The Impact of Paid Sick Leave Policies on Older Workers' Health

Background and Purpose: Work sits in multi-directional relationship as a social determinant of health. Thus, a focus on workplace conditions – especially those that affect low-wage workers and communities – may be an important mechanism to reduce inequities. Workplace policies, such as paid sick leave, may support older workers by offering job-protected flexibility to address health and caregiving needs encountered at this stage in the life course. While there is no federal guarantee of paid sick leave (PSL), many states and municipalities have recently established mandates requiring employers to provide workers with paid sick leave. Previous studies have found that access to PSL via mandates increases health services use and improves the health and mental health of prime-age workers. However, little is known about how PSL mandates impact the employment and health of older workers who may encounter more frequent health and caregiving needs.

Methods: We assess the impact of PSL mandates on the health and employment of older workers (ages 55-70) using data from the 2011-2019 Behavioral Risk Factor Surveillance Survey (BRFSS). To isolate the effects of PSL mandates, we exploit the variation in the timing of the implementation of PSL mandates at the state level using a difference-in-differences (DD) approach. We also consider whether PSL has differential impacts by age relative to social security claims eligibility and gender.

Results: We find minimal effects on the physical health of employed adults ages 55-70 concentrated among older men, with evidence of spillovers to the unemployed male population. PSL led to a reduction of 0.43 days of poor physical health per year among employed men, and 0.37 days among those not working. PSL mandates decreased the number of days respondents reported experiencing bad mental health across both male and female workers. We also identify a 1.7 percentage point increase in employment rates, which suggests that there may be compositional changes in the employed population that bias our estimates toward null.

Conclusions and Implications: Paid sick leave mandates may be an effective workplace intervention to address social determinants of health by requiring employers to provide needed flexibility. However, its impacts vary by life course stage, and the policy might be best suited to acute health issues and short-term caregiving as compared to chronic health issues and longer-term caregiving needs that are more likely to emerge as people age. Findings are most consistent with prior studies for improvements in mental health, where needs and care may differ less by age. However, PSL mandates may benefit older adults through spillover effects via reduced community-level disease transmission and increased caregiving.