Article

The Administration and Financing of Paid Sick Leave

Authors:
  • General Atomics/ LLNL
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Abstract

. Decision-makers in countries considering adoption or reform of paid sick leave policies need to understand the mechanisms used to finance sick leave provision. Using global data on sick leave legislation, the authors find the type of model used – employer liability, social insurance, social assistance, or a combination thereof – has significant implications for the duration and generosity of sickness benefits. However, they find no significant relationship between the duration or generosity of sick leave and economic indicators such as per capita GDP, unemployment rates, or national competitiveness. Potential mechanisms enabling both effective sick leave policies and strong economic outcomes are discussed.

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... In the UK, unless self-employed, on a temporary, or zero-hours contract, we perhaps take it for granted that if we are too ill to work, we will be eligible for short term sick pay. All workers are also eligible for statutory sick pay for longer illness absences (Schliwen, Earle, Hayes, & Heymann, 2011). This is the same for most European countries, but it is far less common in other parts of the world, such as East Asia, where sick leave provision is typically up to the discretion of the employer (Schliwen et al., 2011). ...
... All workers are also eligible for statutory sick pay for longer illness absences (Schliwen, Earle, Hayes, & Heymann, 2011). This is the same for most European countries, but it is far less common in other parts of the world, such as East Asia, where sick leave provision is typically up to the discretion of the employer (Schliwen et al., 2011). Without paid sick leave, low paid workers experiencing severe menstrual symptoms were forced to take unpaid leave or continue working despite their extreme discomfort. ...
... Demands for paid menstrual leave make a lot more sense in this context. Some countries or companies may provide sick leave but penalise its use, either by limiting the number of sick leave days available per year; not providing any sick pay, or only half pay; or incentivising workers to never miss a day's work (e.g. through bonus cash payments) (Schliwen et al., 2011). Another common complaint is that it is impossible to provide short notice cover for sick leave, and so even if experiencing severe symptoms (of any sort) it is better to work through them, since this is less disruptive for colleagues. ...
Chapter
Full-text available
Menstrual leave is an employment policy that allows individuals to take additional paid or unpaid leave from work during menstruation. In recent years, it has been attracting increasing global media and public attention. The motivation behind the promotion of the policy is typically benign, and it is often positioned as being a progressive development in women’s health and rights in the workplace. This chapter argues that the rationale behind this policy makes several exaggerated and incorrect assumptions about the nature, and prevalence of menstrual cycle-related symptoms in the working population. Moreover, menstrual leave policies could reflect, and contribute to, unhealthy and discriminatory practices against women in the workforce. Indeed, sex-specific employment policies such as menstrual leave can easily, albeit unintentionally, reinforce unhelpful and inaccurate societal myths that position ‘all women’ as weaker, less reliable, or more expensive employees than men. The chapter thus concludes that in order to support and improve menstrual health and gender equality in the workplace, it is better to focus on the working conditions and rights of all employees, plus access to good quality reproductive health information and medical treatment, if required.
... In the UK, unless self-employed, on a temporary, or zerohours contract, we perhaps take it for granted that if we are too ill to work, we will be eligible for short term sick pay. All workers are also eligible for statutory sick pay for longer illness absences (Schliwen et al., 2011). This is the same for most European countries, but it is far less common in other parts of the world, such as East Asia, where sick leave provision is typically up to the discretion of the employer (Schliwen et al., 2011). ...
... All workers are also eligible for statutory sick pay for longer illness absences (Schliwen et al., 2011). This is the same for most European countries, but it is far less common in other parts of the world, such as East Asia, where sick leave provision is typically up to the discretion of the employer (Schliwen et al., 2011). Without paid sick leave, low paid workers experiencing severe menstrual symptoms were forced to take unpaid leave or continue working despite their extreme discomfort. ...
... Demands for paid menstrual leave make a lot more sense in this context. Some countries or companies may provide sick leave but penalise its use, either by limiting the number of sick leave days available per year; not providing any sick pay, or only half pay; or incentivising workers to never miss a day's work (e.g. through bonus cash payments) (Schliwen et al., 2011). Another common complaint is that it is impossible to provide short notice cover for sick leave, and so even if experiencing severe symptoms (of any sort) it is better to work through them, since this is less disruptive for colleagues. ...
Chapter
This chapter critically examines the role of gender in work-life balance research. We contextualise the focal topic by first summarising the changing nature of work and domestic roles and the influence of demographic and social shifts. We revisit the meaning of ‘work-life balance’ in light of the diverse and sometimes conflicting conceptualisations used by academics and practitioners. A review of the evidence for gender differences in work-life balance needs and experiences is then provided, with a particular focus placed on caring responsibilities. This leads us to consider the policies and practices that are designed to support work-life balance initiatives are then considered, focusing specifically on flexible working, together with the extent to which these are ‘gender neutral’ both in terms of relevance and uptake. The paper is interspersed with relevant case studies to illustrate the points made. The chapter concludes by setting out priorities for research and practice to promote equitable and effective systemic solutions to improve work-life balance for all.
