Department of Health Policy and Administration, College of Health and Human Development, Pennsylvania State University, University Park, Pennsylvania.
Public Health Institute, Oakland, California.
Am J Prev Med. 2017 Nov;53(5):609-615. doi: 10.1016/j.amepre.2017.06.029. Epub 2017 Sep 1.
Previous studies suggest an association between paid sick leave (PSL) and better population health, including fewer infectious and nosocomial gastrointestinal disease outbreaks. Yet few studies examine whether laws requiring employers to offer PSL demonstrate a similar association. This mixed-methods study examined whether laws requiring employers to provide PSL are associated with decreased foodborne illness rates, particularly laws that are more supportive of employees taking leave.
The four earliest PSL laws were classified by whether they were more or less supportive of employees taking leave. Jurisdictions with PSL were matched to comparison jurisdictions by population size and density. Using difference-in-differences, monthly foodborne illness rates (2000-2014) in implementation and comparison jurisdictions before and after the laws were effective were compared, stratifying by how supportive the laws were of employees taking leave, and then by disease. The empirical analysis was conducted from 2015-2017.
Foodborne illness rates declined after implementation of the PSL law in jurisdictions with laws more supportive of employees taking leave, but increased in jurisdictions with laws that are less supportive. In adjusted analyses, PSL laws that were more supportive of employees taking sick leave were associated with an adjusted 22% decrease in foodborne illness rates (p=0.005). These results are driven by campylobacteriosis.
Although the results suggest an association between more supportive PSL laws and decreased foodborne illness rates, they should be interpreted cautiously because the trend is driven by campylobacteriosis, which has low person-to-person transmission.
先前的研究表明,带薪病假(PSL)与更好的人群健康之间存在关联,包括减少传染病和医院获得性胃肠道疾病的爆发。然而,很少有研究调查要求雇主提供 PSL 的法律是否存在类似的关联。本混合方法研究调查了要求雇主提供 PSL 的法律是否与降低食源性疾病发病率有关,特别是那些更支持员工休假的法律。
最早的四项 PSL 法律根据它们对员工休假的支持程度进行了分类。有 PSL 的司法管辖区根据人口规模和密度与对照司法管辖区相匹配。使用差异中的差异,比较了法律生效前后实施和对照司法管辖区的每月食源性疾病发病率(2000-2014 年),按法律对员工休假的支持程度分层,然后按疾病分层。实证分析于 2015-2017 年进行。
在对更支持员工休假的法律实施 PSL 法的司法管辖区,食源性疾病发病率在实施后下降,但在对员工休假不太支持的司法管辖区上升。在调整后的分析中,更支持员工请病假的 PSL 法与食源性疾病发病率降低 22%(p=0.005)相关。这些结果是由弯曲菌病驱动的。
尽管结果表明,更支持的 PSL 法与降低食源性疾病发病率之间存在关联,但由于该趋势是由弯曲菌病驱动的,而弯曲菌病的人际传播率较低,因此应谨慎解释这些结果。