Paid sick leave policy impacts on health and care utilization in the United States: why policy design matters

The link between policy design choices and health is an important, yet understudied area of public health research. I investigate the impact of the generosity, inclusion, and autonomy of state paid sick leave laws on influenza-like-illness (ILI) rates and its components using data from the Centers for Disease Control and state-level paid sick leave statutes. I found that paid sick leave policies that include small firms and that allow for a larger number of medical uses have lower ILI rates, relative to states with less comprehensive policies. States with policies that had more generous accrual rates and that included a wide variety of worker types (temporary, part-time, students) increased the total number of reported medical cases, relative to states with less comprehensive policies. Policymakers contemplating paid sick leave policies should consider these design choices in their goals to incentivize health care utilization and to reduce contagion. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1057/s41271-022-00371-9.