... The relationship between the generosity of paid sick-leave and three economic indicators (per capital gross domestic product (GDP), unemployment rates and competitiveness) has also been examined. No significant relationship was found between the generosity of a country's sick-leave policy and these macroeconomic indicators [34]. ...
Article
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The Covid-19 pandemic has revealed the importance of social protection systems, including income security, when health problems arise. The aims of this study are to compare the follow-up regimes for sick-listed employees across nine European countries, and to conduct a qualitative assessment of the differences with respect to burden and responsibility sharing between the social protection system, employers and employees. The tendency highlighted is that countries with shorter employer periods of sick-pay typically have stricter follow-up responsibility for employers because, in practice, they become gatekeepers of the public sickness benefit scheme. In Germany and the UK, employers have few requirements for follow-up compared with the Nordic countries because they bear most of the costs of sickness absence themselves. The same applies in Iceland, where employers carry most of the costs and have no obligation to follow up sick-listed employees. The situation in the Netherlands is paradoxical: employers have strict obligations in the follow-up regime even though they cover all the costs of the sick-leave themselves. During the pandemic, the majority of countries have adjusted their sick-pay system and increased coverage to reduce the risk of spreading Covid-19 because employees are going to work sick or when they should self-quarantine, except for the Netherlands and Belgium, which considered that the current schemes were already sufficient to reduce that risk.
... The United States is one of very few developed countries that does not provide universal access to paid sick leave (Heymann et al., 2010;OECD, 2020;Schliwen et al., 2011). In the U.S., employers have traditionally provided paid sick leave voluntarily, leading to highly unequal provision. ...
Article
Full-text available
A growing economic literature studies the optimal design of social insurance systems and the empirical identification of welfare-relevant externalities. In this paper, we test whether mandating employee access to paid sick leave has reduced influenza-like-illness (ILI) transmission rates as well as pneumonia and influenza (P&I) mortality rates in the United States. Using uniquely compiled data from administrative sources at the state-week level from 2010 to 2018 along with difference-indifferences methods, we present quasi-experimental evidence that sick pay mandates have causally reduced doctor-certified ILI rates at the population level. On average, ILI rates fell by about 11 percent or 290 ILI cases per 100,000 patients per week in the first year.
... The United States is one of only three developed countries that does not provide universal access to paid sick leave (Heymann et al. 2010;Schliwen et al. 2011). In the U.S., employers have traditionally provided paid sick leave voluntarily, leading to highly unequal provision. ...
Preprint
A growing economic literature studies the optimal design of social insurance systems and the empirical identification of welfare-relevant externalities. In this paper, we test whether mandating employee access to paid sick leave has reduced influenza-like-illness (ILI) rates in the United States. Using uniquely compiled data from administrative sources at the state-week level from 2010 to 2018 along with difference-in-differences methods, we present quasi-experimental evidence that sick pay mandates causally reduce doctor-certified ILI rates at the population level. On average, ILI rates fell by about 11 percent or 290 ILI cases per 100,000 patients per week in the first year.
... Tracking the status of laws and policies is valuable because they are directly actionable by policymakers and civil society Ata bay et al., 2015;Cassola et al., 2016;Lesnikowski et al., 2016]. Moreover, as described elsewhere, this approach would also enable an assessment of the relationship between policies and outcomes which can range from crosssectional analysis of nationallevel data [Earle, Heymann, 2006;Schliwen et al., 2011] to quasiexperimental longitudinal analyses, depending on the data that are available [Daku et al., 2012;Heymann et al., 2013;Hajizadeh et al., 2015;Conklin et al., 2016;Nandi et al., 2016]. ...
Article
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Несмотря на широкий консенсус международных организаций в отношении важности здорового развития детей в раннем возрасте, мониторинг национальных действий по обеспечению дошкольного образования ограничен. В настоящей статье представлен количественный подход к мониторингу мирового прогресса по достижению задачи 4.2 Целей устойчивого развития (ЦУР) Организации Объединенных Наций (ООН): «…обеспечить, чтобы все девочки и мальчики имели доступ к качественным системам развития, ухода и дошкольного обучения детей младшего возраста». Мы использовали строгий подход для создания новой количественной глобальной базы данных сопоставимых показателей политики, которые характеризуют предоставление национального дошкольного образования для 86% государств - членов ООН. Этот набор данных был проанализирован для изучения глобального неравенства в обеспечении всеобщего дошкольного образования. Мы обнаружили, что 43% всех стран и всего 3% стран с низким уровнем дохода обеспечива- ют бесплатное дошкольное образование. Менее 25% стран предлагают бесплатное дошкольное образова- ние в течение двух или более лет. Это резко контрастирует с начальным образованием, которое предо- ставляется бесплатно в 96% стран. Чтобы проиллюстрировать, как эти данные могут использоваться для изучения взаимосвязей между политикой и ее результатами, мы использовали регрессионный анализ. Дополнительный сбор глобальных данных о качестве дошкольного образования еще более активизирует усилия по мониторингу политики, которая играет ключевую роль в достижении задачи 4.2, и окажет поддержку достижению ЦУР ООН в области образования.
