Sick & Tired: An Analysis of Race, Access to Paid Sick Leave, and Workers' Mental Health

Context: Many workers in the United States regularly choose between their well-being and wages. The consequences of decisions like seeking medical care, self-quarantining, or caring for a sick child in a country with a patchwork of paid sick leave policies (hereafter, PSL) amount to lost wages or complete job loss for workers in states without access to this critical benefit. This lack of security can lead to increased mental distress for workers, which may spill over into their interactions with family or coworkers, causing residual negative health impacts. This spillover effect may be even more pronounced for workers of color, who must reckon with racism and related socioeconomic challenges. Although many researchers have considered the relationship between PSL and physical health outcomes or access to health services, few have examined its relationship with mental health. None have examined PSL and health using a critical race lens to examine whether this relationship is conditional on race. Thus, my research addresses the following questions: Is PSL access related to psychological distress? And if so, does this relationship vary along racial lines?

Method: I use National Health Interview Survey (NHIS) 2018 data to investigate the impact of PSL access on the psychological distress of non-full-time workers in the U.S. I perform several multivariate regressions, including one interacting PSL and race variables to test whether the correlations between PSL and mental distress were moderated by race.

Findings: Results reveal that having access to PSL was significantly correlated with lower levels of psychological distress for non-full-time workers in the sample. Workers of color with PSL were more likely to have higher levels of psychological distress than their white counterparts. Looking at intraracial trends, white workers with PSL had lower levels of distress when compared to those without PSL. Workers of color without PSL actually had lower levels of psychological distress than those with PSL (although this result was not significant).

Conclusion and Implications: When using a racial capitalism framework, these results imply that while access to PSL is crucial for the overall mental well-being of workers, workers of color may not reap the full benefits of this policy. Results suggest PSL is not a “one stop fix-all” policy for all workers, but rather a first stop in achieving workplace equity. Social workers and policymakers may need to consider additional factors driving mental health outcomes for workers of color, like minimum wage or affordable childcare. To the author’s knowledge, this is the first quantitative study of PSL that looks at the variation in psychological distress/mental health along racial lines. Thinking about race beyond its utility as a control variable is critical to understanding the nuanced impact of racism on POC’s mental health and the way key labor policies are experienced differentially across races.