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UCLA analysis of policies in 193 countries shows that gaps in coverage for ill workers put nations’ health and economic security at risk
At a time when the world’s attention is focused on curbing the spread of infectious disease, new research by the UCLA WORLD Policy Analysis Center shows that strengthening guarantees of paid sick leave is crucial to protecting health and economic security around the globe.
Just published in the journal Global Public Health, the WORLD study found that almost every country (94%) mandates some form of paid sick leave at the national level. The United States is one of 11 countries that do not.
Yet, even in nations that guarantee paid time off for illness, the analysis showed critical gaps that undermined the ability of sick workers to follow public health advice and stay home from the very first day of illness. This was true in such countries as Italy and Iran — among the hardest hit in the early days of the COVID-19 pandemic, the study noted.
Rules that limit the duration of leave, set low rates of pay and exclude certain classes of employees put countries’ health and economic systems at risk, the study concluded. The global health emergency underscores the consequences.
“The cost of providing paid sick leave is modest compared to the cost of reining in a pandemic,” said Jody Heymann, founder of the WORLD Policy Analysis Center and a distinguished professor of public policy, public health, and medicine at UCLA.
“This is particularly true once the more rapid spread of disease caused by workers going to work sick is factored in,” said study co-author Amy Raub, principal research analyst at WORLD. She pointed to previous studies showing that ill employees are 1.5 times more likely to go to work when they lack strong paid leave guarantees.
Heymann and Raub led the research team that analyzed government policies in all 193 U.N. member states to answer an array of questions: When do paid sick leave benefits begin and how long do they last? What is the rate of pay? Are self-employed and part-time workers covered? Are there exemptions for small businesses? The findings are based on long-term policies in place as of March 2019 and do not reflect temporary policy changes in response to the outbreak of the novel coronavirus.
“The pandemic provides a stark illustration that expanding sick leave protections to the world’s workers is urgently needed,” Raub said.
Recognizing that their paid sick leave policies left them ill-equipped to combat COVID-19, countries around the world put stronger protections in place. However, Heymann said, “These temporary changes do not ensure that countries are prepared for the next pandemic.”
“In the last 20 years, the world has battled a series of acute health emergencies,” said Heymann, citing severe acute respiratory syndrome (SARS) in 2002, the H1N1 influenza virus in 2009, and Middle East respiratory syndrome (MERS) in 2012, among other outbreaks. “And new and dangerous respiratory diseases are bound to emerge.”
“Well-designed paid sick leave is critical to ensure workers stay home when sick to prevent the spread of COVID-19 and other infectious pathogens — both when the economy is open and during an economic shutdown,” Raub said.
The new study found strong sick-leave policies in place in both low-income and affluent countries. In key areas, the United States’ record lagged far behind:
Beyond the United States, there are critical global gaps:
To conduct the study, the multilingual research team analyzed the full texts of labor and social security legislation, as well as other resources. For each of the 193 countries, source materials were read independently by two researchers, who then compared and reconciled their assessments.
Note to Editors: A fact sheet and maps illustrating key findings from this report are available for download here. Please direct questions to Erin Bresnahan, manager of new initiatives and strategic partnerships at the WORLD Policy Analysis Center, at email@example.com.