... Paid sick leave policies that provide employees with protected time off work with pay if they are sick is an example how government policy can reduce presenteeism. Access to paid sick leave is related to better medical treatment compliance, quicker recovery from illness and overall better health and well being for employees and their families [24]. Without paid sick leave employees do not seek necessary health care and are compelled to come to work sick and under preform [25]. ...
Article
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Background Presenteeism is a growing problem in developed countries mostly due to an aging workforce. The economic costs related to presenteeism exceed those of absenteeism and employer health costs. Employers are implementing workplace health promotion and wellness programs to improve health among workers and reduce presenteeism. How best to design, integrate and deliver these programs are unknown. The main purpose of this study was to use an intervention mapping approach to develop a workplace health promotion and wellness program aimed at reducing presenteeism. Methods We partnered with a large international financial services company and used a qualitative synthesis based on an intervention mapping methodology. Evidence from systematic reviews and key articles on reducing presenteeism and implementing health promotion programs was combined with theoretical models for changing behavior and stakeholder experience. This was then systematically operationalized into a program using discussion groups and consensus among experts and stakeholders. ResultsThe top health problem impacting our workplace partner was mental health. Depression and stress were the first and second highest cause of productivity loss respectively. A multi-pronged program with detailed action steps was developed and directed at key stakeholders and health conditions. For mental health, regular sharing focus groups, social networking, monthly personal stories from leadership using webinars and multi-media communications, expert-led workshops, lunch and learn sessions and manager and employee training were part of a comprehensive program. Comprehensive, specific and multi-pronged strategies were developed and aimed at encouraging healthy behaviours that impact presenteeism such as regular exercise, proper nutrition, adequate sleep, smoking cessation, socialization and work-life balance. Limitations of the intervention mapping process included high resource and time requirements, the lack of external input and viewpoints skewed towards middle and upper management, and using secondary workplace data of unknown validity and reliability. Conclusions In general, intervention mapping was a useful method to develop a workplace health promotion and wellness program aimed at reducing presenteeism. The methodology provided a step-by-step process to unravel a complex problem. The process compelled participants to think critically, collaboratively and in nontraditional ways.
... Although United States Workers' Compensation was gradually introduced after World War I at the state level, several attempts to implement universal health insurance and sick leave coverage failed. Consequentially, the US remains the only industrialized country without universal health insurance and sick leave coverage (Heyman et al. 2010;Schliwen et al. 2011). However, underscored by the epigraph, support for US paid sick leave has grown substantially in the last decade (Lovell, 2003;Levin-Epstein, 2005;Public Welfare Foundation, 2008;Ben-Ishai, 2014). ...
Article
Full-text available
Objective: To profile the sick leave landscape in the United States. Data sources: The 2011 Leave Supplement of the American Time Use Survey. Study design: Bivariate and multivariate analyses to identify (i) employees without sick pay coverage and (ii) employees who attend work sick. Principal findings: Sixty-five percent of full-time employees have sick pay coverage. Coverage rates are below 20 percent for employees with hourly wages below $10, part-time employees, and employees in the hospitality and leisure industry. Conclusion: Each week, up to 3 million U.S. employees go to work sick. Females, low-income earners, and those aged 25 to 34 years have a significantly elevated risk of presenteeism behavior.
... The effect of maternity leave policy on childhood vaccination could be weaker in LMICs relative to high-income countries due to lower rates of participation in the formal labor market among women in LMICs (Schneider et al., 2010;World Bank, 2014). On the other hand, the effect of maternity leave on vaccination coverage could also be more pronounced in poorer contexts where financial constraints may create very strong incentives for women to return to work and where it may be harder for women to take leave after returning to work to get children immunized (Schliwen et al., 2011). Therefore, although fewer women in LMICs are eligible for the benefit, the effects among those who are might be stronger. ...
