"I'm Not the Kind of Person to Just Call Off": Workers' Experiences of Paid Time Off Policies in Low-Wage Healthcare Jobs

Background and Purpose: Paid time off is associated with significant benefits for workers, including better health, improved employment participation, and several positive outcomes for children ranging from reduced infant mortality to increased educational attainment. The U.S. remains the last industrialized country to have no federally guaranteed paid family leave policy, and one of only two countries to not have paid sick leave. Low-income workers are the most affected by this lack of access, with as many as 93% of low-income workers having no paid time off. Given its scarcity, little is known about how low-wage workers use paid time off and, more importantly, how policy implementation affects workers’ experiences. This study examines workers’ experiences accessing paid time off in a sample of single parents working low-wage healthcare jobs.

Methods: Data are drawn from a broader qualitative study examining how single parents navigate low-wage healthcare jobs, children’s schools, and home. Twenty-one single parents of elementary school-aged children participated in two in-depth, semi-structured interviews. Parents identified as majority Black or African American, and all but one were mothers. Parents earned less than a living wage for their family size ($11.90-$21.36/hr). Line-by-line coding was used to identify themes and subthemes inductively, identifying paid time off and its implementation as central to how parents navigated work and home. Intersectionality was used to identify how workplace policy promoted equity or reinforced interpersonal and structural oppression.

Results: Working parents primarily used paid time off for caregiving, most of which was unplanned. Many workers were punished for unplanned use of paid time off through time and attendance policies that reinforced workplace discrimination at interpersonal and structural levels. At the interpersonal level, a few workers with more understanding supervisors had better access to paid time off. Most other parents experienced judgment for using paid time off and participated in defensive motherhood behaviors to maintain credibility at work, suggesting that working mothers experienced discrimination related to their status as single parents. Implementation of the time and attendance policy reinforced structural oppression within the workplace since more privileged workers were not punished for using paid time off. A few workers with highly flexible schedules and autonomy at work accessed paid time off easily, suggesting these job qualities related to workplace privilege. Last, workplace and community structural oppression interacted, such as when gentrification lengthened commutes and put Black mothers at greater risk for punishment. Though beneficial overall, when use of paid time off was punished, workers experienced a range of negative outcomes, including increased stress, inability to transfer to escape hostile workplaces, or termination.

Conclusions and Implications: Focusing on paid time off, this research demonstrates the benefits of examining workers’ experiences of beneficial policies to understand how implementation affects policy effectiveness. Additionally, it shows the benefit of using intersectional theory to obtain a holistic picture of how policies may upset or reinforce problematic power structures embedded in workplace policies. This study suggests that legislation may be needed to adequately protect workers and support caregiving.