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1.
J Health Econ ; 83: 102621, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35490623

RESUMO

Disability onset and major health shocks can affect the labor supply of those experiencing the event and their family members, who face a tradeoff between time spent earning income and providing care. This decision could be affected by the availability of paid family leave. We examine the role of paid leave mandates in caregiving and labor supply decisions after a spouse's disability or health shock. Using data from the Survey of Income and Program Participation, we show that paid leave mandates reduce the likelihood that potential caregivers report decreasing their paid work hours to provide caregiving after a spouse's health shock. However, if caregivers are unlikely to have access to job protection, paid leave mandates also increase the likelihood of leaving the labor market to provide caregiving and working fewer weeks. There is limited evidence of an effect of paid leave on other employment outcomes. Our findings demonstrate that paid leave has some influence on household labor supply decisions after spousal health shocks, but its role should be considered together with the availability of job protection.


Assuntos
Licença para Cuidar de Pessoa da Família , Cônjuges , Emprego , Humanos , Salários e Benefícios , Recursos Humanos
2.
Am J Public Health ; 112(2): 316-324, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35080932

RESUMO

Objectives. To determine if the introduction of New York State's 8-week paid family leave policy on January 1, 2018, reduced rates of hospitalizations with respiratory syncytial virus (RSV) bronchiolitis or any acute lower respiratory tract infection among young infants. Methods. We conducted an interrupted time series analysis using New York State population-based, all-payer hospital discharge records, October 2015 to December 2019. We estimated the change in monthly hospitalization rates for RSV bronchiolitis and for any acute lower respiratory tract infection among infants aged 8 weeks or younger after the introduction of paid family leave while controlling for temporal trends and RSV seasonality. We modeled RSV hospitalization rates in infants aged 1 year as a control. Results. Hospitalization rates for RSV bronchiolitis and any acute lower respiratory tract infection decreased by 30% after the introduction of paid family leave (rate ratio [RR] = 0.71; 95% confidence interval [CI] = 0.54, 0.94; and RR = 0.72; 95% CI = 0.59, 0.88, respectively). There were no such reductions in infants aged 1 year (RR = 0.98; 95% CI = 0.72, 1.33; and RR = 1.17; 95% CI = 1.03, 1.32, respectively). Conclusions. State paid family leave was associated with fewer RSV-associated hospitalizations in young infants. (Am J Public Health. 2022;112(2):316-324. https://doi.org/10.2105/AJPH.2021.306559).


Assuntos
Emprego/estatística & dados numéricos , Licença para Cuidar de Pessoa da Família/estatística & dados numéricos , Planos de Assistência de Saúde para Empregados/organização & administração , Infecções por Vírus Respiratório Sincicial/terapia , Humanos , Lactente , New York , Estudos Retrospectivos , Fatores Socioeconômicos
4.
Epidemiol Rev ; 43(1): 19-32, 2022 01 14.
Artigo em Inglês | MEDLINE | ID: mdl-34622277

RESUMO

Extensive empirical health research leverages variation in the timing and location of policy changes as quasi-experiments. Multiple social policies may be adopted simultaneously in the same locations, creating co-occurrence that must be addressed analytically for valid inferences. The pervasiveness and consequences of co-occurring policies have received limited attention. We analyzed a systematic sample of 13 social policy databases covering diverse domains including poverty, paid family leave, and tobacco use. We quantified policy co-occurrence in each database as the fraction of variation in each policy measure across different jurisdictions and times that could be explained by covariation with other policies. We used simulations to estimate the ratio of the variance of effect estimates under the observed policy co-occurrence to variance if policies were independent. Policy co-occurrence ranged from very high for state-level cannabis policies to low for country-level sexual minority-rights policies. For 65% of policies, greater than 90% of the place-time variation was explained by other policies. Policy co-occurrence increased the variance of effect estimates by a median of 57-fold. Co-occurring policies are common and pose a major methodological challenge to rigorously evaluating health effects of individual social policies. When uncontrolled, co-occurring policies confound one another, and when controlled, resulting positivity violations may substantially inflate the variance of estimated effects. Tools to enhance validity and precision for evaluating co-occurring policies are needed.


