Paid Sick Days HIAs (Case Story)

December 2012

A series of HIAs examining paid sick days legislation at local, state and federal levels.

The Health Impacts of Guaranteed Paid Sick Days: A Case Story

The problem

Almost half of all workers in the United States – including a shocking 85% of food preparers – do not have paid sick days benefits. Lack of access to paid sick days contributes to the spread of flu and other illnesses, exposes the public to diseases carried by sick workers in restaurants and nursing homes, results in unnecessary trips to the emergency room, and prevents workers from staying home to care for a sick dependent.

What we did

Since 2008, HIP has produced six Health Impact Assessments (HIAs) on the health benefits of providing workers with guaranteed paid sick days: a national HIA; state assessments for California, Maine, Massachusetts, New Hampshire, and New Jersey; and a local HIA for Milwaukee, WI. We partnered first with the San Francisco Department of Public Health and then with groups in each location to customize the findings of our national study and collect locally relevant data.

There was a day when I actually had food poisoning. I couldn’t stop throwing up. There was just no way I could have gone in. I got a very nasty letter the next time I came in to work, telling me when my review came I might not get my raise.

– Restaurant worker interviewed for HIA on the Healthy Families Act of 2009

What we found

We found abundant evidence that guaranteed paid sick leave would significantly benefit public health nationwide and locally. It would have a particularly strong effect on stopping flu outbreaks from becoming pandemics and in reducing the transmission of disease through restaurants and other community settings. It also would prevent hunger and financial hardship among low-income workers, who would not lose wages during times of illness. Last, it would reduce health care costs by reducing unnecessary trips to the emergency room for conditions that are treatable by primary care physicians during regular business hours.


Our studies were widely covered by the news media and have helped to change the dialogue around the issue, from just about workers’ rights to also about public health. Using that framing as well as our analyses, organizers recently won paid sick day policies in California and for Federal contractors. The framing has also been used in other successful campaigns, including in Connecticut where advocates won paid sick days at the state level in 2011. Our HIAs also engaged the public health community on this issue and have sparked important public health research and advocacy.

Go to Fact Sheet on All Paid Sick Days HIAs