Article
The availability of maternity leave might remove barriers to improved vaccination coverage by increasing the likelihood that parents are available to bring a child to the clinic for immunizations. Using information from 20 low-and-middle-income countries (LMICs) we estimated the effect of paid maternity leave policies on childhood vaccination uptake. We used birth history data collected via Demographic and Health Surveys (DHS) to assemble a multilevel panel of 258,769 live births in 20 countries from 2001 to 2008; these data were merged with longitudinal information on the number of full-time equivalent (FTE) weeks of paid maternity leave guaranteed by each country. We used Logistic regression models that included country and year fixed effects to estimate the impact of increases in FTE paid maternity leave policies in the prior year on the receipt of the following vaccines: Bacillus Calmette-Guérin (BCG) commonly given at birth, diphtheria, tetanus, and pertussis (DTP, 3 doses) commonly given in clinic visits and Polio (3 doses) given in clinic visits or as part of campaigns. We found that extending the duration of paid maternity leave had a positive effect on immunization rates for all three doses of the DTP vaccine; each additional FTE week of paid maternity leave increased DTP1, 2 and 3 coverage by 1.38 (95% CI = 1.18, 1.57), 1.62 (CI = 1.34, 1.91) and 2.17 (CI = 1.76, 2.58) percentage points, respectively. Estimates were robust to adjustment for birth characteristics, household-level covariates, attendance of skilled health personnel at birth and time-varying country-level covariates. We found no evidence for an effect of maternity leave on the probability of receiving vaccinations for BCG or Polio after adjustment for the above-mentioned covariates. Our findings were consistent with the hypothesis that more generous paid leave policies have the potential to improve DTP immunization coverage. Further work is needed to understand the health effects of paid leave policies in LMICs. Copyright © 2015 Elsevier Ltd. All rights reserved.
... Given the time lag between adaptation actions and likely measurable outcomes, an important complement to outcome measures is monitoring policies and programs. While this presents significant challenges, including defining appropriate dimensions on which to compare policies across countries and finding globally comparative data sources, they have been used to compare and monitor policy responses across all United Nations countries to issues such as improving labor conditions, addressing poverty, and children's needs , Schliwen et al. 2011, Heymann and McNeill 2013. In addition to monitoring policy development, these approaches have allowed examination of the extent to which countries comply with international agreements, whether they have a positive impact on population health and well-being , and whether they are affordable . ...
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The need to track climate change adaptation progress is being increasingly recognized but our ability to do the tracking is constrained by the complex nature of adaptation and the absence of measurable outcomes or indicators by which to judge if and how adaptation is occurring. We developed a typology of approaches by which climate change adaptation can be tracked globally at a national level. On the one hand, outcome-based approaches directly measure adaptation progress and effectiveness with reference to avoided climate change impacts. However, given that full exposure to climate change impacts will not happen for decades, alternative approaches focus on developing indicators or proxies by which adaptation can be monitored. These include systematic measures of adaptation readiness, processes undertaken to advance adaptation, policies and programs implemented to adapt, and measures of the impacts of these policies and programs on changing vulnerability. While these approaches employ various methods and data sources, and identify different components of adaptation progress to track at the national level, they all seek to characterize the current status of adaptation by which progress over time can be monitored. However, there are significant challenges to operationalizing these approaches, including an absence of systematically collected data on adaptation actions and outcomes, underlying difficulties of defining what constitutes "adaptation", and a disconnect between the timescale over which adaptation plays out and the practical need for evaluation to inform policy. Given the development of new adaptation funding streams, it is imperative that tools for monitoring progress are developed and validated for identifying trends and gaps in adaptation response.
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This analysis examines whether the coronavirus disease 2019 (COVID-19) emergency sick leave provision of the bipartisan Families First Coronavirus Response Act (FFCRA) reduced the spread of the virus. Using a difference-in-differences strategy, we compared changes in newly reported COVID-19 cases in states where workers gained the right to take paid sick leave (treatment group) versus in states where workers already had access to paid sick leave (control group) before the FFCRA. We adjusted for differences in testing, day-of-the-week reporting, structural state differences, general virus dynamics, and policies such as stay-at-home orders. Compared with the control group and relative to the pre-FFCRA period, states that gained access to paid sick leave through the FFCRA saw around 400 fewer confirmed cases per state per day. This estimate translates into roughly one prevented case per day per 1,300 workers who had newly gained the option to take up to two weeks of paid sick leave.
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Data
The need to track climate change adaptation progress is being increasingly recognized but our ability to do the tracking is constrained by the complex nature of adaptation and the absence of measurable outcomes or indicators by which to judge if and how adaptation is occurring. We developed a typology of approaches by which climate change adaptation can be tracked globally at a national level. On the one hand, outcome-based approaches directly measure adaptation progress and effectiveness with reference to avoided climate change impacts. However, given that full exposure to climate change impacts will not happen for decades, alternative approaches focus on developing indicators or proxies by which adaptation can be monitored. These include systematic measures of adaptation readiness, processes undertaken to advance adaptation, policies and programs implemented to adapt, and measures of the impacts of these policies and programs on changing vulnerability. While these approaches employ various methods and data sources, and identify different components of adaptation progress to track at the national level, they all seek to characterize the current status of adaptation by which progress over time can be monitored. However, there are significant challenges to operationalizing these approaches, including an absence of systematically collected data on adaptation actions and outcomes, underlying difficulties of defining what constitutes "adaptation", and a disconnect between the timescale over which adaptation plays out and the practical need for evaluation to inform policy. Given the development of new adaptation funding streams, it is imperative that tools for monitoring progress are developed and validated for identifying trends and gaps in adaptation response.
