Inequity in access to paid sick leave in the Seattle area leading up to the COVID-19 pandemic

Abstract

Objectives: To examine inequity in access to paid sick leave (PSL) by race/ethnicity, income, and sex and to examine the association of PSL access with leave-taking, health behaviors, and respiratory pathogen presence among Seattle-area workers. Methods: Survey responses were collected online and in-person from individuals experiencing acute respiratory illness (ARI) symptoms between November 2019 and March 2020 as part of a community-based respiratory viral surveillance study. We used chi-square tests and logistic regression models to assess the association between PSL access and race/ethnicity, household income, and sex. Results: A total of 66.6% of respondents reported having access to PSL. By race/ethnicity, the proportion of participants who reported access to PSL was highest in the Asian group (70.5%), followed by White (68.7%), Latinx (58.4%), two or more races (57.1%), Black (47.1%), and Other (43.1%) (χ2=53.3, p<0.001). Access to PSL increased with household income with the highest income category having the most access to PSL (83.1%) while the lowest had the least (52.9%) (χ2=349.9, p<0.001). Fewer females (65.2%) than males (70.7%) reported access to PSL (χ2=349.9, p=0.002). Conclusions: Access to PSL is inequitably distributed across income, race/ethnicity, and sex. When low-income workers are forced to choose between wages and personal health, it leads to compounding vulnerability for themselves and their families. Providing universal access to PSL will have substantial benefits for all, especially for low-income, BIPOC, and female workers.