The lack of paid sick leave as a barrier to cancer screening and medical care-seeking: results from the National Health Interview Survey.

Lucy A Peipins,Mary C White,Ashwini Soman,Zahava Berkowitz

doi:10.1186/1471-2458-12-520

Lucy A Peipins, Mary C White + Show 2 more

Open Access

https://doi.org/10.1186/1471-2458-12-520

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Abstract

BackgroundPreventive health care services, such as cancer screening can be particularly vulnerable to a lack of paid leave from work since care is not being sought for illness or symptoms. We first describe the prevalence of paid sick leave by broad occupational categories and then examine the association between access to paid sick leave and cancer testing and medical care-seeking in the U.S. workforce.MethodsData from the 2008 National Health Interview survey were analyzed by using paid sick leave status and other health-related factors to describe the proportion of U.S. workers undergoing mammography, Pap testing, endoscopy, fecal occult blood test (FOBT), and medical-care seeking.ResultsMore than 48 million individuals (38%) in an estimated U.S. working population of 127 million did not have paid sick leave in 2008. The percentage of workers who underwent mammography, Pap test, endoscopy at recommended intervals, had seen a doctor during the previous 12 months or had at least one visit to a health care provider during the previous 12 months was significantly higher among those with paid sick leave compared with those without sick leave after controlling for sociodemographic and health-care-related factors.ConclusionsLack of paid sick leave appears to be a potential barrier to obtaining preventive medical care and is a societal benefit that is potentially amenable to change.

Highlights

Preventive health care services, such as cancer screening can be vulnerable to a lack of paid leave from work since care is not being sought for illness or symptoms
Concern about the lack of paid sick leave was heightened during the 2009 H1N1 influenza outbreak when the Centers for Disease Control and Prevention recommended that workers remain at home if they were sick with flu-like symptoms to control the spread of infection [4], and emergency legislation guaranteeing temporary sick leave was introduced in the House of Representatives [5]
Our results from this nationally representative sample demonstrate that sick leave could be a significant barrier to cancer testing and medical care seeking

Summary

Introduction

Preventive health care services, such as cancer screening can be vulnerable to a lack of paid leave from work since care is not being sought for illness or symptoms. The Federal Family and Medical Leave Act (FMLA) provides up to 12 weeks of unpaid leave for specified medical conditions for employees of companies with 50 or more employees [2], but FMLA does not apply to workers who need time off for routine or preventive medical care. Both San Francisco and Washington, DC have passed legislation guaranteeing paid sick leave to workers in their cities. In addition to the potential for reducing the spread of infection, the ability to take sick leave is likely to have an effect on a much wider range of health conditions and care-seeking both for workers and their families

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