Out Sick Without Pay

Women fabricate promotional banners.

Missed wages from unpaid leave have affected populations already at greater risk of severe COVID-19 infection and economic and material hardship, compounding existing economic, racial, and gender disparities.

The Issue

Many people in America live paycheck to paycheck, but COVID-19 infections and related caregiving obligations are causing many workers to miss out on wages.

Key Findings

  • U.S. workers who lacked access to paid leave missed out on an estimated $28 billion in wages over the first two years of the COVID-19 pandemic compared to previous years.

  • Work absences due to personal illness, childcare needs, or family obligations increased by 50 percent when compared to previous years.

  • Workers who were low-income, self-employed, Black, Hispanic, women, or living in households with children saw the largest increases in unpaid absences.

    • 66 percent of Hispanic/Latinx workers and 57 percent of Black workers did not receive pay while absent from work because of personal illness, a childcare need, or another obligation.  
    • Women were more than 40 percent more likely than men to be absent from work without pay during the first two years of the pandemic.
  • Workers in households with less than $25,000 in income annually were more than three times as likely to be absent without pay when compared to workers with annual incomes over $100,000.


Researchers determine that workplace safety standards and public health policies, combined with comprehensive paid leave policies that cover all workers, could help reduce the spread of COVID-19 and protect workers and families from missed wages.

About the Author

The nonprofit Urban Institute is dedicated to elevating the debate on social and economic policy. For nearly five decades, Urban scholars have conducted research and offered evidence-based solutions that improve lives and strengthen communities across a rapidly urbanizing world. Their objective research helps expand opportunities for all, reduce hardship among the most vulnerable, and strengthen the effectiveness of the public sector. Visit the Urban Institute’s Health Policy Center for more information specific to its staff and its recent research.