Rural/urban differences in access to paid sick leave among full‐time workers

• Published in: The Journal of rural health Vol. 39; no. 3; pp. 676 - 685
• Main Authors: Henning‐Smith, Carrie, Dill, Janette, Baldomero, Arianne, Backes Kozhimannil, Katy
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.06.2023
• Subjects: Access; Adolescent; Adult; Adults; Bivariate analysis; chronic conditions; COVID‐19; Educational Status; Employee benefits; Employers; Employment; Health education; Health promotion; Humans; Middle Aged; paid sick leave; Probability; Residents; Respondents; Rural areas; Rural communities; Rural urban differences; Salaries and Fringe Benefits; Sick Leave; Sociodemographics; Surveys and Questionnaires; Time; Urban areas; Urban population; Work; Workers; Young Adult; COVID-19; paid sick leave; employment; chronic conditions
• DOI: 10.1111/jrh.12703
• ISSN: 0890-765X

Purpose Access to paid sick leave is critically important to promoting good health, caregiving, and stopping the spread of disease. In this study, we estimate whether access to paid sick leave among US full‐time workers differs between rural and urban residents. Methods We used data from the 2020 National Health Interview Survey and included adult respondents between the ages of 18 and 64 who were employed full‐time (n = 12,086). We estimated bivariate differences in access to paid sick leave by rural/urban residence, and then calculated the predicted probability of access to paid sick leave, adjusting for sociodemographic and health characteristics, across different education levels. Findings We find a nearly 10‐percentage point difference in access to paid sick leave between rural and urban adults (68.1% vs 77.1%, P<.001). The difference in access to paid sick leave between rural and urban residents remained significant even after adjusting for sociodemographic and health characteristics. The fully adjusted predicted probability of paid sick leave for rural full‐time workers was 69.8%, compared with 76.4% for urban full‐time workers (P<.001). We also identified lower levels of paid leave for rural (vs urban) workers within each educational category. Conclusions Full‐time workers in rural areas have less access to paid sick leave than full‐time workers in urban areas. Without access to paid sick leave, rural and urban residents may go to work while contagious or forego necessary health care. Left to individual employers or localities, rural inequities in access to paid sick leave will likely persist.