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This study examined factors associated with being paid for sick leave after implementation of the New York City (NYC) paid sick leave law. A random sample of NYC residents was surveyed by telephone multiple times over a 2-year period. Participants (n = 1195) reported socio-demographics, awareness of the law, income, work hours per week, and payment for sick time off work. In the year after implementation of the law, part-time workers were significantly more likely to attend work while sick than full-time workers (relative risk = 1.25, 95% CI = 1.1, 1.4). Seventy percent of workers who missed work due to illness (n = 249) were paid for sick leave. Part-time workers, respondents not aware of the benefit (30% of workers), and workers without a college degree were the least likely to be paid for sick days. More than one third (37%) of persons not paid for sick leave worked in retail, food service, or health care. Although 70% of respondents were paid for sick leave after implementation of the law, part-time workers and workers with low education were least likely to access the benefit and more likely to work while sick. The disparity in paid sick leave may have public health consequences as many persons not paid for sick leave had occupations that carry a high risk of disease transmission to others.

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Context: Paid sick leave (PSL) is a public health strategy associated with benefits for workers, businesses, and consumers. In the absence of a federal law, in 2014, New York City (NYC) joined other state and municipal governments with local PSL policies. Objectives: To examine changes in PSL after the implementation of NYC's 2014 Paid Safe and Sick Leave Law and to assess which communities remain less likely to use PSL. Design: This study uses data from multiple panels of the NYC Longitudinal Survey of Wellbeing (NYC-LSW)—a population-representative study of NYC adults—to track changes in PSL, using data collected before and after NYC's Paid Safe and Sick Leave Law was implemented. We use weighted cross-tabulations and multinomial logistic regression models to assess changes in payment for sick leave since the implementation of the law. Setting and Participants: The study includes 2985 NYC adults aged 18 to 64 years who reported working for pay in the year preceding the survey where PSL questions were asked (2014-2019). Main Outcome Measure(s): Use of sick leave and payment for sick leave. Results: Weighted descriptive results show a 7-percentage-point increase (P = .02) in the rate of being paid for all sick days and a 6-percentage-point decrease (P = .02) in not being paid for any sick days. Results from multinomial logistic regression models, adjusting for potential confounders, show that after implementation of the law, workers with low levels of education, who are younger, Latino, and foreign-born remain less likely than their peers to use PSL. Conclusions: We demonstrate that the PSL mandate expanded access for employees but not evenly across groups. These results offer guidance to other jurisdictions implementing PSL policies, suggesting the need for targeted education and enforcement efforts to ensure policies reach sectors where low-wage workers are most prevalent.