida como la condición del trabajador que tras un periodo de incapacidad en que perdió capacidades, se recuperaron al alta (no incapacidad, alta médica de la baja), pero se reincorpora con una nueva situación de salud (capacidades) y adquiriendo el trabajador y el trabajo nuevos riesgos para su salud y nuevos riesgos frente al trabajo. Se realiza estudio de las bajas por cáncer que duraron más de 365 días, y se realiza un seguimiento de las recaídas que existieron en los seis meses siguientes a la reincorporación. Y se realizan propuestas para garantizar un retorno saludable y eficaz. MATERIAL Y MÉTODO: Con el fin de buscar los artículos sobre el retorno al trabajo tras cáncer, las barreras que se presentan y las propuestas para facilitar el retorno efectivo, se revisaron hasta mayo de 2019 las siguientes bases de datos bibliográficas: SciELO, PUBMED. Se realizó también un estudio de los procesos de cáncer que mantuvieron baja prolongada que alcanzó los 365 días, y se analizó cuántos finalmente concluyeron en alta médica, cuántos de estos procesos de alta tuvieron recaídas en los seis meses siguientes y porqué, y cuántas de las recaídas concluyeron en incapacidad permanente. CONCLUSIONES: En estudio efectuado sobre trabajadores con bajas por cáncer que alcanzaron o sobrepasaron los 365 días, se comprueba que el 81% de los casos se incorpora al trabajo con disfunciones que configuran la aptitud sobrevenida y que son estas disfunciones las que causan en un 75% las recaídas en incapacidad en los seis meses siguientes, haciendo fracasar el retorno laboral. Las disfunciones más predominantes y de mayor impacto son la astenia/fatiga, los trastornos psicológicos (incluyendo ansiedad, bajo ánimo, síntomas depresivos, deterioro cognitivo tipo déficit de atención, concentración o memoria), las disestesias /parestesias, y las artralgias. La aptitud sobrevenida modifica su capacidad funcional previa y con unos nuevos riesgos para su salud y frente al trabajo. Se precisa un periodo de adaptación obligado para facilitar la recuperación laboral, sin riesgo y de forma saludable y continuada. Es necesario abordar el alta parcial en esta etapa inicial con disminución de las cargas del trabajo, así como un apoyo psicológico al trabajador que padeció cáncer para afrontar la vuelta al trabajo. Son necesarias políticas de apoyo en la empresa que amparen y apoyen la reincorporación y medidas fiscales que las incentiven, así como una mejora de los criterios de valoración de la incapacidad/capacidad laboral y del conocimiento del trabajo mediante el uso de una ficha ocupacional. Debe tenerse en cuenta una consideración preventiva de las decisiones del retorno al trabajo así como una mejora de la comunicación entre agentes implicados en atención sanitaria, gestores de la incapacidad y el mundo del trabajo. Deberá elaborarse un Plan estratégico de protección integral del superviviente del cáncer y conformar un Mapa de Incapacidad Laboral en España para efectuar el análisis de la incapacidad laboral y su impacto económico, social y sanitario, además de permitir evaluar las políticas gestoras

Thanks to the diagnostic and therapeutic advances, the number of cancer survivors able to work is increasing. Nevertheless, the return to work of the worker who has suffered cancer takes place after a long term work incapacity and after having undergone an aggressive treatment causing the return to be made in sudden circumstances. These are understood as the condition of the worker who after a disability period in which he lost capabilities, he received the medical discharge (not disability, medical discharge of the loss), returning to the job in a new health situation (capacities) and facing the worker and the work new risks for his health and new risks at work. A study of more than 365 days sick leave due to cancer was made as well as a six-months-follow-up of the relapses after the returning to work. Proposals are made to ensure a healthy and effective return. MATERIAL AND METHOD: In order to search not only the articles about the return to work after cancer but also the barriers that may arise and the proposals in order to facilitate an effective return, the following bibliographic databases up to May 2019 were revised: SciELO, PUBMED. A study of cancer processes that kept prolonged sick leave within a 365-day period was carried out, analyzing how many of them did eventually end in medical discharge, how many of these processes had relapsed in the following six months and why had it taken place, and how many of the relapses ended in permanent disability. CONCLUSIONS: In the study carried out on workers with cancer sick leaves that reached or exceeded 365 days, it has been verified that 81% of its cases have been incorporated to work with dysfunctions configuring such sudden circumstances. These dysfunctions are precisely the cause of 75% of the disability relapses in the following six months, causing a failed attempt to return to work. Asthenia / fatigue, psychological disorders (including anxiety, low mood, depressive symptoms, cognitive impairment type attention deficit, concentration or memory), dysesthesias / paresthesias, and arthralgias are the most predominant and most impacting dysfunctions. Supervised aptitude modifies its previous functional capacity undergoing new risks for his health and his work. The following issues should be taken into account: A compulsory adaptation period to facilitate the labor recovery with no risk factors and in a healthy and continuous way; to address the partial discharge in this initial stage reducing the workloads, as well as a psychological support for those cancer workers in order to face the return to work; to support policies in the company protecting and supporting the reincorporation as well as to establish fiscal measures that incentive them; to improve the disability assessment criteria / ability to work, as well as the knowledge of work by using occupational worksheets; to take as well into consideration those preventive returning-to-work decisions; to consider the improvement of the communication between the agents involved in the health care, managers of disability and of the world of work; to prepare a strategic plan for the comprehensive protection of the cancer survivor; to draw up an Occupational Disability Map in Spain in order to carry out the analysis of work incapacity and its economic, social and health impact, as well as to evaluate the management policies

Who benefits from social investment? The gendered effects of family and employment policies on cardiovascular disease in Europe.