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The possible consequences of sick leave can be measured at different levels in society. This chapter focuses on the consequences from the perspective of the sick-listed individual. Sick leave may have both positive and negative consequences for the individual, e.g. regarding disease, health, working life, social life, lifestyle, and emotional aspects. Some of these factors have been investigated in different studies. However, scientific evidence is insufficient since there are too few studies on the consequences of sickness absence and disability pension. The lack of relevant studies is the most striking observation from the review of studies on the consequences of being sick listed.
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The majority of parents in the United States today must balance work and caregiving responsibilities. Workplace policies and community supports markedly influence the ability of parents to care for their children's health and education while obtaining, retaining, and advancing in their jobs. The goal of this article is to analyze the dilemmas faced by working parents in general and by low-income families in particular, to present new data on how public policies in the United States compare to policies in over 150 other countries in addressing these dilemmas, and to suggest what more can be done to meet the needs of all working parents and their children across social class and residence.
Article
In this article, we analyze the determinants of individual absenteeism focusing on the strictness of employment protection and the generosity of sickness benefits. The data come from the European Survey on Working Conditions launched in 2000. Due to its coverage (the EU-14), the data enable us to identify the relative importance of the institutional framework for explaining differences in absence behavior across nations. Our results reveal that, first, employment protection does not influence the number of absence days while sickness benefits increase absenteeism. And, second, the impact of the institutional framework is smaller than that of some individual worker characteristics.
Article
This paper examines the incentive effects of interactions between unemployment insurance (UI) and sickness insurance (SI), two important components of Sweden's social insurance system. The main topic is how the sickness-report rate among the unemployed is affected by (i) the limit of 300 workdays for UI benefits, and (ii) the difference in maximum compensation between UI and SI benefits. Results obtained by duration analysis suggest that sick reports increase as the UI benefit expiration date approaches. There is also evidence of an incentive effect on the sick-report rate because SI offers higher compensation than UI.
Article
Parental involvement in their child's care in hospital has undergone great change over the last century. Studies have shown how ‘maternal deprivation’ and ‘separation anxiety’ expressed by children are detrimental to a child's recovery in hospital. Striving efforts have been made to develop family-centred care, promote normality of the family unit and continue with the normal routine of the child's life within the limitations of a hospital environment and the child's illness. Expectations of the parental role in hospital need to be identified and expressed from both the parents and staff to establish an understanding that will ultimately be best for the child. Many studies have highlighted benefits to both parent and child from parental participation in hospital. However, disadvantages have been identified from resident parents who feel captive to their new situation and role. Efforts for family-centred care are highly advocated now. Care-by-Parent units have been set up in some areas to promote this idea and, although many advantages have been identified, they are not without their problems. The success of parental involvement is dependent on both parents’ and staff's attitudes, enthusiasm and willingness to work together.
Article
This paper examines whether a worker's sickness absence behaviour influences the risk of becoming unemployed. Swedish panel data are used to estimate the relationship between the incidence and the duration of sick leave and subsequent unemployment. The results indicate that an increase in the number of sick leaves as well as an increase in the duration of sick spells are associated with a higher risk of unemployment. An implication of the results is that less absence-prone workers are more likely to remain employed in a recession, which may partly explain the pro-cyclical pattern of aggregate Swedish sickness absence rates.
Article
[Excerpt] This issue on the Americas marks the completion of the first four-volume series Social Security Programs Throughout the World. The combined findings of this and previous reports on Europe, Asia and the Pacific, and Africa highlight the principal features of social security programs throughout the world. The next series begins with the volume on Europe, which will be published September 2004.
Article
[Excerpt] This second issue in the current four-volume series of Social Security Programs Throughout the World reports on the countries of Asia and the Pacific. The combined findings of this series, which also includes volumes on Europe, Africa, and the Americas, are published at 6-month intervals over a 2-year period. Each volume highlights features of social security programs in the particular region.
Article
[Excerpt] This third issue in the current four-volume series of Social Security Programs Throughout the World reports on the countries of Africa. The combined findings of this series, which also includes volumes on Europe, Asia and the Pacific, and the Americas, are published at 6-month intervals over a 2-year period. Each volume highlights features of social security programs in the particular region.The information contained in these volumes is crucial to our efforts, and those of researchers in other countries, to review different ways of approaching social security challenges that will enable us to adapt our social security systems to the evolving needs of individuals, households, and families. These efforts are particularly important as each nation faces major demographic changes, especially the increasing number of aged persons, as well as economic and fiscal issues.