Assuntos
Licença para Cuidar de Pessoa da Família , Política Pública , Humanos , Salários e Benefícios
7.
Am J Prev Med ; 61(2): 182-191, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34294424

RESUMO

INTRODUCTION: Several U.S. states have implemented paid family leave policies for new parents. Few studies have evaluated the impacts of U.S. paid family leave policies on families' health. This study tests the hypothesis that paid family leave policies in California and New Jersey improved parent and child mental health. METHODS: Using national data from the 1997-2016 waves of the National Health Interview Survey, the study assessed changes in parental psychological distress (measured using the Kessler 6 score, n=28,638) and child behavioral problems (measured using the Mental Health Indicator score, n=15,987) using difference-in-differences analysis, a quasi-experimental method that compared outcomes before and after the implementation of paid family leave policies in California and New Jersey while accounting for secular trends in states without paid family leave policies. Secondary analyses were conducted to assess differential responses among prespecified subgroups. Data analysis was conducted in 2018-2021. RESULTS: Exposure to paid family leave policies was associated with decreased psychological distress among parents (-0.49, 95% CI= -0.77, -0.21). There was no association between the paid family leave policies and children's behavioral problems (-0.06, 95% CI= -0.13, 0.012). Associations varied by demographic and socioeconomic characteristics, with some subgroups experiencing benefits, whereas others were negatively impacted. CONCLUSIONS: Study findings suggest that state paid family leave policies improved mental health among parents, with mixed findings among children, including positive, negative, or no changes in mental health, depending on the subgroup. Future work should clarify how more recent state policies, some of which provide more generous benefits and job protections for low-income parents, influence health among affected families.


Assuntos
Saúde Mental , Licença Parental , Criança , Licença para Cuidar de Pessoa da Família , Humanos , Políticas , Salários e Benefícios
8.
Health Aff (Millwood) ; 40(9): 1501-1509, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34310189

RESUMO

Research has demonstrated that paid sick leave reduces the spread of COVID-19 and other infectious diseases and improves preventive care and access to treatment across a wide range of conditions. However, the US has no national paid sick leave policy, and even unpaid leave via the Family and Medical Leave Act (FMLA) of 1993-often viewed as a foundation for new paid leave legislation-is often inaccessible to workers. We analyzed data from a nationally representative survey to determine the extent to which specific FMLA features produce gaps and disparities in leave access. We then used comparative policy data from 193 countries to analyze whether these policy features are necessary or prevalent globally, or whether there are common alternatives. We found that the FMLA's minimum hours requirement disproportionately excludes women, whereas its tenure requirement disproportionately excludes Black, Indigenous, and multiracial workers. Latinx workers also face greater exclusion because of employer size requirements. Of the 94 percent of countries that provide permanent paid sick leave, none broadly restrict leave based on employer size, and 93 percent cover part-time workers without a minimum hours requirement. Enacting permanent paid sick leave that is accessible regardless of employer size, tenure, or hours is critical and feasible.


Assuntos
COVID-19 , Licença Médica , Emprego , Licença para Cuidar de Pessoa da Família , Feminino , Humanos , SARS-CoV-2
11.
Vaccine ; 39(21): 2886-2893, 2021 05 18.
Artigo em Inglês | MEDLINE | ID: mdl-33896660

RESUMO

Time constraints parents face can affect whether infant children are vaccinated on time. Using the National Immunization Survey, we employ a synthetic control difference-in-difference estimation technique to establish a causal relationship arising from California's implementation of Paid Parental Leave Program as a natural experiment. We find California Paid Family Leave reduced late vaccinations by up to 5 percentage points or approximately 10% for children born to parents in California after the policy was implemented. Further, the policy had a stronger impact on families below the poverty line. Thus access to paid family leave can improve on-time immunization of infants.