BACKGROUND: In the context of fiscal austerity in many European welfare states, policy innovation often takes the form of 'social investment', a contested set of policies aimed at strengthening labour markets. Social investment policies include employment subsidies, skills training and job-finding services, early childhood education and childcare and parental leave. Given that such policies can influence gender equity in the labour market, we analysed the possible effects of such policies on gender health equity. METHODS: Using age-stratified and sex-stratified data from the Global Burden of Disease Study on cardiovascular disease (CVD) morbidity and mortality between 2005 and 2010, we estimated linear regression models of policy indicators on employment supports, childcare and parental leave with country fixed effects. FINDINGS: We found mixed effects of social investment for men versus women. Whereas government spending on early childhood education and childcare was associated with lower CVD mortality rates for both men and women equally, government spending on paid parental leave was more strongly associated with lower CVD mortality rates for women. Additionally, government spending on public employment services was associated with lower CVD mortality rates for men but was not significant for women, while government spending on employment training was associated with lower CVD mortality rates for women but was not significant for men. CONCLUSIONS: Social investment policies were negatively associated with CVD mortality, but the ameliorative effects of specific policies were gendered. We discuss the implications of these results for the European social investment policy turn and for future research on gender health equity.

Necesidad de políticas de retorno al trabajo tras incapacidad laboral prolongada, en materia de seguridad social / Return to Work Policies after Long-Term Incapacity for Work Needed, in Terms of Social Security

Las incapacidades prolongadas suponen un alejamiento prolongado del trabajo y más allá de la importante repercusión económica tanto para el sistema productivo, las empresas, el sistema de protección social y sanitaria y los costes para el trabajador, suponen una dificultad intrínseca al retorno saludable, eficaz y permanente. Es decir, precisan del establecimiento de políticas de retorno al trabajo, que posibiliten el que el trabajo no sea causa de enfermedad, tanto en su génesis como en las recaídas, que el trabajo se realice en condiciones saludables y que tras bajas prolongadas su retorno sea estable y continuado en el tiempo. La incapacidad prolongada es una merma en la calidad de vida de los trabajadores, supone un riesgo de convertirse en permanente y de perder el trabajo. Un sistema de protección social como es el sistema de seguridad social precisa de políticas que fomenten el retorno al trabajo, y más en este colectivo que ha sufrido un largo proceso incapacitante, adquiriendo una nueva situación de riesgo por la enfermedad para el trabajo y por el trabajo por la enfermedad padecida y comportando un mayor riesgo de un retorno no saludable ni duradero. Material y método: se revisaron hasta noviembre de 2018 las siguientes bases de datos bibliográficas: SciELO, PUBMED, y otras fuentes que se reseñan en bibliografía. Objetivo: reseñar la necesidad de establecer políticas de retorno de los trabajadores tras incapacidad laboral, para la gestión integral e integradora de la prestación, y la mejora de la salud laboral con criterios no solo de protección económica sino preventiva laboral. Conclusiones: Las políticas de retorno al trabajo tras incapacidad laboral prolongada, en materia de seguridad social, exigen la mejora de los sistemas de registro, la elaboración de un Mapa de Incapacidad en España, efectuar cambios para mejorar la toma de decisiones, facilitar la comunicación de información médico laboral entre el ámbito asistencial, el prestacional y el laboral, mejorar la relación empresa, trabajador, y el sistema de protección, facilitar el alta parcial, posibilitar la situación de baja y alta para distintas exigencias laborales, procurar la conciliación laboral y la vida personal, implementar la flexibilidad horaria, disponer de pleno conocimiento concreto de los requerimientos del trabajo por parte del ámbito asistencial y prestacional, mediante el uso de Ficha Ocupacional, evitar la controversia entre no apto y alta o no incapacidad, garantizar la bioseguridad laboral, propiciar un entorno laboral saludable, velar por el mayor rigor en la determinación de la causalidad del trabajo como fuente de enfermedad, implementar programas específicos de retorno por procesos musculoesqueléticos, trastornos psiquiátricos menores y un plan estratégico en los trabajadores con cáncer. Son necesarios cambios en el paradigma de la gestión que incorpore criterios preventivos y valore la incapacidad laboral ("el no retorno al trabajo") como indicador de gestión sanitaria e indicador de salud laboral. Se necesitan cambios en la norma que hagan posible todo lo anterior

