County Health Rankings & Roadmaps: Paid Sick Leave in New York City

Dec 5, 2013, 2:20 PM


Beginning later next year, more than a million workers in New York City will have a brand new, health-promoting benefit: paid sick leave days that guarantee wages on a set number of days when they or a family member they care for is ill.

The new law, passed last June by the New York City Council and overriding an earlier veto by the mayor, begins to go into effect in April 2014. New York now joins San Francisco, Calif., Washington, D.C., Seattle, Wash., Portland, Ore., and the state of Connecticut in adopting at least some sick leave provisions.

Not every employee in New York City will get paid sick leave under the new law. The bill that passed the City Council initially applies only to businesses with 20 or more employees, who will be required to provide five paid sick days a year; that extends to companies with 15 or more employees beginning October 1, 2015. Smaller businesses and manufacturing firms are exempt from the paid leave provisions for now, though these workers will gain five days of unpaid sick leave, so they can take time off without fear of losing their jobs. Advocates hope to extend paid leave to cover those workers before long.

Advocates say paid sick leave is critical for smaller businesses, and especially for low wage earners. A survey by the Community Service Society (CSS) of New York found that half of low-income respondents said they have less than $500 to fall back on in case of an emergency, and according to CSS, without compensation for sick days, people are often forced to choose between caring for themselves or a loved one and heading to work.

A 2012 study in the American Journal of Public Health shows why the measure that is critical to individuals and families is equally crucial to society as a whole. The study found that lack of certain workplace policies, including paid sick leave, led to an additional 5 million cases of adult H1N1 (swine flu) during the 2009 outbreak.

Funding for much of CSS’s advocacy came through a County Health Rankings & Roadmaps grant to focus on four areas in two New York City boroughs, the Bronx and Brooklyn, that have very poor health rankings. The goal was to build support among small businesses, faith-based organizations and low-wage workers for passage of the ordinance through grassroots events, town halls, story collection and media coverage, as well as by encouraging partners and allies to include this policy as part of their policy agendas. The grant runs through November 2014 and CSS will be focusing its efforts, now that legislation has passed, on creating awareness and implementation of the new law.

NewPublicHealth recently spoke with Nancy Rankin, vice president for policy, research and advocacy at CSS about the new law and its impact.

NewPublicHealth: Key components of the legislation you advocated for passed. What’s next in your efforts on paid sick leave?

Nancy Rankin: We are continuing to work on this issue because we recognize that having a law pass is not the end of the story. We now need to do outreach to inform workers about their new rights and employers about their new requirements, because a new law requires compliance and it requires people to be aware of its provisions.

NPH: Who does the current law leave out?

Rankin: What passed is a huge accomplishment. We covered nearly a million workers who have gained paid sick days who did not have a single paid sick day before. Having nearly a million workers, mostly low wage workers, gain paid sick days is a huge victory.

That said, we did have to make a compromise and there are still many, many workers in small businesses and manufacturing who are guaranteed a set number of unpaid sick days—meaning they won’t lose their jobs if they stay home to take care of themselves of a family member. But we won’t be satisfied until all workers have access to paid sick time.

NPH: Why was the focus of the grant on a few small communities who ranked low in the County Health Rankings?

Rankin: The law affects the whole city, but we wanted to focus our organizing efforts among the communities that had concentrations of low-wage workers who were most at risk and who would most stand to gain from this law. New York City is a very big city and, given limited resources, we didn’t feel like we could do organizing in every corner. So we thought we should focus on communities in areas that had the highest concentrations of low-wage workers and that had the worst health outcomes.

One of the things that we did with support from the grant was to issue a report called Latino New Yorkers Can’t Afford to Get Sick. We brought together personal stories and statistical data on the lack of paid sick days, particularly among low-wage Latino workers and what the impact was. We made the case through personal stories from three perspectives: we interviewed workers that did not have access to paid sick days, we interviewed small businesses owners and we interviewed healthcare professionals.

NPH: Why is paid sick leave linked to health particularly for low-income families?

Rankin: Well, first of all, the low wage workers are the least likely to have access to paid sick days. So, for example, in a survey we did of New York City residents, we found that 62 percent of low income workers were without paid sick day, compared to 29 percent of workers with household incomes of 400 percent of the poverty level. And we found that people didn’t realize that the majority of low-income workers didn’t have access to a single paid sick day.

