The Impact of Connecticut’s Paid Sick Leave Law on Preventive Services

Do state laws that require the availability of paid sick leave increase the use of preventive services? Paid sick leave benefits allow workers to maintain job security when they leave for medical reasons. In recent years, paid sick leave laws have received more attention by health policy makers in terms of its potential to improve public health. Currently, seven states and D.C. have laws that require employers to provide paid sick leave. However, empirical evidence on this topic is limited (DeRigne, et al 2017; Peipins et al 2012). Although prior studies examined the association of paid sick leave and preventive service use, these studies did not use rigorous study designs. Because workers with higher demand for healthcare services may select into firms which offer better health benefits including paid sick leave, the estimated association in these previous studies may suffer from selection bias.

The goal of this study is to use a quasi-experimental study design to estimate the impact of Connecticut’s 2012 paid sick leave law on the use of preventive services. Connecticut was the first state to require private employers to offer paid sick leave benefits to their employees. Using state and time variation from 2007-2016 Behavioral Risk Factor Surveillance System (BRFSS) data, we compare the use of preventive services in Connecticut and in other New England states before and after the implementation of the 2012 paid sick leave law. For general preventive service outcomes, we examined routine checkups, flu vaccinations, and dental visits in the past year. We also examined the use of Pap tests, clinical breast exams, and mammograms for women.

Overall, we found that Connecticut’s 2012 paid sick leave law increased the use of preventive services. Specifically, the rate of routine checkups (1.4%, p<.1), flu shots (2.0%, p<.05), and dental visits (2.7%, p<.01) increased over this period. With respect to cancer screening outcomes for women, we found that the use of Pap tests (9.4%, p<.01), and clinical breast exams (4.4%, p<.01) increased. However, the higher rate of mammograms (1.3%, p=.38) was not statistically significant.

Our findings provide rigorous evidence on the positive impact of a state’s paid sick leave law on preventive service outcomes. These empirical results also suggest that a lack of paid sick leave among some private employers may represent a barrier to accessing preventive services. Finally, policymakers can use legislation to support the use of preventive services and improve the health and productivity of workers.