When it comes to supporting families through paid family and medical leave (PFML) policies, the United States lags behind other developed nations. Just eight states and Washington, D.C. have a paid leave policy in place, and few U.S. workers have access to paid leave through their employer. Existing policies also vary widely by coverage length, benefit amount, and job protections.
Yet public support for PFML policies is high. A 2018 poll commissioned by the National Partnership for Women and Families found that eight in ten voters support a comprehensive national paid family and medical leave policy that covers all people who work.
So what explains the lack of policy action? Perhaps we have not acknowledged paid leave policy for what it really is: a critical backbone of support that follows workers through all the major moments of their lives.
PFML is a rare policy that unites people of all backgrounds, partly because everyone will need it at some point. From the birth of a child, to supporting a disabled sibling, to managing a chronic condition, to caring for an aging parent – paid leave policies afford workers the time and financial stability to care for themselves and their families. These policies allow us to be our whole selves: productive workers, devoted parents, engaged citizens, and responsible consumers. Few other policies follow us across the lifespan in this way.
This spring, Policies for Action partnered with the Institute for Women’s Policy Research and University of California, Berkeley on a series of webinars that explored the latest research on paid leave, lifting the veil on the critical ways that these policies can impact health and well-being for people across their lifespans. What we learned draws connections between policy and practice to advance this critical issue.
Paid leave can promote health equity for new mothers
Paid leave would also help ensure that women can attend recommended medical appointments after the birth of their child. This is especially poignant for Black women who are disproportionality employed in low-wage jobs and are more likely to lack access to paid leave.
The urgency of these issues cannot be understated. Race-based discrimination affects health both directly—living with chronic stress, for example—and indirectly, through a lack of access to quality health care and jobs that come with benefits, such as paid leave.
Additionally, maternal mortality has been on the rise in the U.S. since the 1990s, now reaching the highest maternal mortality rate of any developed nation in the world. Maternal mortality also varies widely by race and ethnicity, with Black women more than three times as likely to die as a result of childbirth than White women. While there are many factors that impact maternal mortality rates—such as disparities in health care access and racial bias within the medical field, among many others—ensuring all women have access to paid family and medical leave would help address some of the health issues that women face around the birth of a child.
Paid leave helps ensure a healthy start to life
Building on these lessons, the second webinar focused on links between PFML and birth outcomes. While infant mortality rates have been declining, the U.S. still fares poorly when compared to other developed nations. Infant and child health also vary widely by race and ethnicity.
Research has already established that breastfeeding (of any duration) is linked to improved health outcomes for children. Yet breastfeeding rates are troublingly low among mothers who work in low-wage occupations, partly because they are less likely to have access to paid leave. Research presented on the webinar showed that New Jersey’s paid leave law had a positive impact on infant health, especially for those from low-income households, as more of these infants were breastfed after the law was enacted (publication forthcoming).
Findings from California point to other ways paid leave could improve infant health. After the state’s paid leave law went into effect, infant hospitalization dropped by as much as 6 percent, and there was a significant reduction in the length of stay in the neonatal intensive care unit. Our speakers also stressed the importance of paid leave to early bonding, infant brain development, and the reduction of occurrence and length of childhood illnesses.
Paid leave is equally important for adult and aging populations
On our third webinar, we explored the importance of PFML for adult health—something that is less often discussed.
By 2035, people 65 and older will outnumber those under 18 for the first time in history, and the number of men and women providing care for older adults will continue to increase. In addition, one in seven people currently live with an adult with a disability.
Given that the majority of people with disabilities lack savings or funds to fall back on in case of financial hardship and 38 percent of individuals who took leave for their own illness did so because of a chronic or ongoing health condition, job-protected paid leave for older people with chronic conditions, adults with disabilities, and their family caregivers would likely improve economic outcomes.
Speakers also presented research showing that nursing home use declined by 11 percent after paid leave passed in California. This has implications for both families and individuals (and the health care system at large), as care at home has been linked with improved health outcomes.
Given that family caregiving can be complicated, costly, stressful, and demanding, the speakers highlighted several programs being tested to ease this burden, including the Kapuna Caregivers program in Hawaii, which pays home caregivers up to $70 per day for the in-home care they provide for their family members.
Caring for an aging parent suffering from Alzheimer’s or tending to the demanding needs of newborn while struggling to juggle work and other family responsibilities may feel like an individual challenge to many workers. Caregiving mostly happens at home, out of the public eye, making it more difficult to connect these daily individual experiences to large-scale efforts to push for policy change.
But as the evidence mounts about the positive health and well-being effects of paid family and medical leave, we hope to see more decisionmakers apply this research to debates at the local, state, and national levels to advance policies for the collective benefit of all.
Photo by Monkey Business Images/Shutterstock.