These are people for whom getting the flu or having to stay home with a sick child amounts to a pay cut, and these families are already living paycheck to paycheck. In an earlier report we published, called Sick in the City, we asked people about whether they had paid sick days and then we asked them a series of follow up questions. We found that workers without paid sick days were more likely to face threats of retaliation at work if they asked for time off, they were more likely to go to work sick, they were more likely to be forced to send sick kids to school or daycare and they were more likely to use the emergency room because they couldn’t go to get medical care during their normal work hours. And that was all the case even when we controlled for income and access to health insurance. So we really connected the dots between lack of paid sick days and the consequences.

NPH: What benefits beyond the individual person and family accrue from paid sick leave?

Rankin: There are several sets of benefits:

  • Paid sick leave reduces financial instability for families and job loss and stress.
  • When individuals and/or their kids go to work and/or school sick they can spread illnesses so it’s not just those individuals, but it’s the wider public health case, especially in a crowded city like New York where we’re cheek-by-jowls, squeezed on subways and in the workplace. So it matters to everyone.
  • There are the health care cost arguments. When people have to use the emergency room, when they delay care for things such as exacerbations of asthma and diabetes and blood pressure because they don’t have time off to attend to their health needs, that contributes to poor health outcomes and costs for dealing with crises because the health issues were not attended to before an emergency.
  • Then there’s the moral argument that this should just be a basic labor standard and that you shouldn’t lose your job because you caught the flu. If the CEO in the corner office can take paid time off, shouldn’t the woman who’s cleaning the office at night also be entitled to take time off?
  • And then there’s the work family argument that someone needs to be able to take care of their ill children.

NPH: What models have you learned from or are you setting the course for everyone else?

Rankin: San Francisco and Washington, D.C. are among the cities that have enacted paid sick days policies, as has the state of Connecticut. Those examples were helpful for us in terms of modeling, particularly San Francisco, which has the strongest paid sick days requirements.

NPH: Do we need a federal measure on paid sick leave?

Rankin: There is a bill before Congress, the Healthy Families Act, that would provide a national floor for paid sick days. But given the gridlock in Congress that’s hasn’t been going anywhere. So what we’re doing as a strategy is to start moving progressive legislation at the community level, at the city level and at the state level. And as we’ve seen with things such as minimum wage, anti-smoking and environmental protection, once a certain number of cities and states pass the legislation and people see that, in fact, the new laws don’t cause business to collapse and everything is just fine, then that paves the way for passage at the federal level. And that’s important. It’s unlikely that every city, every single municipality or every state would pass paid sick leave, and why should you be able to take sick leave in one locale but not in another? So I think there should be a threshold just like you have a federal minimum wage that creates a floor for minimum standards.

NPH: What are the high level barriers to paid sick leave?

Rankin: The biggest barrier has been the opposition of organized big business. The big restaurant chains and powerful corporate lobbies have argued that paid sick leave is well intentioned, but it would be a job killer. And this job-killer complaint is the same argument that we’ve heard against every piece of progressive legislation, starting in New York, 100 years ago after the Triangle Shirtwaist Factory devastation fire that led to basic fire safety rules and other basic labor standard. The best argument against that is to just debunk that myth because the economic research and the economic evidence shows that very small labor costs, such as a few paid sick days a year, are easily absorbed with no impact on employment. It’s comparable to a small uptick in the minimum wage.

And, in fact, when you create a level planning field where all employers have to do this, then those costs can easily be either absorbed because everyone has the same costs which are passed along to consumers or, in some cases, employees. And for those who don’t believe the research, there’s the actual experience that we see now in San Francisco, Connecticut and Washington that have had paid sick days laws in effect and the sky hasn’t fallen over San Francisco and crushed all the businesses. They’re doing fine. In fact, businesses stand to gain because they have a healthier workforce and they have fewer turnovers. People are more productive and they’re better employees when they know if they get really sick or if they have a sick child at home, they can take care of them.

When a child wakes up in the morning and they’re throwing up or they have a fever and the single working mom is worried, asking herself What if I stay home? Can I just give him a Tylenol and send him to school? If I stay home, am I going to lose my job?—people shouldn’t have to make those kinds of choices.

This commentary originally appeared on the RWJF New Public Health blog.