Assuntos
Licença para Cuidar de Pessoa da Família , Licença Parental , Criança , Humanos , Lactente , Pais , Pobreza , Vacinação
13.
BJS Open ; 5(2)2021 03 05.
Artigo em Inglês | MEDLINE | ID: mdl-33688956

RESUMO

BACKGROUND: During the initial COVID-19 outbreak up to 28.4 million elective operations were cancelled worldwide, in part owing to concerns that it would be unsustainable to maintain elective surgery capacity because of COVID-19-related surgeon absence. Although many hospitals are now recovering, surgical teams need strategies to prepare for future outbreaks. This study aimed to develop a framework to predict elective surgery capacity during future COVID-19 outbreaks. METHODS: An international cross-sectional study determined real-world COVID-19-related absence rates among surgeons. COVID-19-related absences included sickness, self-isolation, shielding, and caring for family. To estimate elective surgical capacity during future outbreaks, an expert elicitation study was undertaken with senior surgeons to determine the minimum surgical staff required to provide surgical services while maintaining a range of elective surgery volumes (0, 25, 50 or 75 per cent). RESULTS: Based on data from 364 hospitals across 65 countries, the COVID-19-related absence rate during the initial 6 weeks of the outbreak ranged from 20.5 to 24.7 per cent (mean average fortnightly). In weeks 7-12, this decreased to 9.2-13.8 per cent. At all times during the COVID-19 outbreak there was predicted to be sufficient surgical staff available to maintain at least 75 per cent of regular elective surgical volume. Overall, there was predicted capacity for surgeon redeployment to support the wider hospital response to COVID-19. CONCLUSION: This framework will inform elective surgical service planning during future COVID-19 outbreaks. In most settings, surgeon absence is unlikely to be the factor limiting elective surgery capacity.


Assuntos
COVID-19 , Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Licença para Cuidar de Pessoa da Família/estatística & dados numéricos , Mão de Obra em Saúde , Quarentena/estatística & dados numéricos , Licença Médica/estatística & dados numéricos , Cirurgiões/provisão & distribuição , Centro Cirúrgico Hospitalar , Estudos Transversais , Humanos , Internacionalidade , SARS-CoV-2
15.
J Racial Ethn Health Disparities ; 8(6): 1482-1491, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-33211249

RESUMO

Past and current policies have led to the creation and sustainment of systemic racism. The Family and Medical Leave Act (FMLA) is a key contributor to sustaining health disparities for working Black women in the USA. Black women have a longstanding history of disadvantage and the current family leave policies make this demographic more vulnerable to economic hardship and eventually disparate health outcomes. Using data from the Family and Medical Leave Act in 2012 - Employee Survey (N = 1266), this study conducts logistic regression analyses to examine if this policy disparately benefits white men and white women compared to women of color. Respondents were categorized into leave takers (those who took family and medical leave as needed), leave needers (those who had an unmet need for leave), and employed only (those who neither needed nor took leave). As hypothesized, Black working women (vs. White working men) have the highest odds of having an unmet need for taking a leave followed by Latina women. In addition, Black working women (vs. White working men) had the highest odds of difficulty in making ends meet when they did take leave. The authors also conduct a policy analysis of the FMLA through a critical race theory (CRT) lens to offer policy recommendations, which deconstruct the role structural racism plays in the structure and implementation of the FMLA.


Assuntos
Racismo , Emprego , Licença para Cuidar de Pessoa da Família , Feminino , Humanos , Masculino , Políticas
17.
Stroke ; 51(9): e261-e265, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32811376

RESUMO

In the past decade, stroke medicine has evolved from discovery of innovative diagnostic tools to implementation of new treatments. These advances are projected to increase the demand for stroke neurologists in academic and clinical practices, but hopefully with equitable opportunities for everyone across the gender spectrum. Academic medicine provides opportunities to participate in clinical care, teaching, research, and administration. The early career stage is short-focused on finding an academic niche and developing new skills that will help you navigate the academic environment. A recent InterSECT article emphasized the critical role of women's leadership in stroke medicine. In this article, we reflect on workforce gender disparities and provide 5 practical strategies that may help women overcome barriers and advance their work mission.


