Racial and Ethnic Inequities in Paid Family and Medical Leave: United States, 2011 and 2017–2018

Abstract

Objectives. To examine racial and ethnic inequities in paid family and medical leave (PFML) access and the extent to which these inequities are mediated by employment characteristics. Methods. We used data from the 2011 and 2017–2018 American Time Use Survey in the United States to describe paid leave access by race/ethnicity. We present unadjusted models, models stratified by policy-targetable employment characteristics, and adjusted regression models. Results. We found that 54.4% of non-Hispanic White workers reported access to PFML in 2017–2018 but that access was significantly lower among Asian, Black, and Hispanic workers. Inequities were strongest among private-sector and nonunionized workers. Leave access improved slightly between 2011 and 2017–2018, but the inequity patterns were unchanged. Conclusions. We observed large and significant racial and ethnic inequities in access to PFML that were only weakly mediated by job characteristics. PFML has a range of health benefits for workers and their families, but access remains limited and inequitable. Public Health Implications. Our findings suggest that broad PFML mandates (such as those in other high-income countries) may be needed to substantially narrow racial and ethnic gaps in paid leave access. (Am J Public Health. 2022;112(7):1050–1058. https://doi.org/10.2105/AJPH.2022.306825 )

Early Effects of the New York City Paid Safe and Sick Leave Law

“…In our estimation of the use of PSL, we control for demographic and employment-related characteristics that have been found to be related to receipt and use of PSL,14,30 including sex/gender (male, female), race/ethnicity (Black non-Latino, Latino, other/multiracial non-Latino, or White non-Latino), education (high school degree or less, some college or associate's degree, bachelor's degree or more), age (18-35, 36-45, 46-55, and 56-64 years old), foreign-born status (US-born or foreign-born), presence of a spouse or partner in the household (yes, no), presence of children in the household (yes, no), and a logged income-to-needs ratio (continuous variable). The income-to-needs ratio is measured using total Supplemental Poverty Measure (SPM) resources (posttax cash income plus in-kind benefits, minus nondiscretionary work, childcare, and medical expenses), divided by the SPM poverty line, logged to account for greater effects of income at lower levels of income to needs.…”

“…[27][28][29] While studies demonstrate the role of legislation in increasing PSL availability, research shows that PSL access continues to vary by race, income, employer type, and unionization status. 30,31 One study found that after the NYC law was passed, Latino workers were less likely to be aware of their new coverage. 32 These findings suggest a need to better understand unequal access to PSL and to assess whether such inequalities persist after new legislation is implemented.…”

“…The percentage of businesses that offered sick leave increased in San Francisco from 73% to 91% during the 3 years after passage of its sick leave law and from 67% to 73% in Seattle 1 year after passage of its sick leave law 27–29. While studies demonstrate the role of legislation in increasing PSL availability, research shows that PSL access continues to vary by race, income, employer type, and unionization status 30,31. One study found that after the NYC law was passed, Latino workers were less likely to be aware of their new coverage 32.…”

Work as an Understudied Driver of Racial Inequities in Breastfeeding

“…67 Black women are also more likely to work in jobs that do not offer paid maternity leave. 102,103 Even within the same occupation, Black women can face additional breastfeeding barriers than White women, 104 including racist treatment from a supervisor. [104][105][106][107][108] Accordingly, the left side of our framework shows how, because of racism and unequal access to education and job opportunities, race is associated with employment, occupation, working conditions, and workplace breastfeeding experiences (Figure 1).…”

“…67 Black women are also more likely to work in jobs that do not offer paid maternity leave. 102,103 Even within the same occupation, Black women can face additional breastfeeding barriers than White women, 104 including racist treatment from a supervisor. 104–108…”