Article
[Excerpt] This first issue in the current four-volume series of Social Security Programs Throughout the World reports on the countries of Europe. The combined findings of this series, which also includes volumes on Asia and the Pacific, Africa, and the Americas, are published at 6-month intervals over a 2-year period. Each volume highlights features of social security programs in the particular region. This guide serves as an overview of programs in all regions. A few political jurisdictions have been excluded because they have no social security system or have issued no information regarding their social security legislation. In the absence of recent information, national programs reported in previous volumes may also be excluded. In this volume on Europe, the data reported are based on laws and regulations in force in January 2008 or on the last date for which information has been received. Information for each country on types of social security programs, types of mandatory systems for retirement income, contribution rates, and demographic and other statistics related to social security is shown in Tables 1–4 beginning on page 17. The country summaries show each system’s major features. Separate programs in the public sector and specialized funds for such groups as agricultural workers, collective farmers, or the self-employed have not been described in any detail. Benefit arrangements of private employers or individuals are not described in any detail, even though such arrangements may be mandatory in some countries or available as alternatives to statutory programs. The country summaries also do not refer to international social security agreements that may be in force between two or more countries. Those agreements may modify coverage, contributions, and benefit provisions of national laws summarized in the country write-ups. Since the summary format requires brevity, technical terms have been developed that are concise as well as comparable and are applied to all programs. The terminology may therefore differ from national concepts or usage.
Article
To get a more complete picture of how labor supply is affected by economic incentives, the effects on absenteeism should be taken into account. In particular, absenteeism due to sick leave can be considerable. We examine whether the level of sick leave compensation affects sick leave behavior. Using long time series data (195599) for Sweden with numerous changes of the compensation level, we generally find strong effects. Reforms implying more generous compensation for sick leave tend to be associated with permanent increases in sick leave, and vice versa. These findings are reinforced in a panel study covering the 198391 period.
Article
The ability of employed parents to meet the health needs of their children may depend on their access to sick leave, especially for low-income workers, who may be afforded less flexibility in their work schedules to accommodate these needs yet also more likely to have children in poor health. Our goal was to provide rates of access to paid sick leave and paid vacation leave among low-income families with children and to assess whether access to these benefits is associated with parents' leave taking to care for themselves or others. We used a sample of low-income families (<200% of the federal poverty level) with children aged 0 to 17 years in the 2003 and 2004 Medical Expenditure Panel Survey to examine bivariate relationships between access to and use of paid leave and characteristics of children, families, and parents' employer. Access to paid leave was lower among children in low-income families than among those in families with higher income. Within low-income families, children without >or=1 full-time worker in the household were especially likely to lack access to this benefit, as were children whose parents work for small employers. Among children whose parents had access to paid sick leave, parents were more likely to take time away from work to care for themselves or others. This relationship is even more pronounced among families with the highest need, such as children in fair or poor health and children with all parents in full-time employment. Legislation mandating paid sick leave could dramatically increase access to this benefit among low-income families. It would likely diminish gaps in parents' leave taking to care for others between families with and without the benefit. However, until the health-related consequences are better understood, the full impact of such legislation remains unknown.
Article
The objective of this research note is to challenge the research community to develop a cumulative body of knowledge on the relationship between social support and health. Fruitful approaches to this end include further explication of the concept of social support and its measurement, studies of the causal pathways between social supports and health, and further understandings of the relationship between the different dimensions of support and mental and physical health.
Article
A total of 586 admissions for 12 medical conditions were reviewed. The stay of children accompanied by a resident parent was 31% shorter than those whose parents were not resident. Resident parents benefit the emotional well being of the child and increase hospital efficiency; accommodation for parents should therefore be an integral part of a unit admitting children.
Article
A care by parent scheme was established in the children's department of a university hospital. It was seen as the natural extension of the increased involvement of parents in the care of their children in hospital. A structured observational study was carried out to monitor its effect on the lives of child patients. Children in the scheme spent far less time awake alone, cried less, and slept less than those nursed unaccompanied. They had far more social interaction with a smaller number of adults, most of their contacts being with family members rather than hospital staff. Children with a resident parent but outside the scheme were generally in an intermediate position on these factors.
Article
This is a study of the relationship between social support networks and health of the elderly. The aim was to identify and measure the specific dimensions (characteristics) of a social support network and determine which have the greatest effect on an older person's health status. Also, the study examined the collective effect of all measurable dimensions of the network on health status. The major finding was that there was a high statistical correlation between the social support network and health. This provides objective research evidence to what has been suspected intuitively by social workers. That is, knowledge about the social support network is important in assessing health.
Article
In considering new paradigms for the prevention and treatment of disease and disability, we need to incorporate ways to promote social support and develop family and community strengths and abilities into our interventions. There is now a substantial body of evidence that indicates that the extent to which social relationships are strong and supportive is related to the health of individuals who live within such social contexts. A review of population-based research on mortality risk over the last 20 years indicates that people who are isolated are at increased mortality risk from a number of causes. More recent studies indicate that social support is particularly related to survival postmyocardial infarction. The pathways that lead from such socioenvironmental exposures to poor health outcomes are likely to be multiple and include behavioral mechanisms and more direct physiologic pathways related to neuroendocrine or immunologic function. For social support to be health promoting, it must provide both a sense of belonging and intimacy and must help people to be more competent and self-efficacious. Acknowledging that health promotion rests on the shoulders not only of individuals but also of their families and communities means that we must commit resources over the next decade to designing, testing, and implementing interventions in this area.