Assuntos
Neurologia/educação , Acidente Vascular Cerebral/terapia , Centros Médicos Acadêmicos , Mobilidade Ocupacional , Licença para Cuidar de Pessoa da Família , Feminino , Humanos , Masculino , Mentores , Retorno ao Trabalho , Fatores Sexuais , Mulheres
18.
Soc Sci Med ; 256: 113003, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32464413

RESUMO

OBJECTIVE: To study the effect of California's first in the nation paid family leave policy on maternal postpartum psychological distress for women overall and for disadvantaged groups. METHODS: We use restricted data from 11 waves of the National Health Interview Survey, from 2000 to 2010, to examine mothers with children under the age of 12 months (n = 7379). Outcomes included three measures obtained from the six-item Kessler Psychological Distress Scale: an aggregated score and thresholds for mild and moderate psychological distress. For inference, we used synthetic control models, comparing mothers with infants in California to mothers with infants in the control group, pre-law and post-law. RESULTS: Access to paid family leave was associated with a 0.636-point decrease (95% CI = -1.202, -0.070) in postpartum psychological distress symptoms among mothers with infants, representing a 27.6% decrease from the pre-treatment mean. It was also associated with a 9.1 percentage point reduction (95% CI = -17.8, -0.4) in mild postpartum distress, a 38.4% reduction from the pre-treatment mean. Populations that typically lack access to paid family leave, particularly single and younger mothers, may have seen even larger effects. CONCLUSIONS: Paid family leave was associated with improved mental health for California mothers, suggesting that expansions of state or federal paid family leave policies have the potential to improve maternal postpartum health.


Assuntos
Saúde Materna , Saúde Mental , Licença Parental , Adulto , California , Criança , Licença para Cuidar de Pessoa da Família , Feminino , Humanos , Lactente , Mães
20.
Matern Child Health J ; 24(4): 514-523, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31993933

RESUMO

INTRODUCTION: Paid family leave (PFL) is an important protective policy mechanism to support the health of mothers and children and the economic security of families This paper explores the links of employment and demographic characteristics on leave type and lengths of overall, paid, and unpaid leave in a large city in the United States. METHODS: Using a sample of 601 women who worked during pregnancy from the 2016 New York City Work and Family Leave Survey, multinomial and linear regression models were used to assess disparities in the type and length of leave taking. RESULTS: Women eligible for the Family and Medical Leave Act (FMLA) have higher relative likelihood to take only paid leave (RRR = 6.588, p < 0.01). While Black women utilized 3.739 weeks of leave more than white women overall, holding all else constant (p < 0.1), this additional leave is composed of 4.739 more weeks of unpaid leave (p < 0.05). Shortened leave taking by women with less than a college degree is driven by fewer weeks of paid leave (p < 0.01). DISCUSSION: Using unique data from a survey of recent mothers in New York City, this study provides deeper understanding of disparities in the composition of leave. This study adds to the literature by identifying disparities in leave composition that are masked in consideration of total lengths of leave for Black women and those not eligible for FMLA protections. Given the consequences of short leave taking and reliance on unpaid leave, examination of leave composition is required to identify and address disparities.


Assuntos
Licença para Cuidar de Pessoa da Família/economia , Salários e Benefícios/economia , Fatores de Tempo , Adulto , Emprego/métodos , Emprego/normas , Emprego/estatística & dados numéricos , Licença para Cuidar de Pessoa da Família/normas , Licença para Cuidar de Pessoa da Família/estatística & dados numéricos , Feminino , Humanos , Modelos Lineares , Cidade de Nova Iorque , Salários e Benefícios/estatística & dados numéricos , Inquéritos e Questionários
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