Between inflation, the economic turmoil of tariffs and a looming tax debate that threatens cuts to SNAP, Social Security and our basic safety nets, the last thing any family can take right now is for their breadwinner to miss a paycheck – or lose their job. But that’s the status quo right now for the 4.3 million Pennsylvanians working hard at their jobs, many while managing a chronic illness, and doing it all without paid family leave. Without a guarantee that they can take time off work to take care of their health with pay, one bad flare-up of symptoms could mean the difference between keeping their family afloat and falling into crisis.
It doesn’t have to be that way, as shown by 14 states, including the District of Columbia. Paid family and medical leave is an essential benefit for the estimated half of American adults who have at least one chronic disease. Research we recently published shows that when Massachusetts established its paid leave program, workers with two of the most common health conditions – depression and coronary heart disease (CHD) – reported improved health. And that not only benefits workers themselves. It’s also good for their families, their communities and their employers.
In Pennsylvania, we estimate that nearly 1.1 million employees statewide have at some point been diagnosed with a depressive disorder. More than 112,000 have CHD. That’s a lot of Pennsylvanians who deserve better than impossible trade-offs between their health and their incomes. If the Keystone State enacted a paid family and medical leave program similar to Massachusetts, workers there could see fewer poor health days. That translates to as much as $1.6 billion in productivity gains for Pennsylvania workers with depression, and as much as $440 million in productivity gains for those with CHD.
People with chronic illnesses may need supports like extra work flexibility and time to manage their health. A lack of these supports can make it extra hard to manage household chores, help kids with homework or volunteer in their community when symptoms flare. We call that a “poor health day,” when someone’s health is bad enough that they can’t do their usual activities.
For someone with a job, a poor health day might also mean missing work, and often missing pay. Pennsylvania workers who took unpaid or low-paid leaves for their own serious health conditions lost an estimated $1.1 billion in wages in 2023 alone. Yet if a worker simply cannot afford to miss work, showing up anyway has its own costs. Pushing through an illness on the job means lower productivity: making mistakes, not working at full speed, forgetting tasks or having to re-do work because they weren’t able to focus. In high-risk jobs like construction, being sick at work (sometimes called “presenteeism”) can even lead to on-the-job injuries. Plus when workers miss leave that they need, it can mean delaying or missing treatment and worse health over time. Approximately 260,000 Pennsylvania workers in 2023 didn’t take a medical leave even though they had a serious health condition and needed time away from work.
We found that after Massachusetts’ paid family and medical leave program got going in 2021, workers with depression had about one fewer poor health day per month. And workers with CHD had about 2.5 fewer poor health days per month. That’s straight up good news for their quality of life and shows how important it is for people to have paid leave that covers more than time for new children. Paid family and medical leave is a health policy.
These health improvements are also a big deal for health equity. Both depression and heart disease have disproportionate effects on people of color and women – who at the same time are less likely than average to have paid leave at their jobs. A statewide program that guarantees paid leave for workers, no matter what kind of job they have or how big their employer is, is a game-changer.
Plus, when workers feel better, they’re better able to meet their job responsibilities – less absenteeism and less presenteeism. In Massachusetts, the improvement in poor health days equates to up to $1.2 billion in productivity gains annually for workers with depression, and up to $330 million for workers with CHD.
If Pennsylvania enacted a similar paid leave program, fewer poor health days for workers would also translate to a positive impact on productivity. For a conservative estimate, let’s assume that currently, every time a worker has poor health, they still show up on the job to white-knuckle it through their day, so they have reduced productivity. In that case, fewer poor health days would equate to at least $735 million in productivity gains for Pennsylvania workers with depression, and at least $88 million in productivity gains for those with CHD.
Gains could be higher if currently many workers are simply staying home – often without pay – when they have a poor health day. Fewer poor health days could mean as much as $1.6 billion in productivity gains for Pennsylvania workers with depression, and as much as $440 million in productivity gains for those with CHD.
Fewer poor health days for workers would translate to positive impacts all around. This session, the Pennsylvania legislature has the chance to enact a paid family and medical leave program. Pennsylvanians with chronic illness, their families and their employers deserve the help.
The authors would like to thank Sharita Gruberg, Mettabel Law, Isabella Long and Gail Zuagar for their contributions to this post.
