Chicago — Amid the swelling national conversation about income inequality comes a new report spotlighting that the lack of mandatory paid sick leave in the U.S. disproportionately burdens Hispanics and low-wage workers, including the vast majority of food service employees.
Forty percent of employed U.S. adults, or about 51 million people, get no paid sick days, forcing them to choose between a paycheck — or sometimes risking the loss of their job — and time off to nurse the flu, take care of a sick family member or visit the doctor, according to a report released last month by the nonprofit Institute for Women’s Policy Research.
Those who do have sick time barely use it. Forty-five percent of workers with paid sick days had not used any in the previous 12 months; 5 percent had used 11 or more days. Among those with paid sick days who took fewer than 11 days off (this group was the focus to eliminate outliers with extended medical leaves), the median usage was 2.1 days.
Employees without sick days took a median of 1.6 days off due to illness or injury, suggesting some go to work sick, forgo preventive care or send sick kids to school, the report said.
Long criticized for being the only advanced economy not to mandate that employers provide any type of paid time off, the U.S. has left it to states and cities to implement their own laws.
Access to paid sick leave varies widely among groups, according to the new report, which uses data from the 2014 National Health Interview Survey.
Less than a fifth of food preparation and service workers have access to paid sick days, while close to 90 percent of employees who work in computers, architecture and engineering do. Other occupations short on sick days are personal care/service (which includes jobs such as manicurists and child care workers) and farming/fishing/forestry; in those two categories, a quarter of workers get paid sick days.
Among Hispanics, who fill a lot of service jobs, just 46 percent get paid sick days, far fewer than whites and African-Americans , at 63 and 62 percent, respectively, and Asians, at 67 percent.
The lower you are on the totem pole, the less likely it is that you can take a sick day off. Two-thirds of supervisors get sick days, compared with fewer than half of nonsupervisory workers. While 86 percent of workers who make more than $65,000 a year get paid sick leave, less a quarter who make less than $15,000 a year do; among part-time workers in the lowest earnings bracket, just 14 percent get the perk.
Dr. Peter Mayock, site medical director of an Erie Family Health Center in Chicago, sees the fallout daily from people delaying care when they can’t take off from work or even make an appointment in advance because they don’t know their work schedule until the last minute. It is particularly acute among patients with chronic illnesses such as diabetes, who require frequent follow-ups and appointments with specialists, he said.
“We see people with their diabetes completely out of control; they are starting to have damage to their vision,” said Mayock, who estimates that as many as half his patients are in jobs that don’t offer paid sick days. Almost three-quarters of the patients at Erie Family Health Center, which sees about 70,000 medical patients annually, are Hispanic, and most are low-income.
While the clinic has evening and Saturday hours to accommodate work schedules, many of Mayock’s patients work two jobs or have heavy family obligations with little support. Afraid of risking their jobs, patients instead risk complications of their illnesses, which can come with an even heavier financial cost.
“They do eventually lose their job when they have a heart attack or a stroke or they lose their vision or go on dialysis,” Mayock said. “It is devastating not just to them but to their families.”