Article
Children respond psychologically to the prospect of surgery in a variable and age-dependent manner. This review summarizes the psychoanalytic, cognitive, behavioural and family system models of child development. It then reviews studies of hospitalization and anaesthesia in children. These studies suggest that younger children, children previously anaesthetized, and children who experience turbulent anaesthetic inductions are at particular risk for postoperative behavioural disturbances. Strategies of dealing with children and their parents during the perioperative period are discussed. Such strategies include: allowing a parent to be present during induction of anaesthesia, administering sedative premedication, creating a supportive environment, educating children and parents (verbal descriptions, tours, books, videos), and establishing rapport with children and their parents. Age-specific techniques of establishing rapport with children are discussed. If children are less anxious during the perioperative period, not only will they often exhibit less behavioural disturbances postoperatively, but they may face subsequent medical care more easily.
Article
This note has reviewed the protection of workers against income loss during the first 6 months of illness or injury. The national income loss due to short-term sickness and disability during the first 6 months of illness, as expressed by pre-tax wages, was about 69.6billionin1991.Ofthisamount,about69.6 billion in 1991. Of this amount, about 46.5 billion (66.8 percent) was replaced by income-protection programs, including paid sick leave; group insurance; temporary disability insurance, under statutory State provisions; individual insurance; workers' compensation; general assistance; and the 6th month of the Social Security Disability Insurance program. In 1991, within the private sector, wage and salary workers lost 47.2billionbecauseofnonoccupationalillnessesorinjuries,ofwhich47.2 billion because of nonoccupational illnesses or injuries, of which 17.6 billion (or 37.3 percent) was replaced. Coverage against income lost because of illness in the U.S. workforce favors full-time professional and technical employees with longer service in large or medium firms, and especially favors public sector employees. The lowest level of coverage is provided to part-time employees with limited seniority who work in production and related areas in small, private establishments. About 70 percent of wage and salary workers in the private sector have some protection through their employment against earnings losses caused by short-term illness or injury; 44 percent of these workers have short-term disability insurance, and half have sick leave coverage.
Article
Social support has been implicated as a significant factor in recovery from myocardial infarction and coronary artery bypass surgery. Questions surrounding the role of social support in recovery that this article will answer include the following: How powerful is social support in promoting recovery? Must social support interventions be complex to be effective? What are the effects of problematic social support? How does social support promote recovery? How can nurses improve social support to maximize patient outcomes?
Article
Most private health insurance in the United States is an employment-related, nonportable fringe benefit. As a result, severing an employment relationship can lead to a loss of such coverage. The risk of losing coverage has been identified as a primary reason for not changing jobs and has shaped the debate over health care reform. This paper examines the relationship between employment-related health insurance and job mobility. We model the likelihood that a worker voluntarily changes employment, based upon insurance status and wages at an initial job, expected insurance status and wages at alternative employment, other fringe benefits, and worker and dependent health status. Analyses of data from the 1987 National Medical Expenditure Survey support the "job lock" hypothesis.
Article
The primary aim of the study was to analyse similarities and differences between repeated spells of short-term sick-leave (more than 3 spells of less than 7 days' duration in a 12-month period) and long-term absence through sickness (at least 1 spell of more than 59 days' duration in a 12-month period) in relation to variables representing certain social circumstances and aspects of the work situation. Particular attention was paid to gender differences. The study, which had a cross-sectional design, employed data from the surveys of living conditions (ULF) conducted by Statistics Sweden over the period 1986-89. The study group comprised 13,828 employed persons between the ages of 16 and 65. The results suggested the existence of a common mechanism by which a variety of factors are related to the taking of both repeated short spells and long-term sick-leave; gender differences with regard to the effect of working conditions on the taking of sick-leave may be incorrectly estimated if factors related to occupational structure are not taken into consideration; a less than additive effect of physical job demands and repeated short spells of sick-leave on subjective health was found.
Article
Day care is currently a common way of providing treatment for minor and average paediatric surgical procedures. The purpose of this study was to assess possible benefits of increasing parental involvement in the care of operated children in a day‐care surgery unit. By giving parents information and education about post‐operative care, the goal was to facilitate recovery and minimize time spent in hospital. Results show that parents in the intervention group were well prepared to assume a greater part of the care of their children. Children in the intervention group appeared to have less pain and fewer children vomited post‐operatively than children in the control group.