Long-term incapacities mean a prolonged work absence, and beyond the significant economic repercussion for the productive system, the companies, the social and health protection system and the costs for the worker, they mean an intrinsic difficulty to the healthy, effective and permanent return. That is, the establishment of return-to-work policies for preventing work-related illness, both in its genesis and in its relapses is required; to manage a health condition situation at work and to make worker's return stable and continued in time after extended periods of sick leave. Long-term disability implies not only a deterioration in the worker's quality of life but a risk of becoming permanently disabled and a risk of losing employment. A social protection system such as the social security system requires policies that encourage the return to work, especially in this group that has suffered a long disabling process, acquiring a new disease risk situation due to work and for the work due to the disease developed. It implies a higher risk of not having a healthy nor lasting return. Material and method: The following bibliographic databases were reviewed until November 2018: SciELO, PUBMED, and other sources reviewed in bibliography. Objective: To emphasize the need for establishing policies for the return of workers after incapacity for work, for the integral and integrative management of the service and the improvement of occupational health with economic protection criteria and preventive occupational protection criteria. Conclusions: The policies of returning to work after long-term incapacity for work require, in matters of social security, to improve the registration systems, to prepare an Incapacity or Disability Planning in Spain, to implement changes in order to improve the decision-making process, to facilitate the communication of occupational health information among the healthcare area, the benefit area and the occupational area, to improve the company-worker relationship and the protection system, to facilitate partial discharge, to enable the sick leave and medical discharge situations according with different work requirements, to achieve a balance between work and personal life, to implement flexible schedules, to make use of an Occupational File in order to have full concrete knowledge of the work requirements by the care and benefit area, to avoid the controversy between not fit and medical discharge or no disability, to guarantee occupational biosecurity, to promote environment healthy work, to ensure the greatest rigor in determining the causal of work as a source of disease, to implement specific return to work programs for workers with musculoskeletal disorders and minor psychiatric disorders and to implement a cancer strategy implementation plan for workers with cancer. Changes in the management paradigm that incorporate preventive criteria and assess work disability ("non-return to work") as an indicator of health management and an indicator of occupational health are needed. Changes in the norm are needed to make all of this possible

The Impact of Parental and Medical Leave Policies on Socioeconomic and Health Outcomes in OECD Countries: A Systematic Review of the Empirical Literature.

Policy Points: Historically, reforms that have increased the duration of job-protected paid parental leave have improved women's economic outcomes. By targeting the period around childbirth, access to paid parental leave also appears to reduce rates of infant mortality, with breastfeeding representing one potential mechanism. The provision of more generous paid leave entitlements in countries that offer unpaid or short durations of paid leave could help families strike a balance between the competing demands of earning income and attending to personal and family well-being. CONTEXT: Policies legislating paid leave from work for new parents, and to attend to individual and family illness, are common across Organisation for Economic Co-operation and Development (OECD) countries. However, there exists no comprehensive review of their potential impacts on economic, social, and health outcomes. METHODS: We conducted a systematic review of the peer-reviewed literature on paid leave and socioeconomic and health outcomes. We reviewed 5,538 abstracts and selected 85 published papers on the impact of parental leave policies, 22 papers on the impact of medical leave policies, and 2 papers that evaluated both types of policies. We synthesized the main findings through a narrative description; a meta-analysis was precluded by heterogeneity in policy attributes, policy changes, outcomes, and study designs. FINDINGS: We were able to draw several conclusions about the impact of parental leave policies. First, extensions in the duration of paid parental leave to between 6 and 12 months were accompanied by attendant increases in leave-taking and longer durations of leave. Second, there was little evidence that extending the duration of paid leave had negative employment or economic consequences. Third, unpaid leave does not appear to confer the same benefits as paid leave. Fourth, from a population health perspective, increases in paid parental leave were consistently associated with better infant and child health, particularly in terms of lower mortality rates. Fifth, paid paternal leave policies of adequate length and generosity have induced fathers to take additional time off from work following the birth of a child. How medical leave policies for personal or family illness influence health has not been widely studied. CONCLUSIONS: There is substantial quasi-experimental evidence to support expansions in the duration of job-protected paid parental leave as an instrument for supporting women's labor force participation, safeguarding women's incomes and earnings, and improving child survival. This has implications, in particular, for countries that offer shorter durations of job-protected paid leave or lack a national paid leave entitlement altogether.

Educating Restaurant Workers About Paid Sick Leave: A Pilot Study From New York City.

Across the United States, cities, states, and counties are rapidly adopting paid sick leave laws. Paid sick leave policies for restaurant workers may be particularly beneficial, since these workers are less likely to have these benefits and have the potential to spread infection through food-handling and engagement with the public. In order for paid sick leave laws to work, workers and employers must be educated about these laws broadly and effectively. Focusing on New York City, we conducted a pilot research using key stakeholder interviews to learn about New York City's successes and challenges in educating workers and businesses about the law. Our findings indicate several lessons learned, including allocating sufficient funding, combined use of coalition building and organizing models, and attention to the needs of immigrant restaurant workers. Findings also suggest that greater attention should be paid to proactively addressing workplace organization and practices that thwart paid sick leave use.