Article
To highlight the significant impact of social relationships on health and illness and suggest implications of these effects for health promotion efforts among older adults. Published studies on social relationships and health (or health behaviors) for the period 1970-1998 were identified through MEDLINE by using the key words social relationships, social support, and health, as well as review of health-related journals such as the American Journal of Epidemiology, Annals of Epidemiology, American Journal of Public Health, Journal of Health and Social Behavior, Social Science and Medicine, and the Journals of Gerontology. Major published original research was considered. Where published research was too extensive for full discussion of all studies, preference was given to studies focusing on older adults and those using stronger methodology (i.e., representative samples, longitudinal data, or multivariate analyses controlling for potential confounders). Reported findings were organized in terms of three major categories: (1) results related to major health outcomes such as mortality, CHD, and depression; (2) findings related to health behaviors; and (3) findings related to potential biological pathways for observed health effects of social relationships. Protective effects of social integration with respect to mortality risk among older adults are the most thoroughly documented, although protective effects have also been documented with respect to risks for mental and physical health outcomes and for better recovery after disease onset. There is also now a growing awareness of the potential for negative health effects from social relationships that are characterized by more negative patterns of critical and/or demanding interactions, including increased risks for depression and angina. Biological pathways are suggested by evidence that more negative social interactions are associated with physiological profiles characterized by elevated stress hormones, increased cardiovascular activity, and depressed immune function, whereas more positive, supportive social interactions are associated with the opposite profile. Available data clearly indicate that social relationships have the potential for both health promoting and health damaging effects in older adults, and that there are biologically plausible pathways for these effects. Such evidence suggests that aspects of the social environment could play an important role in future health promotion efforts for older adults, although careful consideration of both potentially positive as well as negative social influences is needed.
Article
This study investigates whether rights to parental leave improve pediatric health. Aggregate data are used for 16 European countries over the 1969 through 1994 period. More generous paid leave is found to reduce deaths of infants and young children. The magnitudes of the estimated effects are substantial, especially where a causal effect of leave is most plausible. In particular, there is a much stronger negative relationship between leave durations and post-neonatal or child fatalities than for perinatal mortality, neonatal deaths, or low birth weight. The evidence further suggests that parental leave may be a cost-effective method of bettering child health.
Article
Treatment under the traditional medical model has largely ignored the family's knowledge, expertise and potential therapeutic effects on hospitalized mentally ill people. This paper reviews the family's role as caregiver. It reports on an evaluation of services by caregivers. Its findings reflect views stated in other surveys in identifying the need for improvement in education and social support for families, greater family involvement in the patient's care and improvement in staff attitudes towards families. The study concludes by describing the development of a family support project in a Nursing Practice Development Unit in a secure ward and offers a blueprint for mental health nurses in facilitating the more active involvement of families in the recovery of their family members.
Article
Studies have demonstrated the health benefits of work resumption for adults experiencing health problems, but there are important gaps in the research examining the factors that would help these individuals return to work. This study examines if working conditions predict whether women who experience angina or a myocardial infarction (MI) return to work. A sample of 289 employed women from the Nurses' Health Study was analyzed. Bivariate chi-square and logistic regression analyses were conducted to examine the relationship between working conditions and the likelihood of returning to work after experiencing an MI or angina. Seventy-nine percent of women returned to work after experiencing an MI or angina. Women who had paid leave were substantially more likely to return to work after an MI or angina episode than women without this benefit (adjusted odds ratio [OR] 2.7, p = 0.04). Public and corporate policies to promote paid leave for female workers who experience a serious health condition are likely to help these workers return to their jobs, thereby providing important health and economic benefits for both workers and society.
Article
Sick-leave days differ widely among industrialised countries. For the US it is 5, for Sweden 20 and for Poland 26 days per year and per employee. The possible causes for these differences have apparently not been systematically analysed. Two groups of contributing factors are considered: (i) objective causes, like the general health situation, employment of women and older persons, and (ii) behavioural reactions (a) to macroeconomic conditions, like unemployment or the possibility to work outside the official labour market, and (b) to the design of institutions, like the generosity of granting sick leave or the strictness of employment protection. On the basis of a panel for 20 countries and for the years 1996–2002, it is econometrically shown that the main explanatory factors are the generosity of granting sick leave, the strictness of employment protection and the employment of older persons. The unemployment rate and the employment of women—contrary to the result of some single-country studies—do not contribute to the explanation of sick-leave differences between countries. (JEL classification: I12, I18)
Consequences of being on sick leave
  • Vingård
Increased parental participation in a paediatric surgical day-care unit
  • Kristensson-Hallström
Short‐term and long‐term sick‐leave in Sweden: Relationships with social circumstances, working conditions and gender
  • Blank Nelson
The relationship of social support and health
  • Bloom
Studies show U.S. trails on sick leave: Proposed law at odds with employers' goal” inWashington Post 16
  • Joyce Amy
Sickness disability and work. Keeping track on the economic downturn
  • Oecd
Taking U.S. pulse on paid sick leave” inUSA Today 12
  • Cauchon Dennis